An Advanced Adult Circumcision Technique in London
Medically reviewed by Mr A. R. Khan, MBBS, FRCS, FRCS (paeds), Paediatric Surgeon/urologist
What is the Khan Technique Circumcision?
The Khan Technique Circumcision is an advanced adult circumcision technique developed by Mr Khan over more than 30 years of surgical experience and almost 6,000 circumcision procedures. It combines the precision of traditional freehand surgery, the symmetry of the forceps-guided (bone cutter) technique, and the benefits of hidden dissolvable stitches with tissue glue to achieve natural cosmetic results, reliable healing, and low complication rates.
Unlike a single fixed method, the Khan Technique adapts the operation to each patient’s anatomy and condition. It is particularly suited to men with phimosis, balanitis xerotica obliterans (BXO), recurrent infections, and frenular problems, as well as anyone seeking the best possible cosmetic outcome. At the London Circumcision Centre, it has been refined over many years into a safe, modern approach to older children and adult circumcision.
Why was the Khan Technique developed?
Many people assume circumcision is a standard operation. In reality, several techniques exist, each with strengths and limitations.
Traditional freehand surgery is flexible but relies heavily on the surgeon’s eye to achieve symmetry. Forceps-guided (bone cutter) circumcision gives consistent skin removal but is less adaptable when the anatomy is unusual. Stapler circumcision is quick and neat but is limited by the device’s fixed size and design.
Rather than choosing a single method, Mr Khan combined the strongest features of each while eliminating many of their weaknesses. The result is the Khan Technique, designed to deliver symmetry, a natural cosmetic appearance, hidden dissolvable stitches, reduced wound tension, tissue-glue reinforcement, comfortable recovery, and adaptability for complex cases such as BXO and severe phimosis.
How is the Khan Technique performed?
The procedure is usually performed under local anaesthesia, keeping patients comfortable while avoiding the risks of a general anaesthetic.
- Careful assessment. Every procedure begins with a detailed examination of the foreskin. If severe phimosis prevents inspection of the inner foreskin, a dorsal slit is performed first so the surgeon can assess the underlying tissue before deciding how much skin to preserve. This individual assessment is a defining feature of the technique.
- Preserving healthy inner skin. When the inner foreskin is healthy, roughly 1–2 cm is preserved to maintain a natural appearance and comfortable skin mobility. Where BXO (lichen sclerosus) is present, more of the affected tissue is removed to reduce the risk of persistent disease. Unlike fixed-device methods, the operation is tailored to the individual.
- Precise circumferential dissection at the inner mucosal skin. A carefully planned circumferential line over the mucosal skin is marked before the incision. At this stage, the frenuloplasty is performed, and the frenulum is also lengthened where necessary, thereby preventing postoperative tethering and improving symmetry.
- Forceps-guided outer-skin division. The outer foreskin is divided using a forceps-guided (bone cutter) technique, giving reliable symmetry while allowing the scar line to follow the natural contours of the penis. The scar is created by angling the forceps so that it is slightly longer underneath the penis (ventral skin) and shorter on the upper surface (dorsal skin) to achieve a more natural result.
- Restoration of the dartos layer. One of the distinctive steps is the restoration of the dartos fascia, the connective-tissue layer beneath the skin. Four dissolvable stay sutures rebuild this deeper support layer before the skin is closed, reducing tension on the skin edges during erection and improving long-term scar quality.
- Hidden subcuticular closure. Instead of multiple visible skin stitches, two small anchor sutures align the wound before it is closed with a continuous subcuticular dissolvable suture. Almost every stitch stays beneath the skin, with only one or two small stitches visible externally. Because all sutures are dissolvable, no stitch removal is required.
- Tissue-glue reinforcement. Medical-grade tissue glue is applied over the wound, creating a waterproof barrier, adding wound strength, reducing bacterial contamination, and improving comfort. This reinforced closure is particularly valuable during nocturnal erections in adults and older children.
- Protective dressing. A firm pressure dressing is applied and usually kept dry for the first three days. Patients receive detailed written aftercare instructions before leaving the clinic.
Benefits of the Khan Technique
The technique combines several proven surgical principles into a single approach. Benefits include a symmetrical, natural-looking scar; hidden dissolvable stitches with no stitch removal; a waterproof tissue- glue seal; lower wound tension; comfortable recovery; reduced infection risk from a sealed wound; and adaptability for phimosis and BXO. It is suitable for both older children and adults.
For many patients, the most noticeable difference is cosmetic. Because the stitch closure is placed under the skin rather than across it, there is no row of external stitch marks and no “railway-track” scarring. Restoring the dartos layer first means the skin heals without being pulled tight, which helps the final scar sit flat and fade more evenly. And because every suture dissolves on its own, there is no uncomfortable stitch-removal appointment a week or two later — a practical advantage that adult patients in particular appreciate.
Khan Technique vs traditional and stapler circumcision
| Feature | Khan Technique | Traditional (freehand) | Stapler |
| Symmetry | Guided + planned scar line | Depends on the surgeon’s eye | Fixed geometry |
| Hidden stitches | Yes (subcuticular) | No | Usually yes |
| Tissue glue seal | Yes | Usually no | no |
| Dartos layer restored | Yes | Rarely | No |
| Scar placement | Follows natural contour | Variable | Fixed |
| Adaptable for BXO | Cut depth adjusted | Possible, no guide | Limited |
| Stitch removal | None (dissolvable) | Often needed | Usually none |
Who is suitable for the Khan Technique?
The technique is suitable for adult circumcision and older children, and for tight phimosis, recurrent balanitis, BXO (lichen sclerosus), frenular problems, revision circumcision, and cosmetic circumcision. Every patient undergoes an individual assessment before surgery.
Recovery after the Khan Technique
Most patients experience only mild discomfort after surgery, and recovery generally follows a predictable pattern.
First three days: the dressing is kept dry, and rest is advised; some swelling is normal.
After about a week, most patients return to office work and are walking comfortably.
Two to four weeks: swelling settles, and the scar begins to soften.
Around six weeks, most patients have healed sufficiently to resume sexual activity, subject to their surgeon’s advice. Healing times vary between individuals.
What makes the Khan Technique different?
Unlike fixed circumcision methods, the Khan Technique is individually adapted to each patient. Its combination of freehand precision, forceps-guided symmetry, deep-tissue restoration, hidden dissolvable sutures, and tissue-glue reinforcement is designed to produce consistent cosmetic and functional outcomes across a wide range of anatomy — including the more challenging cases that fixed devices handle less well.
Adaptability matters most in difficult cases. A stapler or fixed-ring device commits the surgeon to a single geometry regardless of tissue appearance; the Khan Technique instead adjusts how much skin is preserved, how the frenulum is handled, and how tightly the cut is made based on the assessment. This is why it performs well not only in routine circumcision but also in scarred, recurrent, or BXO-affected foreskins where a one-size-fits-all approach can leave disease behind or remove too much healthy skin.
What does the medical evidence show?
Published research supports the individual components used in the Khan Technique. A systematic review and meta-analysis in Urology (Martin et al., 2018) found that tissue glue may reduce operative time and postoperative pain, while showing no significant differences in bleeding, infection, or wound breakdown compared with sutures. Separate comparative studies of cyanoacrylate tissue adhesive have reported good cosmetic results and, in one small series, lower wound-infection scores. Taken together, this evidence supports the use of tissue adhesive alongside dissolvable (absorbable) sutures, which are the standard closure for circumcision in UK practice.
Patients seeking independent information about circumcision, its risks and its alternatives can also refer to the British Association of Urological Surgeons (BAUS) patient guidance at baus.org.uk, which reflects current UK best practice.
Frequently asked questions
Is the Khan Technique painful?
The operation is performed under local anaesthesia, so patients should not feel pain during surgery. Mild discomfort afterwards is usually well controlled with simple pain relief.
Are the stitches visible?
Almost all stitches are hidden beneath the skin using a subcuticular closure, with only two or three small stitches possibly visible.
Do the stitches dissolve?
Yes. All sutures dissolve naturally and do not require removal.
Is the Khan Technique suitable for phimosis?
Yes — it is particularly effective because the operation is adapted to the severity of the phimosis.
Can patients with BXO have the Khan Technique?
Yes. Diseased tissue can be removed while preserving healthy tissue wherever appropriate.
How long does recovery take?
Most patients return to desk-based work within a few days, with complete healing over several weeks. Individual recovery varies.
Is tissue glue safe?
Medical-grade tissue glue has been widely used in surgery for many years and can strengthen wound closure while helping reduce the risk of infection.
What is the cost of the Khan Technique?
It starts from £750
Why choose the London Circumcision Centre?
The London Circumcision Centre specialises in circumcision surgery for children and adults. Our clinics in South Woodford, Leyton and Cambridge offer specialist circumcision surgeons, modern techniques, local-anaesthetic procedures, comprehensive aftercare, evidence-based treatment, and personalised surgical planning. Every patient receives an individual consultation to determine the most appropriate treatment.
Book a consultation
If you are considering adult circumcision in London, the Khan Technique offers a modern, evidence-informed approach designed for natural cosmetic results, comfortable healing, and reliable long-term outcomes. Whether you have phimosis, BXO, recurrent infections, or are considering circumcision for personal or cultural reasons, our surgical team can help.
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References
- British Association of Urological Surgeons (BAUS). Circumcision — Patient Information. baus.org.uk
- Martin A, Nataraja RM, Kimber C, Pacilli M. The Use of Tissue Glue for Circumcision in Children: Systematic Review and Meta-analysis. Urology. 2018;115:21–28.
- Comparative studies of cyanoacrylate tissue adhesive versus conventional suturing for circumcision.
- Published evidence on absorbable sutures and tissue adhesive in circumcision surgery.
Disclaimer: This article is for general educational purposes only and does not replace a professional consultation with a qualified surgeon. Every patient is assessed individually, and treatment recommendations depend on their specific clinical circumstances.