Dr Michael Read performs circumcisions with the reassurance that decades of experience provide. His focus is on providing a safe and non-traumatic procedure for your infant or young boy. Infant circumcision and the circumcision of pre-pubertal boys is performed using the Plastibell technique. A small ring fits over the head of the penis under the foreskin. The ring size is selected at the time of surgery. A tie is applied to the outside of the foreskin compressing the skin against the Plastibell ring. This effectively clamps off the blood flow to the end of the foreskin and allows it to be removed. Advantages of Plastibell Circumcision Over Other Techniques The tie is placed circumferentially around the foreskin and provides a ligature on all the vessels, so bleeding should not occur. The tie effectively seals the foreskin and diminishes ascending infection. The nerve supply is cut off along with the blood supply and therefore post-operative pain should be minimised. The design of the Plastibell aids removal of the appropriate amount of foreskin. There is no special restriction on usual activities after the circumcision. Babies can be bathed and dressed normally until the Plastibell falls off spontaneously. Boys can resume usual activities as soon as they wish. Prior to the Circumcision Procedure During an initial consultation, Dr Read will discuss the procedure and advise the child’s parents or guardian/s about what to expect post-procedure. This consultation can be scheduled on a day prior to the surgery date however most patients will undergo the procedure on the same day. Please advise our reception staff if same-day surgery is desired so that adequate time can be allocated. Dr Read will apply a numbing cream one hour before surgery and then wrap it in plastic to ensure contact is maintained. The cream provides effective pain relief and ensures your child experiences minimal discomfort. Before surgery, a parent or guardian will be required to read and sign a consent form. One of our experienced nursing staff will take your boy and assist Dr Read while he performs the procedure, which usually takes around 20 minutes. Dr Read will return your child to you for comforting and feeding after the procedure and explain the post-operative management. Dr Read will provide after-hours contact details should any concerns arise post-operatively. Best communication is by messaging and sending a photograph identifying your concern. After the Circumcision Procedure The numbing cream works very well for the procedure and can provide several hours of post-operative benefit. Babies less than two to three months old usually have little discomfort. Older boys can experience some stinging from the urine. The head of the penis can be a little raw for some days where it is necessary to separate it for the circumcision. Dr Read will discuss appropriate pain relief. Kenacomb is a post-operative ointment recommended. This should be applied two to three times daily to the head of the penis inside the ring. Kenacomb provides lubrication and protection against swelling and infection. In infants the ring will usually separate and fall off four to seven days post-procedure, like an umbilical cord. Older boys have thicker skin and separation can normally be delayed for a couple of weeks. Continue using Kenacomb for some days after the ring separates. A smear of blood may appear on the nappy, but fresh bleeding should not occur after the circumcision. Redness and swelling can occur in the penis with the normal healing process but this will quickly settle after ring separation. It is important to make a follow-up appointment after ring separation. It can be necessary to separate some shaft skin from the head of the penis. If this is not done skin can adhere to the glans and smegma, a creamy liquid that is a mix of old mucus and dead skin cells can accumulate under this adherent skin. Smegma will always accumulate under the foreskin of the uncircumcised. It is one of the desirable benefits of circumcision that it will be easier to clean and not accumulate. Dr Read will demonstrate how to manage longer term care. Frequently Asked Questions Why is Plastibell circumcision Dr Read’s technique of choice? The Plastibell technique is designed to produce a good cosmetic outcome and contributes to a safe circumcision. The risk of bleeding and ascending infection is diminished as the tie is placed circumferentially around the foreskin, providing a ligature on all the vessels and sealing the foreskin. This also cuts off the nerve and blood supply to the foreskin, minimising post-operative discomfort. There is no restriction on your boy’s usual activities after circumcision. Babies can be bathed and dressed normally until the Plastibell falls off spontaneously and boys can resume usual activities as soon as they wish. Will it be a painful experience for my child? Dr Read will apply a numbing cream to the penis one hour before surgery and then wrap it in plastic to maintain contact. The cream provides effective pain relief during the procedure and can provide several hours of post-operative benefit. Babies less than two to three months old usually have little discomfort, however older boys can experience some stinging during urination. Dr Read will discuss appropriate pain relief during consultation. How long does the procedure take? The procedure itself usually takes around 20 minutes. One of our nursing staff will take your boy and assist Dr Read while he performs the procedure. Dr Read will return our child to you for comforting and feeding after the procedure and explain the post-operative management. If the numbing cream is applied by Dr Read at his clinic, you will need to allow an additional 45-60minutes for this to take effect. How do I care for my child after the procedure? A tube of post-operative ointment called Kenacomb to lubricate and protect against swelling and infection will be provided. This needs to be applied two to three times daily to the head of the penis inside the ring. After ring separation, usually occurring four to seven days post-procedure, Kenacomb should continue to be applied. A smear of blood on the nappy may appear, and redness and swelling of the penis can occur with the normal healing process. A follow up appointment will need to be made after ring separation for Dr Read to review the circumcision and demonstrate how to manage longer term care. Don’t forget to share this via Twitter, Google+, Pinterest and LinkedIn.