Not All Circumcisions Are the Same: The Difference Between Traditional and Cosmetic Circumcision

When men call our clinic and start the conversation with questions about price, rather than technique or outcomes, it is clear that they are unaware that all circumcisions are not equal.

Asking for “the price of a circumcision” is like blindly calling a variety of car dealerships and asking “what’s the price of a car?”

Are you calling a high-end showroom or a used car warehouse?

An unknowing person may make a very poor decision and receive a product that is far from their initial goal when their decision making is informed primarily or solely by price.

What Is a “Traditional” Circumcision?

In the U.S., the vast majority of adult circumcisions are performed by board-certified urologists in a hospital-based setting under general anesthesia. They are usually done for medical necessity.

True Medical Indications:

• Severe phimosis unresponsive to steroid treatment
• Penile tumors requiring tissue removal

Many urologists may stretch the diagnosis to help a patient get insurance coverage, but outside of these specific cases, most circumcisions are elective and not medically necessary.

When it comes to technique, traditional circumcisions are performed with the primary goal of functional resolution of a problem (for example resolving phimosis) with little to no focus on the aesthetic outcome.

The Traditional Mindset: “No One Cares What It Looks Like”

This is the most damaging misconception in adult male circumcision. Many urologists operate under the belief that aesthetic outcome doesn’t matter and they perform the procedure accordingly. These circumcisions are performed as fast as possible using crude technique designed to resolve the medical problem and eliminate the risk of post-operative bleeding and wound dehiscence. Cosmetic outcomes are not taken into consideration.

As a result of the traditional mindset and financial incentives, traditional circumcision almost alwayd results in a combination of unsightly cosmetic defects.

Three Common Aesthetic Issues:

1. “Lumpy Bumpy” or Wart-Like Scars. Result from uneven closure and puckering of the skin.

2. “Railroad Track” Scars. Result from aggressive suture techniques used to reduce bleeding and use of cheap suture that causes inflammatory response.

3. Poor Incision Placement or Excessive Skin Removal. Hurried decisions regarding incision placement can result in an unbalanced look or penoscrotal web creation.

What Is a Cosmetic Circumcision?

Cosmetic circumcision involves a different mindset, a different technique, and ultimately a different outcome.

What Sets It Apart:

• Aesthetic intentionality: Smooth, clean, proportional
• Flat, linear scar lines: Avoiding bunching and contour distortion
• Reduced risk of pigment changes or unsightly stitch marks
• Customized skin removal: Tailored to the individual’s anatomy and cosmetic goals

This is not just surgery. It’s craftsmanship that requires experience, technical precision and a commitment to excellence.