Circumcision in adults: indications, procedure and recovery

What circumcision is

Circumcision is the procedure that removes the foreskin, the fold of skin and mucosa that covers the glans. It is one of the oldest and most widespread surgical procedures in the world, but in adults it differs from that in children: the tissues are more vascular, spontaneous erections (including night-time ones) put tension on the sutures in the first days, and recovery requires a little more care.

It can be total, when the glans remains uncovered both at rest and in erection, or partial, when only the part of the foreskin causing the problem is removed and at rest the glans remains partly covered. The choice is made together during the consultation, according to the reason for the procedure, the anatomy and the patient's preferences.

Circumcision should not be confused with preputioplasty, which widens the foreskin without removing it and which, in many cases of phimosis, is a more conservative alternative.

Why an adult undergoes circumcision

Medical reasons

• Phimosis: the foreskin is too tight and the glans cannot be uncovered, or is uncovered with pain, at rest or in erection. In adults it is often the consequence of repeated inflammation, small scars or a skin disease called lichen sclerosus.
• Recurrent balanoposthitis: inflammation or infection of the glans and foreskin that recur despite appropriate treatment.
• Paraphimosis: the retracted foreskin becomes trapped behind the glans and constricts it. It is an emergency, which is resolved first by reducing the foreskin; circumcision is considered afterwards, to prevent it from recurring.
• Short frenulum with pain or small tears during intercourse: if there is also a foreskin problem, I correct the frenulum in the same procedure (frenuloplasty); if the problem is only the frenulum, frenuloplasty alone is usually enough.

Personal, hygiene or aesthetic reasons

Some men ask for it for easier hygiene or for a redundant foreskin they dislike. These are legitimate requests, which I approach with the same caution as a procedure for medical reasons: we talk about it openly, including risks and limits.

Cultural or religious reasons

For many people circumcision has a cultural or religious meaning. In this case too the procedure is performed with the same safety criteria and with fully informed consent.

When surgery can be avoided

Circumcision is not always the first choice. Depending on the case:

• mild phimosis, or phimosis linked to inflammation, may improve with local treatment, usually a cortisone cream prescribed by the doctor;
• lichen sclerosus is treated first with local cortisone therapy; the guidelines reserve circumcision for cases that do not respond or that have already caused significant narrowing;
• if the problem is only the frenulum or a limited tight ring, frenuloplasty or preputioplasty may be enough.

If during the consultation I think the procedure is not necessary, or that a simpler alternative may be enough, I will tell you.

What the literature says about benefits

Many exaggerated claims circulate on this subject. Here is what the studies really say.

• HIV: large studies conducted in Africa, in populations with a high prevalence of HIV, showed a reduction of about 60% in the risk of infection in circumcised men during heterosexual intercourse. The World Health Organization's recommendations for those countries are based on these data. In Italy the situation is very different, and circumcision never replaces the condom.
• Penile cancer: it is a rare cancer. A meta-analysis shows a protective effect for circumcision performed in childhood, linked above all to the elimination of phimosis; for circumcision performed in adulthood this protective effect has not been demonstrated.
• Sexuality: the best-quality studies indicate that circumcision performed for medical reasons does not on average worsen erectile function, sensitivity or sexual satisfaction. However, it is not a treatment for premature ejaculation: anyone who promises this goes beyond the evidence.

How the procedure is performed

I perform the procedure at Aesthetic Clinic in Turin; it takes about an hour. Consultations can also take place in Asti and Alessandria.

1. Anaesthesia: local anaesthesia with a block at the base of the penis, which makes the area insensitive to pain. When needed, or if the patient is very tense, I add light sedation.
2. Marking: before incising I mark on the skin the lines of the excision, calibrating the amount of outer skin and inner mucosa to remove, so that there is no excessive tension in erection and the scar falls in as natural a position as possible.
3. Incision and haemostasis: I use the CO₂ laser or radiofrequency (Ellman, 4 MHz), which allow me to incise and control bleeding precisely, limiting damage to nearby tissues.
4. Frenulum: if the frenulum is short or already torn, I correct it at the same time with a frenulum plasty.
5. Suture: I close with absorbable stitches, which do not need to be removed and fall out on their own in about 10–15 days.
6. Histological examination: the tissue removed is always sent for histological examination, which can confirm or exclude lichen sclerosus or other skin changes.

Antibiotic prophylaxis is provided. At the end of the procedure you go home the same day, with a dressing and written instructions for the following days.

Recovery: realistic timings

In the first days swelling (oedema), some bruising and discomfort that can be controlled with common painkillers are normal. Spontaneous night-time erections can give a feeling of tension on the stitches: this is common and does not damage the wound.

After a total circumcision the glans remains uncovered and for a few weeks may be more sensitive to contact with clothing; the sensitivity diminishes gradually as its surface adapts.

Risks and possible complications

Circumcision is a common procedure and, in most cases, without problems. But no procedure is free of risk: in surgery 1 + 1 does not always equal 2.

• Bleeding or haematoma in the first days;
• wound infection, uncommon;
• prolonged swelling, which can last a few weeks;
• partial opening of a stitch, usually linked to erections or to exertion;
• temporary hypersensitivity of the glans or, more rarely, changes in sensitivity;
• irregular scar, asymmetry or removal of tissue in a less than ideal amount (too much or too little), which in rare cases requires a small touch-up;
• rarely, narrowing of the urethral opening (meatal stenosis) or reactions to the medications used.

Before the procedure I take the time needed to explain these risks one by one: I prefer the patient to arrive at fully informed consent, even if this sometimes frightens them a little.

Related pages

• Preputioplasty and phimosis: the conservative alternative, which widens the foreskin without removing it
• Frenuloplasty: correction of a short frenulum, alone or together with circumcision
• Glans corona filler: an intimate medicine treatment, without a scalpel

Frequently asked questions

Scientific references

Medically reviewed by Dr Giulio Maria Maggi, Plastic Surgeon — last review: 29 September 2026

Article written by

Dr Giulio Maria Maggi

Aesthetic Plastic Surgeon — Turin, Asti and Alessandria
Medical Director — Aesthetic Clinic (Turin)
Registered with the Turin Medical Council (Ordine dei Medici di Torino) no. 20595
Full Member of AICPE — Italian Association of Aesthetic Plastic Surgery (verify)

Information sheets on Instagram: @dott_giuliomariamaggi

Expertise and areas of interest

Dr Maggi trained specifically in intimate medicine and surgery by working for 12 years alongside Prof. Renato Marten Perolino, urologist and plastic surgeon, at Villa Maria Pia Hospital and, privately, at Clinica Fornaca and Clinica Cellini in Turin. From him he learned male-to-female gender-affirming surgery, and he was first operator in breast augmentation procedures on Prof. Perolino's patients undergoing gender transition. He also trained internationally with Prof. José Guerrero Santos in Guadalajara and with Prof. Andrew A. Jacono in New York, in the Deep Plane facelift technique.

His particular areas of focus are:

• Functional and aesthetic intimate surgery, male and female
• Deep Plane facelift
• Blepharoplasty
• Liposculpture and fat grafting (lipofilling)
• Breast surgery
• Body contouring

Clinical approach: «Prima comprendere» ("Understand first"). No promises of results: indications, risks and limits explained frankly, so that every patient can make a truly informed choice.