A circumcision removes the foreskin, the sleeve of skin covering the head (glans) of the penis. For newborns, the procedure takes roughly 20 minutes or less. For older children and adults, it takes longer and involves stitches to close the wound. The specific technique depends on the patient’s age, but all methods follow the same basic principle: separate the foreskin from the glans, cut away the excess skin, and allow the area to heal.
How Newborn Circumcision Works
Newborn circumcisions are performed using one of three devices. All three accomplish the same goal, but the mechanics differ.
With the Gomco clamp, the doctor places a bell-shaped cap under the foreskin and over the glans to protect it. The foreskin is pulled up over the bell, and a metal plate is tightened down to compress the skin against the bell. This stays in place for about five minutes, cutting off blood flow so the area won’t bleed. The doctor then trims away the excess foreskin with a scalpel and removes the clamp.
The Plastibell method works similarly at first. A plastic ring is placed over the glans and under the foreskin. The foreskin is pulled over the ring, and a string is tied tightly around a groove in the plastic. This cuts off circulation to the foreskin above the string. The doctor trims the excess skin and snaps off the handle, leaving the plastic ring in place. It falls off on its own as the area heals, typically within a week or so.
The Mogen clamp is the fastest of the three. The doctor holds the foreskin with clamps at the 3 o’clock and 9 o’clock positions, then slides it into a narrow slit in the metal device. The clamp is locked shut, crushing the skin to prevent bleeding, and the foreskin above the clamp is cut away. The concave side of the clamp faces toward the glans to protect it during cutting.
Pain Management During the Procedure
Circumcision is not done without pain control. For newborns, doctors typically use a local injection called a dorsal penile nerve block: a small needle delivers numbing medication at two points near the base of the penis, blocking sensation to the area. Some providers also apply a numbing cream about an hour beforehand for additional comfort. Combining both methods tends to provide better pain relief than either one alone.
Older children who need the procedure sometimes receive general anesthesia, meaning they’re fully asleep. When general anesthesia is used, fasting rules apply. Formula-fed infants under 12 months can’t eat within six hours of the procedure, while breastfed babies must stop nursing at least four hours before. All children need to stop drinking clear liquids two hours before their scheduled arrival time.
Adults typically receive a local anesthetic injection at the base of the penis, similar to what a dentist uses before filling a cavity. You’re awake but shouldn’t feel sharp pain during the procedure.
How Adult Circumcision Differs
Adult circumcision is a more involved surgery than the newborn version. Two main techniques are used: the dorsal slit and the sleeve resection.
In the dorsal slit technique, the surgeon makes a single cut along the top of the foreskin, extending about 75 percent of the distance from the tip toward the head of the penis. The foreskin is then held out from the shaft and trimmed away at its base with scissors. Blood vessels on the surface are tied off to control bleeding, and the wound edges are closed with dissolvable stitches spaced every 4 to 7 millimeters around the circumference.
The sleeve resection is more precise cosmetically. The surgeon marks two circular incision lines: one on the outer skin near the head, and another on the inner foreskin about a centimeter behind the ridge of the glans. This creates a “sleeve” of skin between the two lines. The surgeon cuts along both marks, peels the sleeve of tissue away, controls any bleeding, and stitches the edges together. This approach gives the surgeon more control over exactly how much skin is removed.
Both adult techniques involve a step where the frenulum, the sensitive band of tissue on the underside of the glans, is carefully reattached with a specific stitch pattern. This area tends to bleed more than other parts of the incision, so it’s typically addressed first.
Complication Rates
Circumcision is one of the most common surgical procedures performed, and serious complications are uncommon. For newborns, the rate of adverse events is less than 0.5%. The most frequent problems are bleeding (roughly 1 in 1,000 procedures) and the need for minor corrective procedures afterward (about 2 in 1,000). When circumcision is performed after infancy, complication rates rise 10 to 20 times higher, which is one reason it’s typically done in the first few weeks of life when families choose the procedure.
The American Academy of Pediatrics concluded in its most recent policy statement that the health benefits of newborn circumcision outweigh the risks. Those benefits include reduced risk of urinary tract infections in the first year of life, lower rates of certain sexually transmitted infections including HIV, and reduced risk of penile cancer. That said, the benefits weren’t large enough for the AAP to recommend routine circumcision for every newborn. The organization’s position is that the decision belongs to parents, who should be given accurate information about both benefits and risks.
Recovery and Aftercare for Adults
After an adult circumcision, the area will be swollen and tender. Swelling typically takes a few weeks to fully resolve. Once any bandage is removed, you can shower, but should pat the incision dry rather than rubbing it. Choosing underwear that holds the penis upright against the body helps reduce swelling.
The most important restriction: no sexual intercourse or masturbation for six weeks. This gives the incision line time to heal completely and reduces the risk of reopening the wound. The dissolvable stitches break down on their own during this period, so there’s no need to have them removed.
Recovery for Newborns
Newborn recovery is faster. The area may look red and swollen for the first few days, and you might notice a yellowish film forming over the glans. This is normal healing tissue, not a sign of infection. Parents are usually instructed to apply petroleum jelly to the tip of the penis with each diaper change to prevent the healing skin from sticking to the diaper. If a Plastibell ring was used, it will fall off within about a week. Pulling it off early can cause bleeding.
Signs that warrant a call to your pediatrician include persistent bleeding that doesn’t stop with gentle pressure, foul-smelling discharge, fever, or the baby not urinating within 12 hours after the procedure.