Circumcision is a topic that brings up a lot of decisions. While some parents may know right from the start what their opinion on male circumcision is, others may have questions about whether circumcision is right for their family.
Infant circumcision is an entirely personal decision. The American Academy of Pediatrics released an official statement on male circumcision after a prominent study found that circumcision does reduce the rate of some types of penile cancer. Overall, the benefits outweigh the risks. But they ultimately concluded that circumcision is not a medical decision. It’s a personal decision for parents.
In other words, there is no official medical preference on circumcision, so it's completely up to you to decide if you want to circumcise your son.
Circumcision is a standard procedure that will remove the foreskin from the head of the penis. There are different ways it can be done in adults, but in infants the only choice may be how much foreskin to leave and how "loose" or freely it can move on the shaft of the penis. The style your doctor chooses may depend on their personal preference and experience with the procedure, or what you request.
A loose circumcision style will remove less foreskin, leaving more of it room to move on the penis. A tighter circumcision style removes more foreskin, leaving the skin tighter on the shaft. In general, how the foreskin is removed will determine if the circumcision is loose or tight, but the length of the penis can also affect it. This decision can be fairly easy to make when performing a circumcision on an older boy or adult man. For infant circumcision, the judgment can be more difficult. While the doctor may plan to make the circumcision “looser” or “tighter,” it is much harder to know how the circumcision will look when the baby grows up.
There aren't any studies that prove that one style of circumcision is better than another. The styles come down to personal preference and belief. Those who support loose circumcisions say that leaving more of the skin allows for more natural movement of the penis. Some doctors also believe it's beneficial to allow some extra skin so the male can "grow" into his skin.
A loose circumcision leaves more of the foreskin on the penis. As the circumcision site heals, there is more of a risk of that skin attaching, or adhering, to the penis.
There is an increased risk of an adhesion with a looser circumcision style simply because there is more skin there that may attach. In serious cases, the adhesion might be severe enough that it causes medical complications and a repeat circumcision to correct the problem.
To prevent an adhesion from forming, parents have to simply be sure to retract the remaining foreskin from the head of the penis after it heals in about a week, so that all the skin is able to move freely. It’s also important not to retract the skin before it’s fully healed. If it reattaches, your doctor can retract it in the office in most cases. Most adhesions resolve on their own over time.
With more loose skin, there is also more of a need to clean under the skin, much like an intact penis. Bacteria and other debris can get trapped under the skin, so you will have to clean under it and teach your son to clean under it as well.
The other types of circumcision styles vary from "tight" to "loose," with different variations in between. The "tightest" style removes as much of the foreskin as possible, while looser styles leave more of the foreskin intact.
Most commonly, doctors perform a circumcision that is in the middle of the two types, unless you specifically request otherwise or the doctor has a personal preference.
Choosing a loose circumcision style for your son is just like the decision to circumcise or not. It comes down to your personal preference and beliefs. You can make the choice that feels best for your family and discuss any potential benefits of a loose circumcision style with your doctor.