Foreskin restoration

Foreskin restoration is the process of expanding the skin on the penis, via surgery or stretching methods, to replace the foreskin (prepuce) covering the glans penis. It may be useful for men who have been circumcised, who have a naturally short foreskin, or who have sustained an injury to the foreskin. Males with phimosis may also use techniques similar to non-surgical foreskin restoration to remedy their condition.

Reasons for foreskin restoration

Men attempt foreskin restoration for many reasons. Some attempts to restore the foreskin, usually through tissue expansion techniques, are aimed at improving sexual sensation. Other men have cited a desire to appear natural, or to regain a sense of control over their sexual organs.

Foreskin restoration is attempted mostly by circumcised adult men, sometimes with the assistance of support groups who share information and ideas. Many believe foreskin restoration should be delayed until sexual development is completed at around 18 years of age and in some cases the early 20's.

History

A form of foreskin restoration, historically known as epispasm, was practiced among some Jews in Hellenistic and Roman societies.^*

European Jews, along with men circumcised for medical reasons, sought out underground foreskin restoration operations during World War II as a method to escape Nazi persecution.^*

The practice was revived in the late twentieth century using modern materials and techniques.^*

The National Organization of Restoring Men (NORM) was founded in 1989 in San Francisco, as a non-profit support group for men restoring their foreskins. It was originally known as RECAP, an acronym for the phrase Recover A Penis.Since then several chapters of this organization have been founded throughout the United States, as well as internationally in Canada, the United Kingdom, Australia, New Zealand, and Germany.([http://www.norm.org/coord.html See NORM Locations worldwide)

Surgical techniques

Surgical methods of foreskin restoration, sometimes known as foreskin reconstruction, usually involve some method of grafting skin and/or mucous membrane taken from elsewhere on the body, typically the scrotum, onto the distal portion of the penis. Another method involves a four stage procedure in which the penile shaft is buried in the scrotum for a period of time(1). Such techniques have generally not produced satisfactory results, with some patients experiencing serious complications.

Nonsurgical techniques

Nonsurgical methods of foreskin restoration are performed by means of stretching the skin, dartos muscle, and mucous membrane covering the shaft of the penis. The stretching stimulates new growth, but requires patience and dedication; the process may take several years to complete.

Varying degrees of success have been reported by males employing stretching techniques.

The most common method of restoring the foreskin is to use tape to provide adhesion to the skin. The tape can be attached to elastic straps or weights to apply tension to the skin, directing the skin, along with any remnant of inner mucosa, over the glans. An example of a taping method is T-Tape, which was developed in the 1990s with the idea of enabling restoration to take place more rapidly.

Specialized foreskin restoration devices that grip the skin without tape are also commercially available. The tension produced by any device used should be adjusted so as to never cause pain or discomfort. This is often the limiting factor in any tissue expansion, since there is a risk of damaging tissues by use of excessive tension.

Physical aspects

The natural foreskin has three principal components, in addition to blood vessels, nerves and connective tissue: skin, which is exposed exteriorly; mucous membrane, which is the surface in contact with the glans penis when the penis is flaccid; and a band of muscle within the tip of the foreskin. Generally, the skin grows more readily in response to stretching than does the mucous membrane. The ring of muscle called the dartos, which normally holds the foreskin closed, is completely removed in the majority of circumcisions and cannot be regrown, so the covering achieved via stretching techniques is usually looser than that of a natural foreskin. According to some observers, however, it is difficult to distinguish a restored foreskin from a natural foreskin because restoration produces a "nearly normal-appearing prepuce" ^*.

Nonsurgical foreskin restoration does not restore the frenulum or the ridged band. Although not commonly performed, there are surgical "touch-up" techniques that can re-create some of the functionality of the frenulum and dartos muscle.

The process of foreskin restoration seeks to regenerate some of the tissue removed by circumcision, as well as providing coverage of the glans. According to research, the foreskin comprises over half of the skin and mucosa of the human penis ^*.

Tissue stretching has long been known to stimulate mitosis, and some research shows that regenerated human tissues have many of the attributes of the original tissue ^*.

In some men, foreskin restoration may alleviate certain problems they attribute to their circumcisions. Such problems, as reported to an anti-circumcision group by men circumcised in infancy or childhood, include prominent scarring (33%), insufficient penile skin for comfortable erection (27%), erectile curvature from uneven skin loss (16%), and pain and bleeding upon erection/manipulation (17%) (see poll at NOHARMM).

Foreskin restoration can be a means for man (and his sexual partner) to experience the rolling and gliding action of the penile shaft skin along the erect shaft. This mode of stimulation is not available to circumcised men without restoration.

Some men who have undertaken foreskin restoration report a visually smoother glans, which they attribute to decreased levels of keratinization following restoration. However, a study that investigated the effect of glans coverage on levels of keratinisation found no difference in keratin levels^* within the group studied.

Although research studies have found no measurable difference with respect to glans sensitivity ^*^*. According to some, however, protecting the glans from dryness and abrasion with clothing can allow the glans texture to change to a quality similar to that of intact genitalia among men who undergo this process.

Emotional, psychological, and psychiatric aspects

Foreskin restoration has been reported as having beneficial emotional results in some men, and has been proposed as a treatment for negative feelings in some adult men about their infant circumcisions (see Penn, Greer, Goodwin, and Boyle et al.). Such claims are not supported by all medical authorities, however.

Such negative feelings were discussed in the poll mentioned above. Respondents suffered from: emotional distress, manifesting as intrusive thoughts about one’s circumcision, including feelings of mutilation (60%), low self-esteem/inferiority to intact men (50%), genital dysmorphia (55%), rage (52%), resentment/depression (59%), violation (46%), or parental betrayal (30%). Many respondents (41%) reported that their physical/emotional suffering impeded emotional intimacy with partner(s), resulting in sexual dysfunction. Almost a third of respondents (29%) reported dependence on substances or behaviors to relieve their suffering (tobacco, alcohol, drugs, food and/or sexual compulsivity).

In "Prepuce Restoration Seekers: Psychiatric Aspects," a 1981 study published in the Archives of Sexual Behavior, four case study subjects seeking surgical foreskin restoration were examined. The studies provide examples of the psychiatric motivational forces behind the desire for foreskin restoration among some men (see full text at (Mohl et al)).

Books

"Decircumcision: Foreskin Restoration, Methods and Circumcision Practices" by Gary M. Griffin, ISBN 1879967057.
"The Joy of Uncircumcising!: Exploring Circumcision: History, Myths, Psychology, Restoration, Sexual Pleasure, and Human Rights" by Jim Bigelow and James L. Snyder, ISBN 093406122X

External links

Plastic surgery | Body modification | Penis

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