Caregivers sometimes develop concern that not enough skin was removed during newborn circumcision. These newborn circumcisions are most often done using special devises, either “plastibells” or “Gomcos”, placing a protective cup over the head of the penis and then pulling the foreskin over and removing it. They are reliable devices when used properly, and newborn circumcision has very few complications.
The most common reason caregivers become concerned about possible excess skin is that healthy babies develop fat around the base of the penis (and in their thighs) that pushes the skin out to look too long. To verify that, we simply push the fat out of the way with our fingers at the base of the penis at the top and bottom and observe to see if there is excess. It is uncommon the find true excess skin after a newborn circumcision that needs surgical revision. Minor excess seems to correct itself at puberty, and we do not have teenagers requesting circumcision revision for excessive skin. No special care is needed by caregivers if there is a minor excess of skin. Adhesions that develop around the head of the penis typically improve on their own after toilet training.
Rarely, excess skin is present despite a prior circumcision. When several centimeters of extra skin can be seen even when pushing the pubic (baby) fat away, a redo circumcision to remove the excess may be recommended. This involves a minor outpatient procedure.
This boy appears to have too much skin after his newborn circumcision, and the head of the penis is not visible (A). However, when the normal fat around the penis is pushed away (B) it is seen that the penis is normal and there is not too much skin. No surgery or other treatment is needed and with time the penis will become more obvious as the infant loses his baby fat, usually before starting school.
Much less commonly, excess skin is present despite a prior circumcision. In this boy, several centimeters of extra skin is evident (A), even when pushing back the baby fat (B).