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Date Posted: 07:14:35 11/22/09 Sun
Author: Jeff
Subject: Frenulum Tying Report (Detailed)

Hi everyone. The ligation method seems to have worked for me. I made 4 separate ties over a period of several weeks; the result is a longer frenulum that is - for all intents and purposes - attached lower down on the glans face. I probably had a mild- to moderate breve before this. Here's some notes on my experience:

Equipment:-

I was unable to find a suture needle/thread in the pharmacy so used a thin hand sewing needle ('sharps') instead. I sterilized this in a flame for a few seconds and washed in antiseptic once cool. I couldn't get hold of any EMLA cream either, but did find something called 'Germalene' - an antiseptic cream with mild local anesthetic. For tying I used 0.2mm fishing line (rated as 3.0kg line).

Preparation:-

Beforehand I examined the stretched frenulum over a torch light. I found it easy to identify the arteries*. I was also thinking about where I wanted to pierce: close to the glans (but not where the frenulum skin actually merges into the glans!) and - in my case - about half a centimetre along from where the ridge of the frenulum joins the glans. I could have gone further along/down than this, but wanted to take it gradually - checking how it appeared after each ligation was complete. When examining the frenulum I also noted where the skin was lighter in the torchlight, as this is thinner and easier to pierce.

*While researching this method I couldn't find any reference to what happens if you pierce/tie from below the arteries. It would be good if someone can fill these details! Is there a lot of swelling, do the arteries rupture, etc.? I didn't need to go in below the arteries on any of my ligations - and I'm not sure I'd want to, unless I knew what to expect.

The piercing:-

I cleaned the site (cotton ear buds proved useful for cleaning, applying cream etc.) and sat flat-footed on the floor. I stuck a couple of lengths of microporous tape to the sides of the glans (away from the frenulum/foreskin) and strung them across to one of my thighs. I arranged it so it would act like a third hand - holding the glans, allowing me to pull the frenulum open with one hand and insert the needle with the other. (Microporous tape is a sticky white tape, normally used to secure wound dressings). I applied the mild anesthetic cream and let it work for a few minutes, then wiped off the excess so I could see where to pierce. Having a torchlight positioned under the site made it easier to see what I was doing. I'd already made a mental note of where I wanted to insert the needle, so it was just a case of taking some slow deep breaths and going for it! It didn't actually hurt much. I'd imagine if you were using a proper suture needle and EMLA cream you'd feel very little at all. I pierced the skin and pulled through plenty of fishing line to hold onto when tightening the knot (I actually found I needed to wrap the line around my index/middle fingers to get the knot nice and tight). Note that I just folded the fishing line back on itself in the eye of the needle - rather than knotting it - as I'd already discovered the knot was a bit tricky to pull through the skin. Peeling off the microporous tape from the glans afterwards was a bit uncomfortable, but this was the best method I could think of for piercing the frenulum with only one pair of hands!

The tying:-

I found the tying procedure sore - but by tightening the initial throw of the surgeon's knot a bit at a time, and allowing the discomfort to subside between each tug, I was to able to get the knot really tight without too much discomfort. I was actually sceptical at first about tightening it too much; I was concerned the line could cut through the skin there and then (!) or that the discomfort was going to last until the knot fell out in several days time. I needn't have worried about these thing. I don't think it's possible to cut through the skin while tying the knot - skin is tough stuff. And the discomfort disappeared fairly quickly - the constricted skin soon dies off, taking any sensation with it. In fact, in the days following the tying I only felt a slight occasional twinge. Basically the knot needs to be tight as this is vital to the success of the method.** I used a surgeon's knot (i.e. a double overhand knot, followed by a single overhand knot) and added two additional single overhand knots. The head of the knot felt a bit uncomfy and tended to bite into the surrounding skin a bit over the following days - perhaps using a softer kind of thread (like a sterile silk suture) would have made this less of an issue, or perhaps applying Vaseline (rather than E45 cream) lessens this effect. Or maybe even locating the knot head to one side of the frenulum ridge? Anyway, I digress! When tying, I tried to angle the ligature slightly towards the tip end of the penis, so it would cut through the frenulum a bit diagonally. My theory was that this would mean less frenulum skin to reassimilate itself into the glans, which would produce a neater finish. However, in practice I don't think it made that much difference. Anyway, once I was happy the knot was tight and secure I cut the excess fishing line - leaving about half a centimetre - and covered the site with antiseptic cream. I left it alone overnight.

**On one occasion I didn't make the knot tight enough, and could tell after a few days that it wasn't 'cutting' through properly. I decided I either needed to remove the ligature by extremely carefully trying to snip away the knot or simply to thread a new piece of line through the existing hole and tie another (tighter) ligation alongside the existing one. Trying to cut the knot head would have been very fiddly and left little margin for error (!), so I opted to put in the additional tie. (The fishing wire was stiff enough that I could just poke it carefully through the existing hole (without a needle); I also found a bit of E45 cream helped it go through easier.) I was careful to position the new ligature right next to the existing one, but it still seemed to result in a little triangle of dead tissue forming between the two ties. This concerned me a bit at the time, but in due course it fell out. I actually think if I was ligating a larger amount of skin, or had especially thick skin, I would have found it necessary to do a second ligation like this after a few days as a matter of course, to ensure the continuity of the 'cutting' process.

The wait:-

After I was all tied-up it was simply a case of keeping the site clean and letting the ligature do its work. I soaked the area two or three times a day, for about 10 minutes at a time. After a couple of days I'd notice small bits of dead skin float away in the water when soaking. I bathed as normal - but was wary of shower gel/soap! After a few days I was able to wiggle the knot slightly and very gentle stretch the site, which I think aided the process. I applied E45 cream twice daily - others have suggested using Vaseline.

During these few days the blood flow to the ligated frenulum skin is cut off and the skin subsequently dies. The ligature then serves to 'cut' through this dead skin, primarily from the ridge inwards, until - having worked its way through all the skin - it detaches along with some dead skin. During the process the adjacent live skin relaxes away from the site, resulting in a fairly neat finish; the aim is that the frenulum ends up longer and - depending on how close to the glans you pierce - for all intents and purposes attached lower down on the glans face.

Aftercare:-

After the knot came out I applied some antiseptic cream to the site; then I just kept it clean and allowed it to settle down. I continued using E45 cream daily (perhaps skin healing cream would have been better) and gently stretching the frenulum to keep it supple.

Good luck!

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