Hi Alice,

I'm a 19-year-old uncircumcised male. There was a group discussion about sex in my dorm, and people were describing how erect, an uncircumcised and circumcised penis should look alike, that the foreskin should pull back all the way. I had never thought anything of this before, but looking it up on the internet found that I have what I believe to be a frenulum breve, in that my foreskin retracts (unlike phimosis) but not all they way. Unfortunately, all of the information about this (as well as surgery info) is from the UK. I have searched the web for hours and couldn't find any information about this condition in the US. I was just hoping you might shed some light on my condition, as well as on a procedure called frenuloplasty.

Dear Reader,

There are many ways a penis and its foreskin might appear, and there isn’t necessarily only one way it could look. As long as there’s no pain associated with your foreskin not retracting all the way, it's probably just one more aspect to appreciate about the uniqueness of your anatomy. But it could be good explore a little further: the frenulum (Latin for "little bowstring") is a small strip of skin that joins the glans (the head of the penis) to the foreskin. It’s often likened to the joining ridge under the tongue.  Most often when the penis is erect, the frenulum allows the foreskin to retract completely and freely. However, if the frenulum is short, referred to, as you put in your question, as "frenulum breve," it can pull on the foreskin and cause it to slide forward — which may be painful for some. The procedure you ask about, a frenuloplasty, is a simple and highly successful procedure that lengthens the frenulum. For more on the frenulum, the condition in question, and ways to address it, keep reading!

Many people find that the frenulum is very sensitive and its stimulation can be erotic and arousing. However, the pulling that may be caused by a short frenulum can be painful, especially during ejaculation, masturbation, and sex, when the frenulum may actually tear and bleed. The pulling might be resolved by using extra lubricant during sexual activity, but if you’re still experiencing discomfort during sex or masturbation, there are options to relieve these feelings.

One way is through the frenuloplasty procedure. The average age for surgical treatment is from 17 to 27 years old. This outpatient procedure is performed under local anesthesia, often by a urologist, and doesn't require admission to a hospital or any overnight stay. In a frenuloplasty, a series of small cuts are made in the frenulum in the shape of a z or a y (conveniently called a z-plasty or y-plasty), typically increasing the length of the frenulum from one to one and a half centimeters. The incisions are usually sewn up with small dissolving stitches, which are barely visible and fall out in about ten days or so. Most patients don’t use any painkillers apart from the anesthetic used during surgery. There may be a little bleeding for 12 to 48 hours post-operation, but it’s usually minimal enough to allow for regular daily activities. It takes about six weeks for the incision to fully heal, but after three weeks, most individuals are able to return to their routine sex lives. Rarely, the skin may scar from the surgery, causing it to contract, or there might be some damage to veins or arteries in the area.

Along with frenuloplasty, which has the aforementioned risks, there’s a less invasive method available, called the pull and burn method. This procedure uses concentrated heat to make a small tear in the frenulum while carefully retracting the foreskin. It requires no sutures at all and reportedly causes minimal pain and little to no scarring.

If you’re experiencing pain as a result of your frenulum breve, you may want to make an appointment with your health care provider to discuss treatment options. However, treatment may not be necessary. It may be helpful to consider whether or not the partial retraction of the foreskin is painful or gets in the way of sexual pleasure. If not, there may be no charge to interfere; everyone’s genitalia are one-of-a-kind!

Alice!

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