The Penis Podcast Episode 7 | Follow on Spotify | Follow on Apple iTunes
DR JAYSON: Thanks Dr Gav, and together we are the dick doctors and we are going to be talking about all things penis. Our area of expertise is injectable penis augmentation. There’s a lot to talk about them and together myself and Dr Gavin will be doing that. Today we’re going to be talking about Frenuloplasty.
DR GAV: Ok, so a good place to start would be what frenulum is, many guys probably wouldn’t know exactly what that is.
DR JAYSON: Ok, well, maybe the first thing I’ll do is I’ll show you my frenulum, so here it is (shows frenulum beneath tongue).
DR GAV: Oh dear.
DR JAYSON: That’s not going to work very well on a podcast, so a frenulum is a band of tissue that tends to restrict the movement of another tissue. If you take your tongue and stick it up underneath your upper lip, that thin band of tissue there is what’s called the frenulum of your upper lip, similarly, there’s a frenulum on the penis as well. It’s present on the underside of the glands that’s attaching it to the foreskin. So guys who are uncircumcised, will be familiar with the frenulum and guys who are circumcised, will be much less familiar with it because often the frenulum is basically excised in the circumcision process.
DR GAV: Right. So why are we talking about the frenulum today? Why is it so important and why is it good and why is it bad? Does it cause any issues?
DR JAYSON: So, the frenulum is a normal part of your penis/part of your body and its there for a reason, which is to help pull the foreskin back over the head of the penis, to keep it covering the glands. And therefore, when you’ve been circumcised, you don’t need it anymore because there’s no foreskin to pull back.
DR GAV: That makes sense.
DR JAYSON: For some guys, it will cause a problem because it can be which can actually lead to it splitting and tearing. And I know that you’ve seen guys with this problem just like I have and apparently it is a terrible, terrible pain in the head of the penis. It’ll often happen while they’re having sex, from that tension on the foreskin. And it could be in the middle of having sex that the frenulum itself splits. And I mean, that’s that for having sex at that time which can take quite a while to heal up. Unfortunately for some, it never totally heals up so they’ve always got this little fissure in the frenulum that’s constantly irritated. So every time they’re getting an erection, there’s potentially this tight splitting/cutting/burning pain underneath the glands of the penis. So there’s always this fear of getting an erection, which must be terrible.
DR GAV: Yeah, that’s definitely a bad thing. So you mentioned at the start about getting a Frenuloplasty, which would mean operating on it and getting rid of this problem?
DR JAYSON: Yeah, so what needs to be done is release that tension in the frenulum and get it to heal across. For the most part it’s a relatively thin band of skin just under local anaesthetic that we can divide down, put a few dissolving stitches and get it to heal so that tightness is released, so the underside of the foreskin becomes more mobile and they don’t have to worry while erect that it’s going to be tight and split post op. So as you know, it’s a relatively quick procedure with a little bit of local anesthetic, and we’ve also got a special machine that minimises any bleeding while diving through. So there’s multiple ways of doing it, different doctors and surgeons have their own preferences, some people like avoiding stitches altogether and just put on a bit of tissue glue which is the medical version of super glue and then keep it lubricated usually with an antibiotic type ointment or Vaseline. We get clients to gently retract the foreskin morning and night as you don’t want the two sides sticking back together during the healing process.
DR GAV: Sure. And before going down that path, are there other less invasive solutions?
DR JAYSON: Yes, you get these sort of ointments that help in getting that little split to heal which immediately start the healing process, but it’s still likely to split again. You could also have steroid injected into that area that takes away some of the inflammation. And with doing that, you might be able to get a little bit of stretch into the ligament, but it’s a relatively small amount, and for the majority of people, it’s not really the answer to what they want. Do you use any other methods?
DR GAV: Yeah, so pretty similar to what you’re saying with the steroid, but it doesn’t have to be the injectable maybe a months course of a topical steroid.
DR JAYSON: Yeah.
DR GAV: And to the same area and much the same way it helps reduce the inflammation, but also thin and help stretch out the skin or tissue a little bit more which creates just enough of a stretch to take away some of that tightness. But yes, I mean it does actually work for a few people out there, but if there’s a significant tightness that is causing significant tears, generally that’s not enough.
DR JAYSON: Not enough. Yeah I’ve generally found, like as a temporising measure, that can be good. But yeah, most of the guys who get to see me about a tight frenulum and having pain and tears, are ready for the surgery and the cream just isn’t enough for them, and maybe if they’re seeing their GP initially about it, that could be an adequate sort of first line. So probably have that conservative treatment first, and then we offer them a more definitive solution so that way they’ve at least had that option of having a conservative treatment.
DR GAV: Yeah, and I guess a lot of guys that have this problem would be a little scared about having cutting going on down there and the downtime. But as you said, they need to know it is not that significant, the healing time is only over a couple of weeks really.
DR JAYSON: Yeah, there will be downtime anyway with a surgery. I remember when we were training in this a few years ago, some of these young guys were just petrified. There were some that had never had a sexual experience so that fear of tearing the frenulum became a significant issue. And of course, they also don’t know who to go to, generally. They don’t just go to their GP and say “I’ve got this problem and find a solution for it”. So guys, in general, if you’ve got anything wrong with your health anyway, go and see your GP first. You might find that there’s a solution that’s a lot easier than what you thought it was going to be. Also, of course, there is a little blood vessel at the base of the frenulum that we need to be a little bit careful of. Certainly I’ve never experienced any significant bleeding while doing this procedure. We’ve also got that diathermy machine that helps with little bleeds. Also, deeper again, there is this sensory nerve we general don’t get anywhere down near to. In general, with the procedure, it’s a fairly simple division first and then stitching the skin back together. Occasionally you get some clients with really wide frenulums, which demands a little bit more surgery. There are also procedures like “Z plastys”, where we rotate the skin around. But overall, I found success with the simplest procedures.
DR GAV: And I believe it isn’t very painful during recovery?
DR JAYSON: No, no. In fact, generally, they’re really relieved right after as that tension and splitting is now gone. I remember this one guy that did it, came back to us saying he did have a little pain but it was like, 90 percent better! In fact, we put a steroid injection in him and that did seem to help. So it’s not like any surgical or medical procedure, it’s not a one hundred percent guarantee fix for everybody. But it’s certainly a big step forward for the vast majority of guys.
DR GAV: And if it doesn’t release the attention entirely, I guess there are other options like getting a full circumcision maybe??
DR JAYSON: I find most guys are quite attached to their foreskin and want to keep it. You’ve really got to have a fairly significant ongoing issue to want to go down the full circumcision route. So that’s maybe the last resort if they have to get that far.
DR GAV: All right, well I think that really covers the frenulum, what it is, why it may cause an issue and what the potential solutions are. So as Dr Jayson said, if you have a problem, you need to book in and talk to a doctor, or a GP like me, that’s totally fine and then you can come then book a free consult with us at the CALIBRE clinic.
DR JAYSON: Great. Okay guys! If you do have any questions about Frenuloplasty or anything else, just post it down below. We look forward to hearing from you, otherwise we’ll be back again soon with another episode of The Penis Show with the dick doctors!
And don’t forget, confidence changes everything.