Impressions of my circumcision revision and procedure 01/10/05:
I hardly slept the night before from all of the excitement and apprehension of what was less then 12 hours away... Prior to arriving, I had previously chatted with Dr. Dave on the phone and in e-mail about a number of expectations in the outcome from the procedures to be done. I had also received permission for Joe S. to attend the operation to take still photos (sorry, but Dr. Dave would not allow us to video it, which was truly a shame, as watching his hands work was incredible to see!)
It was Monday morning, 01/10/05 my big day arrived! Joe and I had arrived at The Circumcision Centre at 12:30, although my appointment was for 1:00, I always try to be early to appointments as I feel it’s respectful. I had such butterflies in my stomach on the ride there that I thought I was going to throw up, but the excitement of what was before me, and the realization of how long I’ve dreamt about this had overpowered my basic urges to reconsider it!
Just as with so many other prior patients of Dr. David’s impressions, we walked in to the waiting room, and behind the sliding glass window, there he was. Dr. Cornell and Bart were prompt to greet us and didn’t make us wait or anything! We did some basic paperwork, and were taken to the consultation room. Dr. David was absolutely charming and professional, but of course I had already expected that from all of the conversations I have seen from him. After some basic discussion, I dropped my pants and underwear and he proceeded with the exam. Although we have had numerous communications preparing for this, I took the time to re-explain my desires for the outcome of the surgery:
A) Due to a prior injury, where my Prince Albert was ripped out and subsequently repaired (badly) by another surgeon, I was looking at having the 00ga hole (9.2 mm) repaired and sealed closed. The hole I had was jagged and raised through the frenulum (quite different than before the accident!) He wasn’t certain this would be accomplishable due to sheer size of the hole, but he would try.
B) My frenulum was always getting raw and red because it was raised and tight, and although a "fun zone", needed to be removed.
C) I had a lot of scrotal tissue that went up the underside of my penis. This resulted in a penoscrotal web (a "sail" or "web") of tissue that connected the centre of my penis to my scrotum. It basically ran along the rhaph line (seam) and was always getting hurt and raw. It connected up the penile shaft and connected into the frenulum, making it all very tight (when I was erect.)
D) Finally, I wanted to be circumcised via sleeve resection, as high as possible and very tight. I wanted to retain as much mucosal surface as possible; but I also want a very straight circumcision seam (i.e. a perfectly circular, in perspective to my abdomen.) I was looking for complete foreskin removal for a VERY tight circumcision. I wanted no visible scar line, and the scar itself to be completely flat (not raised.)
(My heartfelt gratitude to all of the folks in the adult circumcision and revision yahoo group for all their input! Especially David P. (UK), who underwent pretty much the same four procedures I was just about to do! His input was invaluable in helping me plan the road map to getting my new "equipment" constructed!)
Dr. David seemed a little overwhelmed with what was before us, yet confident, decided that we had better start right away, as it was going to take some time. I signed the consent form, which when read, statement #2 was quite amusing (you’ll know what I mean when you see it for yourself!) Joe and I took a quick break, and Dr. David finished up his lunch while Eric, his assistant prepped the OR -- about 15 minutes later, and feeling slightly nervous again we headed back up to the office where the worst part was about to happen... The needle! (I really hate needles!) Again, I pulled down my pants and shorts and Dr. David made an injection in my pelvis region (just above and to the right of the penis.) After that, I could hardly feel the rest of the injections as he went around the base of my penis and then into the penis and frenulum region itself. I was allowed to pull up my pants and was escorted to the washroom by Eric where I was told to undress and given a paper robe. (Special thanks to George who said to keep your socks and T-shirt on! I think I would have felt cold if not for that!) I was brought into the room where I was to lose my foreskin (and everything else!), sat on the table and centred on an absorbent cloth. My heart raced.
The tray of surgical tools was immense. Clamps, sutures, scalpels and other various devices. Eric attached a chilly sticky pad, about 9"x3" to my right flank. This was the ground lead for the electric cauterising tool I had heard so much about from other patients of Dr. David. We found a good place for Joe to stand (out of the way) so he could photograph the procedure. Dr. David then checked to ensure I was completely numb -- only one tiny spot had any sensation, and it took a clamp to be put on for me to feel it. A tiny bit more anaesthetic was injected into the area and we were ready to begin.
I lied back, and without me even knowing it, because it was so quick and painless, was the frenulumectomy. It was clamped and cauterised in the blink of an eye. Then it was onto the former Prince Albert. I could start to smell the cauterising tool doing it’s thing. Kinda smells like BBQ Chicken Wings that are being burned in the oven -- but I couldn’t feel a thing. It didn’t take too long, and once Dr. David was pleased with what the tool did, he began to suture the former frenulum and hole up.
Now it was onto the part that would prove to be the most difficult... Removing the "sail" of tissue from between my penis and scrotum. I did not want to watch this part, and frankly, it was a bit out of view any ways. Dr. David used the electric cauterising tool to cut a diamond-shaped chunk of skin away (just over 2" [5cm] in length.) When this was done, I felt my balls drop down and felt them resting on my legs (my legs were not numb of course!) -- what an odd feeling! There are two distinct scrotal tissue layers he needed to go through, and then stitch, which made this the longest portion of the procedures. When he closed up, he needed to manually re-create the rhaph line (that’s the seam that goes through the centre of your body; most noticeable between the anus and the frenulum), and that required a special suturing technique. I think about 45 minutes to an hour were spent working on this change.
The last, and in my opinion, most famous Dr. David Cornell "signature" portion of the procedure was to begin. The sleeve resection circumcision. This was the part that I wanted to see for myself. He began with his scalpel, just above the original gomco scar, cutting a perfectly circular line all the way around, making very shallow cuts and cauterising little bleeders as he went. To my amazement, there were more adhesions between the shaft and the internal structure. He was very delicate but precise with his cuts. Once the lower cut had been made, he began on the bottom line; which had been drawn with a surgical marker. Again, slowly, making a perfect circle until the skin was loose - but still somewhat attached from the underside. He carefully went around the tissue and lifted it up from the internal penis structure, finally trapping it in a pair of forceps and then cut it away! That visual in itself, the fact that that was my penis losing it’s skin forever, made my mind reel with delight. Then came the cleanup, cauterising veins and things from the underside that were under the tissue and visually inspecting it for any potential problems. Then he pulled the skin together, carefully lined it up and placed clamps all around it to hold it together - he was meticulous in ensuring the alignment was perfect. Four sutures were placed in strategic locations and then steri-strips were applied (tiny, super-strong Band-Aids) and then he cleaned up my penis with some exterior anaesthetic, showed me my penis and explained a few things that he had done. Then he proceeded to wrap white gauze around it; followed by Coban (kind of like a strong, sticky ACE bandage) - this will remain on my penis for the next 15 days.
I got up off the table, it was 3:30pm, and I needed to take a wicked piss and clean up some of the blood on my legs (not too much.) I cleaned up, and sat to pee to discover that I could pee straight without retracting (well, there was nothing left to retract!!) Wow! That was cool! It’s the little things that really have been amusing; like "tapping" when finished peeing instead of "milking", or having the head sticking out all the time rubbing on things like my underwear. The next 15 days are going to be reminiscent of being 8 years old seeing all the wrapped Christmas presents under the tree and knowing I can’t get to them until the 25th! On January 25th, my bandage comes off (and although it won’t be completely healed, nor have it’s permanent appearance), I know it’s going to look a hell of a lot better than it did on the morning of the January 10th, 2005!
(Comments made in this message are from the patient’s point of view from what they saw and understood during the procedure, there are many more aspects to what progressed in the operation that I could not even begin to explain. Please take these comments that way [i.e. I am not a physician, don’t consider everything in this message medically accurate!])
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in the "Chaz (Boston)" folder. For access to all 100+ images of the procedure, please contact me personally with the purpose for such access.