Changes

Surgical foreskin reconstruction has remained largely unchanged since Celsus first described the procedure 2000 years ago. An incision is made around the base of the [[penis ]] and the penile shaft is denuded (in other words, the [[skin]] is peeled off), leaving the [[shaft skin]] attached only beneath the [[glans penis]]. This [[skin]] is then pulled forward to replicate a [[foreskin]]. To tighten the new foreskin and improve its contour, a wedge-shaped section may be removed and the opening sutured shut. [[Skin]] is then harvested from the scrotum and grafted onto the [[penis ]] to patch the missing [[shaft skin]]. This is performed as a series of three operations, followed by several sessions of electrolysis to kill the hair follicles in the grafted [[scrotal skin]].

Celsus described two methods, the above method mostly for children with naturally short [[foreskin]], and a different method for patients [[circumcised ]] after the customs of certain races.

The persecution of Jews under the Nazi regime made the state of being [[circumcised ]] a life-threatening fact, making no difference whether the person had lost his [[foreskin ]] for religious reasons or because of a congenital or acquired [[phimosis]]. So every circumcised man at that time was in danger of being denounced and, therefore, had to hide his genital state or have it [[uncircumcised]]. There exist several personal reports of patients undergoing and doctors performing uncircumcision during this time. One example is the work of Tenenbaum who knew several of these doctors and also examined some of the patients treated.<ref name="schultheiss1998" />

Feriz performed several operations on [[circumcised ]] patients in occupied Holland. After a circumferential incision at the base of the [[penis ]] the penile [[penile skin]] was pulled over the [[glans]], forming the new [[prepuce]]. The proximal [[skin]] defect was then covered by burying the [[penis ]] under a tunnel of ventral [[scrotal skin]]. In a second stage operation about 10 days later he mobilized the [[penis ]] and closed the new [[skin]] layer at the underside of the [[penis]]. The scrotal defect was easily closed in all cases. In his publication from 1962, Feriz reported no complications, and all of his patients were satisfied with the postoperative result; none of them requested a reversal of the surgery after the war.<ref name="schultheiss1998" />

In 1965, Tushnet reported three different procedures to restore the [[prepuce ]] depending on the age of the patient, the remaining preputial [[skin]], and the skill of the surgeon.<ref name="tushmet1965">{{REFjournal

Since the 1970s a new movement of [[foreskin restoration]] has emerged mainly in the [[United States ]] not originating from social, religious, or political demands. With non-therapeutic male infant [[circumcision ]] being well established in America, more and more adult [[circumcised ]] males are disturbed by the fact that the shape and function of their body had been altered after birth. Their main complaint is the loss of function; the prepuce is not just seen as a part of the human [[skin]] but referred to as a [[Foreskin#Sensory_functions| sensory organ]] of the body.<ref name="sorrells2007">{{Sorrells etal 2007}}</ref> [[Circumcision ]] results in a lack of this organ and furthermore in a decrease of lubrication and sensibility of the [[glans ]] because of increasing [[keratinization ]] of the epithelium. Others are disturbed by the outer appearance of their [[circumcised ]] [[penis ]] and want to regain the natural status of a covered [[glans ]] for physical and emotional wholeness and aesthetic body imaging. Some are additionally irritated by the feeling of being mutilated as an infant without the chance to have a free choice of their genital status. A high percentage of these patients even resent their parents, doctors, or culture for their [[circumcision]].<ref name="schultheiss1998"/><ref name="watson2017">{{REFjournal

In 1963 Penn from Johannesburg, after performing a proximal circular incision and pulling forward the penile [[penile skin]] to form a new [[prepuce]], covered the denuded shaft with a "free graft", not indicating from where he took this graft.<ref name="penn1963" />

An American medical doctor had a surgical reconstruction of his [[foreskin]] performed in the 1970s. He recently released a NSFW report on his surgical foreskin restoration.<ref>{{REFweb |url=https://drive.google.com/file/d/1Hmguuseuh0qyQjzc3WkbHvr9Qf3o99TN/view |title=Was It Worth All My Extra Effort? |last=Anonymous |first= |init= |publisher=Google |date= |accessdate=2022-12-12}}</ref> His report does not represent current practice. Goodwin covered the same defect in 1990 by implantation of the [[penis ]] into the scrotum first and then liberating it in a second stage.<ref>{{REFjournal

Toronto plastic surgeon Dr Robert H Stubbs performed a surgical restoration in a two-stage procedure in [[Canada]].<ref>{{REFnews |title=BC man's foreskin op a success |url=https://www.nationalreviewofmedicine.com/issue/2006/06_30/3_patients_practice01_12.html |last=LaLiberté |first=Jennifer |init= |author-link= |publisher=National Review of Medicine |website= |date=2006-06-30 |accessdate=2022-08-22 |quote=}}</ref> One of the simplest methods involved the implantation of a small platinum ring within the tip of the "foreskin." The ring held the [[skin]] in place over the [[glans]], resulting in a "created phimosis" (meaning that the [[skin]] could not be retracted while the ring was in place). The hope was to generate enough new [[skin]] to permanently re-cover the glans after the ring was removed. As it turned out the [[skin]] that was left was a fibrous, raised band where the platinum ring had been lodged and there was not enough [[skin]] to cover the [[glans]].<ref name="bigelow1994">{{REFjournal

While reviewing the results of the implanted-ring procedure, an engineer living in the Pacific Northwest hit upon the idea of using tape to hold the [[skin]] in place over the [[glans]]. His intent was to avoid both the surgery needed to have the platinum ring implanted and the unsightly fibrous band it left. This simple idea was circulated among a small network of men who had been sharing whatever information they could find on [[foreskin restoration ]] as well as their ideas and experimentation. As a result, in 1982, [[BUFF]] (Brothers United for Future Foreskins) was born.<ref name="bigelow1994" />

Despite the possible complications of surgery and the inevitable presence of scars, the main disadvantage seems to be the different color and texture of the original penile [[penile skin]] and the graft. This outcome may not be what the patient had expected; therefore, most foreskin restoration seekers nowadays prefer [[Tissue expansion|skin expansion]] systems, which avoid these problems.