About The Procedure

Before the Circumcision (applying the LMX4 anaesthetic cream)

A generous amount of LMX4 should be applied to the whole outside of the penis.

Once that area is thickly coated with cream, wrap with cling-wrap (to keep the cream in place and not out in the nappy where it is wasted). The cling-wrap is left open at the free end so that urine can pass through. It is important to check the cream once or twice over the two hours and top up if necessary.

The cream is slowly absorbed over that two hour period so that if he has had lots of cream on for two hours he should not feel any pain. Furthermore, the anaesthetic effect lasts for about four hours afterwards and by the time the anaesthetic wears off, the tissue beyond the tie is dead anyway, so that even afterwards there shouldn't be any interval during which he experiences pain.

Last Advice: Try not to feed him for two hours before his circumcision. That way, he's less likely to wee, or poo, or throw-up, and also a feed immediately afterwards will help settle him down rapidly.

Important - Please read

Some people are under the impression that there is no cutting involved and that is not so. It is normal practice to trim off the surplus foreskin but not till after the circulation is cut off. If that's not done it's too difficult to keep clean and more likely to get infected. Removal of the foreskin is part of the Plastic Circumcision Device procedure, so that when the procedure is over, circumcision is complete. However, due to the application of the anaesthetic cream, he should not feel any pain.

After the Procedure

Advice to parents - What now?

You can bathe him normally - as soon as you get home if you wish. It is a good idea to leave him without a nappy after his bath to let the air get to it and dry it out and then you should apply some Betadine ointment (not Betadine liquid or cream).

Apply betadine twice daily.

Applying the Betadine

The ointment is mainly an added precaution against infection, but being greasy, it also acts as a cushion between the head of the penis and the ring to minimise rubbing. The betadine should be applied down the inside of the ring, round the head of his penis and round the outside as well. Use a cotton bud to spread the betadine inside the ring.

The ring will separate of its own accord. That usually takes between three and seven days, although it can come off sooner, it can hold on longer. It doesn't matter how long it takes, you simply continue applying the Betadine for a day or two after the ring comes off.

After the circumcision has healed

After the circumcision has healed it is usually necessary to separate the shaft skin from round the head of the penis. If that is not done, smegma can accumulate under the adherent skin. That is why it is so important that he should return for review after the circumcision has healed.

Smegma is a mixture of old mucus and dead skin cells. It always accumulates under the foreskins of uncircumcised boys. It acts as a focus for infection, but even more importantly it is the presence of smegma when they are young that predisposes to cancer of the penis later in life. The biggest single advantage in having him circumcised is that it is now easy to keep clean, and when he is old enough to shower himself, it should be totally self-cleaning.

Important Points

Check for fresh bleeding, and if this occurs in the first 24 hours, please phone immediately because it just shouldn't happen. Bleeding after the first 24 hours is usually only a drop or two and of no consequence.

The penis usually does get red and swollen. That is of no concern - it is just part of the normal healing process. That redness and swelling increases when the ring is about to separate off and settles rapidly after the ring is off.

It is most important to bring him back after the circumcision has healed (about two - three weeks after the procedure). Don't neglect this.

If you have any worries, please contact us.




Many boys do develop a pad of "puppy fat" in front of their pubic bone. That "puppy fat" pushes the shaft skin forward so that it overhangs or even covers the head of the penis.

The penis is anchored to the pubic bone and tends to get "buried" in the fat pad.

If that should happen with your boy, there will be a necessity, every day, when you bathe him, to push that shaft skin back firmly towards his pubic bone. This is for two reasons:

  • If you can't see it, you can't clean it. Smegma will accumulate in the groove behind the head of the penis.
  • Also, if those skin edges are allowed to remain in contact, undisturbed, for more than 24 hours, they can readhere.

    Don't be scared of it - you won't hurt him! And you won't have to do it forever. Most boys seem to burn up that "puppy fat" with running around, riding bikes and all those boy things!