

Originally Published: November 16, 2007 - Last Updated / Reviewed On: October 3, 2008
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Hi Alice,

I'm a 19 yr 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, or foreskin, can look, and not necessarily one way they "should" look. As long as there is no pain associated with your foreskin not retracting all the way, it's probably just one more thing to appreciate about  your anatomy's uniqueness. But let's 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 is often likened to the joining ridge under the tongue. Many men find that the frenulum is very sensitive and its stimulation can be erotic and arousing. 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. This pulling can be painful, especially during ejaculation, masturbation, and during intercourse, when the frenulum can actually tear and bleed.

But no need to despair. The procedure you ask about, a frenuloplasty, is a simple and highly successful procedure that can help to remedy any discomfort. Basically, a frenuloplasty is an operation that lengthens the frenulum. The average age for surgical treatment is from 17 to 27 years old. This outpatient procedure is performed under local anesthesia, often by an urologist — no need for admission in 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 to as a z-plasty or y-plasty), typically increasing the length of the frenulum from one to one and a half centimeters. The incisions are sewn up with small dissolving stitches, which are barely visible and should fall out in about ten days.

Most men do not need any painkillers apart from the anesthetic used during surgery. There can be a little bleeding for twelve to forty-eight hours post-operation, but this is usually minimal enough to allow for normal daily activities. It takes about six weeks for the operation to fully heal, but after three weeks most men are able to enjoy a normal sex life. Rarely, the skin may scar from the surgery, causing it to contract. In this case a circumcision might be necessary, but again, this is very unusual.

If you are 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. Columbia students can make an appointment with their primary care provider through Open Communicator or by calling x4-2284. However you may not need treatment at all. Consider whether or not the partial retraction of the foreskin is painful or gets in the way of sexual pleasure. If not, no need to interfere; it's OK to look different from the other guys.