Care after removal, implantation, frenuloplasty

Traditionally, swelling of the frenulum of the penis occurs after it has been damaged. This may be caused by some kind of trauma during rough or too rapid sexual contact, or masturbation. Finally, this may be a consequence of the frenulum being too short, because such a pathology turns out to be very common and often even congenital. Even in those adolescents who do not have a short frenulum at birth, it can form when the corpora cavernosa grow much faster than the skin of the penis.

If only this could lead to deformation and psychological problems for teenagers. But a short frenulum often becomes the cause of painful sensations that arise during sexual intercourse, premature ejaculation, and even swelling of the frenulum of the penis if some kind of injury suddenly occurs. There is nothing pleasant about this and such conditions should not be ignored if they occur. Contact a medical specialist immediately before major complications occur.

Make an appointment with a urologist by phone or by filling out the online form

Answers to frequently asked questions on the topic of the frenulum of the penis:

• Which doctor treats frenulum of the foreskin?
• Where to go with a problem on the frenulum of the foreskin?
• What tests should be taken if there are problems with the frenulum of the penis?
• Diagnosis of diseases of the frenulum of the penis
• Treatment of diseases of the frenulum of the penis
• Is it possible to remove the frenulum of the penis?
• Swollen frenulum of the penis
• Rash on the frenulum of the penis
• Herpes on the frenulum of the penis
• How does the foreskin affect sensitivity?
• How to stretch the foreskin?
• What is the foreskin for?
• Diagnosis of diseases of the foreskin?
• Why doesn't the foreskin open completely?
• What to do if the foreskin is swollen?
• Have plaque appeared under the foreskin?
• Do you perform foreskin plastic surgery at your clinic?

What is frenulotomy (frenuloplasty)

Frenulotomy is a minor surgical operation during which the short frenulum is lengthened using incisions and suturing. The procedure is simple and takes 15-20 minutes.

Indications for frenulotomy:

• Discomfort during sexual intercourse, periodic tears, bleeding, inflammation of the frenulum;
• Premature ejaculation (when nerves grow into the scar tissue formed after ruptures);
• Inability to properly wash the area around the head, accumulation of smegma in the preputial fold, inflammation (balanitis, balanoposthitis);
• Curvature of the penis due to strong tension of the frenulum (ptosis of the glans), pain during erection.

Contraindications: active infectious inflammatory processes in the body, exacerbation of chronic diseases, immune pathologies, poor blood clotting.

Should I have surgery or not?

Structure of the penis

The frenulum is a longitudinal fold located between the head of the penis and the foreskin: with its direct participation, the exposure of the head during sexual intercourse is regulated, and it coordinates its bends.

In a non-erect state, it keeps the foreskin from drooping excessively.

Microtraumas and scarring of the frenulum can lead to its shortening, which is manifested by the following symptoms:

• feeling of tension in the frenulum during sexual intercourse,
• the appearance of bruises in the frenulum after intercourse,
• periodic inflammation of the foreskin and glans penis,
• tears with bleeding or complete rupture.

Due to unpleasant, painful sensations and minor bleeding, a man holds back during sexual intercourse, which can lead to erectile dysfunction.

Indications

Frenulotomy is indicated for conditions such as:

• 
  phimosis and paraphimosis

• bridle too short
• scars and growths on the frenulum of the foreskin
• premature ejaculation due to pathology of the glans penis
• frenulum rupture

Despite the fact that this operation has no age restrictions, does not require special training and is performed very quickly, this area is very sensitive, so it is worth considering the presence of contraindications.

Contraindications for surgery

• problems with blood clotting
• mental illness or epilepsy
• inflammatory diseases and infections of a local or general nature
• malignant tumors
• acute periods of chronic diseases
• presence of syphilis, hepatitis, HIV

Frenuloplasty is considered a lighter version of circumcision, but this intervention is less radical and preserves the natural anatomy of the genital organ.

Preparation

Doctors recommend giving up alcoholic beverages a week before surgery. Some clinics prescribe antibiotics for 2 days to protect against infectious inflammation.

In 2-3 days you need to remove hair from the groin area. To avoid cuts, you can use Weet hair removal cream.

In preparation for frenulotomy, it is necessary to donate blood the day before (for HIV, hepatitis, syphilis, general analysis, coagulogram) and a test for lidocaine. The operation is not abdominal, so there is no need to undergo other standard preoperative examinations. An ECG is only required for patients over 40 years of age.

What is a coagulogram and what disorders does the analysis reveal?

On the day of surgery you can eat and drink. The manipulation is performed under local anesthesia. The doctor injects lidocaine under the frenulum (to a depth of 2 mm) and waits until the target area is completely numb.

How is plastic surgery of the foreskin frenulum performed?

Today, several methods of lengthening the frenulum are available: classical - using a regular scalpel, laser and radio wave (using a scalpel-coagulator). Most experienced genital surgeons prefer a regular scalpel.

Classic frenulotomy

Classic method of penile frenulum correction:

1. First, a transverse dissection of the frenulum is made.
2. Then the edges of the wound are stretched in the shape of a diamond.
3. The final step is to adjust the skin tension and apply sutures.

The suture is applied with the same threads that are used in maxillofacial surgery. By 21 days they usually completely resolve or fall out. The finished suture is filled with surgical glue to avoid infection and separation of the edges. Such a wound can be wetted within a day; when wiping, simply blot it with a towel. If the seam is simply treated with brilliant green, then it is not recommended to wet it for about a week.

Frenulotomy scheme

Less popular dissection schemes (modifications of frenuloplasty) of the frenulum are Z and VY. In the first case, an incision is made in the shape of the letter Z: first, a vertical incision is made in the center of the frenulum, from which two oblique incisions are made in opposite directions at an angle of 60 to 80˚. Movable skin flaps are then formed, folded and stitched so that the first incision becomes horizontal. An aseptic compression bandage is applied for 5 days.

Z-modification scheme

This type of plastic surgery is used to get rid of premature ejaculation. This is a more traumatic technique than the classical one. It is not always possible to achieve an increase in the duration of sexual intercourse in this way.

The VY modification (cut in the shape of a V and then stitched into a Y shape) is often technically impracticable and is therefore practically not used.

Laser and radio wave plastic surgery

Laser plastic surgery differs from classical surgery in the absence of blood and lower risk of wound infection. The frenulum tissues are non-contactly burned out in layers with a laser, and the vessels are immediately sealed. This is what laser frenuloplasty looks like:

Radio wave excision of the frenulum of the penis is performed using the Surgitron installation (high-frequency radio waves). There are no scars left, infection does not penetrate, but there are disadvantages: high cost and the likelihood of the edges of the wound diverging during an erection.

Photos before and after plastic surgery

Below are photos from the forum https://uro-forum.ru/viewtopic.php?t=7493. These are examples of quality work done. The author is Dr. Babykin A.V., photo 18+ :

• Before and after plastic surgery - https://prntscr.com/rx6ls5;
• The first day after plastic surgery - https://prntscr.com/rx6lyh;
• 4th day after plastic surgery - https://prntscr.com/rx6m3o;
• The result of plastic surgery in a month - https://prntscr.com/rx6mdi.

Ptosis of the head: before and after - https://prntscr.com/rx6miv.

Surgery for plastic surgery of the frenulum of the penis (frenulotomy)

Having a frenulum in itself is not a problem. Normally, this anatomical formation performs a number of useful functions:

• regulates the degree of exposure of the glans penis during sexual intercourse;
• promotes the correct position of the head during erection;
• does not allow the foreskin to descend below a certain position;
• contains a large number of receptors, which makes it extremely sensitive to sexual stimulation and provides increased sexual pleasure.

Few men with a short frenulum know that there is no need to endure pain and discomfort during sex, and the appearance of tears is a serious reason to immediately consult a doctor. Every tear or rupture is very painful. The wound is overgrown with a connective tissue scar, which makes the frenulum even shorter. Result: psychological problems, development of complexes and complete renunciation of sexual life.

It will take an experienced surgeon no more than an hour to perform a frenulotomy. The day will need to be spent on examination and preparation for surgery. Within another week, you will need to treat the wound at the site of the frenuloplasty at home. As you can see, the treatment is simple. The only thing that limits the widespread use of frenulotomy is the insufficient level of awareness among the male population about the possibilities of plastic surgery.

Technique of frenulotomy operation

The technique for lengthening the frenulum is simple: the tissue is cut transversely and sewn longitudinally. It is necessary to expand the scope of surgical intervention in cases where:

• there are cicatricial changes in the area of ​​the glans penis;
• other imperfections of the male external genitalia require correction.

Depending on the extent of the intervention, the doctor decides on the preferred method of pain relief. In simple cases, local anesthesia is sufficient.

Indications for frenuloplasty

Frenulotomy is performed in the following cases:

• difficulties associated with attempts to expose the head of the penis, the appearance of a feeling of pain and tissue tension;
• history of ruptures and tears;
• pain and discomfort during sexual intercourse, early ejaculation, lack of pleasure from sex;
• phimosis or paraphimosis.

Here the following should be especially noted: the sooner a man seeks medical help, the better. Every tear is a scar. The more scars, the more difficult it is for the surgeon to correct the situation.

Laser plastic surgery of the frenulum

The use of a laser when performing frenulotomy is much more preferable than a scalpel for many reasons:

• the laser beam seals the vessels, which reduces blood loss during surgery;
• laser pulses not only cut, but also solder the edges of the wound, which makes it possible to do without suture material;
• faster tissue healing;
• lower risk of developing purulent-inflammatory complications of the operation.

The aesthetic result of an operation performed using a medical laser is beyond praise.

Rehabilitation period

During the month after the operation, you will have to comply with a number of restrictions that relate to:

• thermal procedures, including visits to baths and saunas;
• physical activity;
• onset of erection.

All this can lead to divergence of the wound edges and the need for repeated intervention.

For 2 weeks, you may experience swelling, rawness or pain in the area of ​​the postoperative wound, and discomfort when urinating. You can reduce the severity of symptoms by wearing comfortable and fairly tight-fitting underwear, as well as taking painkillers. The doctor may also prescribe antibiotics to prevent purulent-inflammatory processes.

Rehabilitation

After the operation, the patient rests in the ward for several hours, then he is sent home. After 2-3 days you can go to work, if it does not involve lifting heavy loads (the seam may come apart).

There is usually some slight swelling or bruising in the first 24 hours, which goes away within a few hours. Within two days, a few drops of blood may come out of the suture. This is fine. They need to be blotted with a sterile napkin and observed over the wound.

Antibacterial therapy is usually not required. The course of antibiotics is replaced by antiseptic ointment "Levomekol". A thin layer of it is applied to the suture area once a day for 5 days. You must appear for a dressing change the next day, and for a final examination after 10 days. The pain goes away completely after 2 weeks. During an erection, slight discomfort may remain for 3-4 weeks.

Levomekol is an antibacterial combined agent for external use with a pronounced immunostimulating and anti-inflammatory effect. Price from 126 rub.

The function of urination is not affected by the plastic frenulum in any way. There should be no discomfort or any difficulties. To avoid pain during tension, erections, especially morning ones, should be avoided. To prevent them, you can use a bandage during the first day.

There are practically no restrictions on daily physical activity. Contact sports and strength exercises should be avoided for the first 3 weeks.

Complete healing of the wound after frenuloplasty occurs after 3 weeks. After 21 days you can have sex. Some doctors allow it earlier, but there is a risk of suture rupture or infection.

If, based on the results of the control examination, there is a tendency to form a rough scar, then Contractubex ointment is prescribed.

Contractubex is a gel for the treatment of scars. Price from 589 rub.

After frenuloplasty, the sensitivity of the head may decrease by 15-20%. There should be no fear of complete loss of sensitivity and impotence, since the head is innervated by the branches of the neurovascular bundle, which runs along the back of the penis. Normal sensitivity will return if the patient does not become too obsessed and does not get neurosis on this basis.

Lip frenuloplasty

Another operation that requires surgical intervention is plastic surgery of the frenulum of the upper lip. It is carried out on the recommendation of an orthodontist (for example, if the patient needs to correct the bite in the future using a plate or braces) or a speech therapist (if the frenulum interferes with articulation).

The labial frenulum is responsible for additional attachment of the upper or lower lip to the jaw bones. Most often the upper frenulum undergoes surgery. This operation does not take long and does not have any negative physiological or aesthetic impact on the patient’s health and appearance.

Rules of care after frenuloplasty

If you have undergone this minor operation, then you need to know about the rules of oral care for the first time after the operation.

Two to three hours after the operation, you can apply cold to the lip. It is strictly forbidden to consume hot food on the day of the operation. Brushing your teeth in the next 24 hours is also undesirable, as is rinsing your mouth. Every other day, you can rinse your mouth with chamomile infusion.

Avoid contact of the operated surface with the tongue and dirty hands. Do not touch the wound. If you feel itching and burning at the operated site, you can take a pain reliever. But remember that taking aspirin is strictly prohibited, since it affects blood clotting.

Complications

Complications after frenuloplasty are rare and are mainly due to the fault of doctors: incorrect preoperative assessment of the condition of the frenulum, infection, but usually this is a lack of experience. Alarming symptoms:

• Increasing redness of the wound;
• Bleeding;
• Persistent swelling or pain;
• Discharge of pus;
• Temperature increase.

In these cases, there is no need to delay contacting a doctor.

Some patients complain that tension on the frenulum is felt even after frenulotomy. The reason is that surgeons do not follow the technique when leaving the base. This happens especially often with bloodless techniques. You need to not just cut the frenulum, but carefully remove the “scallops” and eliminate the tension at the base.

If everything is done correctly, then a month after the operation, instead of a suture, a thin pale pink thread will remain, which smoothly passes into the median suture of the head. Everything looks natural.

If the foreskin is too narrow, it is impossible to limit yourself to plastic surgery of the frenulum alone. You will have to do circumcision (circumcision) and removal of the frenulum (frenulotomy). The fact is that during frenuloplasty there is even greater tension on the foreskin, resulting in pinching of the head (paraphimosis), as shown in the photo below. This condition requires urgent medical attention, otherwise necrosis will begin.

Paraphimosis after frenuloplasty (head in brilliant green, photo 18+) - https://prntscr.com/rx6pki.

This condition (photo 18+) - https://prntscr.com/rx6pxo, is very close to paraphimosis and also requires immediate medical intervention. Painkillers and antiseptics will not help.

The same penis after repositioning the head and antimicrobial therapy (blotting with chlorhexidine, wiping with Lekomekol) - https://prntscr.com/rx6qfq. Initially, the surgeon did his job poorly. The wound will now heal by secondary intention, since the seam is falling apart and will continue to fall apart, and the rehabilitation time will drag on for 2 months.

Swelling and damage to the frenulum

Quite dangerous factors that threaten to damage or harm the frenulum of the penis can be:

• Dry vagina of the partner;
• Defloration procedure;
• Sexual intercourse that is too fast or rough.

Such things can result not just in swelling, but in a rupture or some kind of damage, after which the inflammatory process begins.

Often there is a problem with getting help in a timely manner - in particular, due to the fact that such troubles happen at night - then it is necessary to perform a number of actions before contacting a doctor. At the same time, you can call our clinic whenever you want.

In the event of the onset of edematous processes in the area of ​​the frenulum and other injuries that cause bleeding, the following measures must be taken:

• Try to remain as calm as possible and do not panic, even if the bleeding does not stop.
• Try to stop the bleeding with your fingers - press the frenulum to the place where it tore.
• Once the bleeding has stopped, treat the wound with peroxide.
• Do not apply very tight bandages.
• Contact a medical specialist and the medical specialist will advise you on all other actions.

Usually, severe damage to the frenulum requires subsequent surgical correction. Sometimes circumcision is even necessary. Let a qualified healthcare professional decide which course of treatment is best for your recovery.

Useful information on problems associated with the frenulum of the penis:

• Calling a urologist to your home
• Balanitis
• Balanoposthitis
• Frenum plastic surgery
• Urethral swab
• Prostate massage
• Circumcision
• Tests for STIs
• Treatment of sexually transmitted diseases
• Ultrasound at home
• Frenum of the penis
• Pyelonephritis
• Ultrasound of the bladder
• Diagnosis of sexually transmitted infections
• How to prepare for an appointment with a urologist?
• How to get tested for urological diseases?
• What tests can be done by a urologist?
• What diseases does a urologist treat?
• What symptoms should you consult a urologist for?
• How to make an appointment with a urologist at the clinic?

This article is posted for educational purposes only and does not constitute scientific material or professional medical advice.

Author:

Kasabov Vadim Vladimirovich Dermatovenerologist
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How much does plastic surgery of the foreskin frenulum cost and where to have the operation performed?

Many clinics offer this service. The operation, at first glance, is simple, but requires high professionalism and accuracy from the doctor. Otherwise, the result will be not only aesthetically, but also physically unsatisfactory.

Trusted doctors recommended on forums:

1. Menshchikov K. A. Department of Urology and Genital Surgery “MAK IVF”, Moscow. Price 15 thousand rubles. along with a consultation.
2. Babykin A.V. Clinic “Medprime”, “Open Clinic”, Moscow. Prices: plastic for tension or rupture - 25 thousand rubles. with consultation on the day of surgery, correction of defects after other clinics - 31 thousand rubles, preliminary consultation - 2 thousand rubles.
3. Sokolshchik M. M. Clinical Center for Microsurgery at the Federal State Institution “Treatment and Rehabilitation Center of the Federal Service for Healthcare”, Moscow. The price of frenuloplasty is 17,500 rubles. + ward 3800 rub. per day.

A good specialist in the field of intimate plastic surgery is Dr. Bakirkhanov S.K. (Mont Blanc Clinic, Moscow).

Proven doctors in the field of intimate plastic surgery

Frenumplasty in other cities:

• In St. Petersburg: honey (8 thousand rubles), Pirogov clinic (37,620 rubles), Laser Doctor clinic (laser plastic surgery 9 thousand rubles).
• In Volgograd: “Dialine” (5240 rubles), “Health +” (3900 rubles).
• In Samara: medical clinic “Nauka” (5 thousand rubles), “Medical Radiation Center” (7500 rubles).
• In Yekaterinburg: honey (12 thousand rubles), SMT clinic (7500 rubles).

Frenuloplasty can theoretically be done under compulsory medical insurance, but many clinics refuse patients.

Reviews after surgery

Reviews from men who have undergone frenuloplasty are mostly positive. Some have problems with sexual desire. The patient’s question and Dr. Bakirkhanov’s answer are given below.

There are also those who were unlucky with the doctor, as a result of which a large scar formed at the site of the frenulum. The same surgeon as the previous one cut it out. As a result, the man was left with a painful wound covered with scar tissue. Bakirkhanov's answer: