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}}</ref> Other biological phenomena such as tissue inflammation can also be considered expansion.
}}</ref> Other biological phenomena such as tissue inflammation can also be considered expansion.


==Skin expansion==
== Skin expansion ==
 
[[Skin]] expansion is a common surgical procedure to grow additional [[skin]] through controlled mechanical overstretch.<ref name="whyitworks2021" /> It creates [[skin]] that matches the color, texture, and thickness of the surrounding tissue, while minimizing scars and eliminating risk of rejection.
[[Skin]] expansion is a common surgical procedure to grow additional [[skin]] through controlled mechanical overstretch.<ref name="whyitworks2021" /> It creates [[skin]] that matches the color, texture, and thickness of the surrounding tissue, while minimizing scars and eliminating risk of rejection.


When [[skin]] is stretched beyond its physiological limit, mechanotransduction pathways are activated. This leads to cell growth as well as to the [[Mitosis| formation of new cells]].<ref name="whyitworks2021" />
When [[skin]] is stretched beyond its physiological limit, mechanotransduction pathways are activated. This leads to cell growth as well as to the [[Mitosis| formation of new cells]].<ref name="whyitworks2021" />


The growth of tissue is permanent, but will contract to some degree when the tension is removed.
The growth of tissue is permanent<ref>{{REFbook
|last=Bigelow
|first=Jim
|init=J
|author-link=Jim Bigelow
|year=1995
|title=[[The Joy of Uncircumcising]]
|work=
|editor=
|edition=
|volume=
|chapter=Ch. 13: Skin expansion:How it works and what it provides
|scope=
|page=
|pages=132-9
|location=Aptos, California
|publisher=Hourglass Book Publishing
|ISBN=0-934061-22-X
|quote=The gain in sensitivity is the first and most consistent benefit of restoration.
|accessdate=2023-08-15
|note=
}}</ref>


=== Mechanics of skin expansion ===
=== Mechanics of skin expansion ===
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  |pages=166-75
  |pages=166-75
  |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278515/
  |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3278515/
|quote=
  |pubmedID=3278515
  |pubmedID=3278515
  |pubmedCID=22227432
  |pubmedCID=22227432
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}}</ref>
}}</ref>


==Applications==
== Applications ==
 
=== Relief of phimosis or tight foreskin ===


===Relief of phimosis or tight foreskin===
Tissue expansion by manual [[stretching]] effectively widens the [[foreskin]] to treat [[phimosis]] or [[paraphimosis]].<ref>{{REFjournal
Tissue expansion by manual [[stretching]] effectively widens the [[foreskin]] to treat [[phimosis]] or [[paraphimosis]].<ref>{{REFjournal
  |last=Dunn
  |last=Dunn
Line 60: Line 82:
  |DOI=10.1111/j.1445-2197.1989.tb07640.x
  |DOI=10.1111/j.1445-2197.1989.tb07640.x
  |accessdate=2019-11-07
  |accessdate=2019-11-07
}}</ref> <ref name="beauge1991">{{REFdocument
|title=Conservative Treatment of Primary Phimosis in Adolescents
|url=http://www.cirp.org/library/treatment/phimosis/beauge/
|contribution=
|last=Beaugé
|first=Michel
|publisher=Saint-Antoine University
|format=
|date=1991
|accessdate=2022-11-20
}}</ref> <ref name="beauge1997">{{REFjournal
}}</ref> <ref name="beauge1997">{{REFjournal
  |last=Beaugé
  |last=Beaugé
Line 77: Line 109:
}}</ref> One should continue to stretch until one's [[foreskin]] [[Gliding action| glides]] smoothly back and forth. This works best when topical steroid ointment (available by prescription) is used along with the stretching.
}}</ref> One should continue to stretch until one's [[foreskin]] [[Gliding action| glides]] smoothly back and forth. This works best when topical steroid ointment (available by prescription) is used along with the stretching.


====A word to intact teens====
==== A word to [[intact]] teens ====
Boys are born with a [[foreskin]] that is non-retractable for reasons of protection. The inner surface is fused with the [[glans penis]] by a [[synechia]] (similar to a fingernail that is glued to the nail bed of the finger). Also the tip of the foreskin is too narrow to retract. As a boy gets older, the synechia disintegrates and releases the foreskin and the foreskin gets wider as a boy ages, so the foreskin gradually becomes [[Retraction of the foreskin|retractable]]. Some boys go through puberty but find that their [[foreskin]] is still too narrow to permit retraction.


Beaugé (1997) reported that boys, who [[Masturbation| masturbate]] by pulling their foreskin away from the body, will not stretch the tight part of the foreskin so non-retractile foreskin will persist. He advised changing the method of [[masturbation]] to the more conventional method of pulling the foreskin toward the body so that the narrow orifice get stretched.<ref name="beauge1997" />
Boys are born with a [[foreskin]] that is non-retractable for reasons of protection. The inner surface is fused with the [[glans penis]] by a [[synechia]] (similar to a fingernail that is glued to the nail bed of the finger). Also the tip of the [[foreskin]] is too narrow to retract. As a boy gets older, the synechia disintegrates and releases the foreskin and the foreskin gets wider as a boy ages, so the foreskin gradually becomes [[Retraction of the foreskin|retractable]]. Some boys go through [[puberty]] but find that their [[foreskin]] is still too narrow to permit retraction.  


The traditional way of addressing this issue was to consult a urologist and get a [[Adolescent and adult circumcision| circumcision]], however we now understand that in the vast majority of cases, manual stretching over a few months will widen the foreskin by tissue expansion, make the foreskin retractable and eliminate the need for a destructive [[Adolescent and adult circumcision| circumcision]].
Beaugé (1997) reported that boys, who [[Masturbation| masturbate]] by pulling their foreskin away from the body, will not stretch the tight part of the foreskin so non-retractile foreskin will persist. He advised changing the method of [[masturbation]] to the more conventional method of pulling the [[foreskin]] toward the body so that the narrow orifice get stretched.<ref name="beauge1997" />
 
The traditional way of addressing this issue was to consult a [[Issues with American urologists and the practice of male circumcision| urologist]] and get a [[Adolescent and adult circumcision| circumcision]], however we now understand that in the vast majority of cases, manual [[stretching]] over a few months will widen the [[foreskin]] by tissue expansion, make the foreskin retractable and eliminate the need for a destructive [[Adolescent and adult circumcision| circumcision]].
 
=== Foreskin restoration ===


===Foreskin restoration===
Tissue expansion has also been used for the technique of non-surgical [[foreskin restoration]], which applies tension externally using specialized devices and/or manual stretching to replace circumcised tissues with newly expanded residual [[shaft skin]].<ref>{{REFjournal
Tissue expansion has also been used for the technique of non-surgical [[foreskin restoration]], which applies tension externally using specialized devices and/or manual stretching to replace circumcised tissues with newly expanded residual [[shaft skin]].<ref>{{REFjournal
  |last=Radovan  
  |last=Radovan  
Line 124: Line 158:
  |DOI=10.1503/cmaj.109-4009
  |DOI=10.1503/cmaj.109-4009
  |accessdate=
  |accessdate=
}}</ref> Men who have been circumcised stretch and apply tension to their shaft and foreskin remnants to expand and elongate tissue in efforts to produce a functional foreskin. This form of tissue expansion can take years, as the amount of [[skin]] growth required is typically around 15 square inches.<ref>{{REFweb
}}</ref> Men who have been [[circumcised]] stretch and apply tension to their shaft and foreskin remnants to expand and elongate tissue in efforts to produce a functional [[foreskin]]. This form of tissue expansion can take years, as the amount of [[skin]] growth required is typically around 15 square inches.<ref>{{REFweb
  |url=http://www.noharmm.org/snip.htm
  |url=http://www.noharmm.org/snip.htm
  |title=Not a "Snip," But 15 Square Inches
  |title=Not a "Snip," But 15 Square Inches
|trans-title=
|language=
  |last=Hammond
  |last=Hammond
  |first=T
  |first=Tim
|init=T
|author-link=Tim Hammond
  |publisher=
  |publisher=
  |website=NOHARMM
  |website=[[NOHARMM]]
  |date=2012-02-28
  |date=2012-02-28
  |accessdate=2019-10-10
  |accessdate=2019-10-10
|format=
}}</ref> This process does not regenerate or restore the function of the [[frenulum]] or the [[ridged band]]. It does, however, typically involve growing more [[shaft skin]] and [[preputial mucosa]], which serves to moisten and protect the [[glans penis|glans]]. Men who have restored their [[foreskin]] typically notice increased sensitivity and [[dekeratinization]] of the glans.<ref>{{REFweb
|quote=
}}</ref> This process does not regenerate or restore the function of the [[frenulum]] or the [[ridged band]]. It does, however, typically involve growing more [[shaft skin]] and [[preputial mucosa]], which serves to moisten and protect the [[glans penis|glans]]. Men who have restored their foreskin typically notice increased sensitivity and dekeratinization of the glans.<ref>{{REFweb
  |url=http://www.cirp.org/pages/restore.html
  |url=http://www.cirp.org/pages/restore.html
  |title=Foreskin restoration for circumcised men
  |title=Foreskin restoration for circumcised men
|trans-title=
  |publisher=[[CIRP]]
|language=
|last=
|first=
  |publisher=
|website=Circumcision Information and Resource Pages
  |date=2013-08-17
  |date=2013-08-17
  |accessdate=2019-10-10
  |accessdate=2019-10-10
|format=
|quote=
}}</ref>
}}</ref>


===Excessive circumcision===
==Lengthening one's foreskin==
 
There are several reasons a person would want to lengthen his existing [[foreskin]]. The longer the [[foreskin]] is, the more securely it will stay protectively in place over the [[glans penis]]. Many regard a longer foreskin or [[acroposthion]] as more esthetically pleasing. A longer foreskin provides better protection against [[keratinization]] than a shorter foreskin. A longer foreskin also allows a longer [[gliding action]] with better sensation than a shorter foreskin.
 
One uses the same techniques as are used for for non-surgical [[foreskin restoration]].
 
=== Excessive circumcision ===


Men who have been [[circumcised]] sometimes report that there is not enough [[skin]] left to allow full [[erection]] of the [[penis]], so the [[penis]] is shorter than before [[circumcision]]. They may also experience tight, painful [[erection]]s.  In such cases, tissue expansion may help to get full length and relieve pain during [[erection]].
Men who have been [[circumcised]] sometimes report that there is not enough [[skin]] left to allow full [[erection]] of the [[penis]], so the [[penis]] is shorter than before [[circumcision]]. They may also experience tight, painful [[erection]]s.  In such cases, tissue expansion may help to get full length and relieve pain during [[erection]].


===Short natural foreskins===
=== Short natural foreskins ===
[[Intact]] men who have a short natural [[foreskin]] may use tissue expansion to lengthen their [[foreskin]]. It frequently results in [http://acroposthion.com/ancient-greeks-and-the-foreskin/ improved appearance] as well as increased comfort and sensation with improved [[gliding action]]. One uses the same techniques as used for for non-surgical [[foreskin restoration]].
 
[[Intact]] men who have a short natural [[foreskin]] may use tissue expansion to lengthen their [[foreskin]].  
 
An [[acroposthion]] may be created gradually with consistent regular stretching with a device or manually.
 
=== Correction of an uneven foreskin ===
Some foreskins are naturally shorter on one side than the other. This may be corrected over time by manually stretching only the short side.
 
=== Retraining of a long retracted foreskin ===
A few [[intact]] males will elect to wear their [[foreskin]] permanently retracted for months or years. Later, when they change their mind about the advisability of that practice, they find that their foreskin will not remain in its normal position where it covers and protects the [[glans penis]], because it seems to have become shorter. In such cases, it is necessary to provide traction on the [[foreskin]] to lengthen it to its normal length. The same techniques used by [[circumcised]] men, who are restoring their lost foreskin, works very well in such cases.


{{SEEALSO}}
{{SEEALSO}}
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* [[Frenulum breve]]
* [[Frenulum breve]]
* [[Mitosis]]
* [[Mitosis]]
* [[Penis]]
* [[Phimosis]]
* [[Phimosis]]
* [[Retraction of the foreskin]]
* [[Retraction of the foreskin]]
* [[Stretching]]
* [[Stretching]]
* [[Plastic surgery]]


{{LINKS}}
{{LINKS}}
* {{URLwikipedia|https://en.wikipedia.org/wiki/Tissue_expansion|Tissue expansion|2025-08-17||}}
* {{REFweb
|url=http://acroposthion.com/the-tip-at-the-end/
|title=The ‘Tip’ At The End
|publisher=Acroposthion
|date=
|accessdate=2023-01-15
}}
* {{REFjournal
* {{REFjournal
  |last=Zöllner
  |last=Zöllner
Line 249: Line 300:
  |accessdate=2022-08-20
  |accessdate=2022-08-20
}}
}}
* [http://phimosisjourney.com/ A Phimosis Journey]
* {{REFweb
|url=http://phimosisjourney.com/
|title=A Phimosis Journey
|last=
|first=
|init=
|publisher=
|date=
|accessdate=2023-12-24
}}


{{REF}}
{{REF}}


[[Category:Education]]
[[Category:Foreskin restoration]]
[[Category:Foreskin restoration]]
[[Category:Penis]]
[[Category:Physiology]]
[[Category:Physiology]]
[[Category:Foreskin anatomy]]
[[Category:Teen]]
[[de:Gewebedehnung]]
Retrieved from "https://en.intactiwiki.org/wiki/Tissue_expansion"