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== Time to restore ==
Please see:
* [https://www.restoration-calculator.online/ Foreskin Restoration Calculator]
→Regeneration of the foreskin: Revise text.
|pubmedCID=22083672
|DOI=10.1503/cmaj.109-4009
|accessdate=2023-10-10
}}</ref>
Foreskin restoration can be achieved via surgical and/or non-surgical means. Men take up foreskin restoration to restore [[Dekeratinization| sensation]] to the [[glans penis]] and to restore the [[gliding action]] of the natural [[penis]]. Another reason for restoring is a desire to create the natural appearance of an [[intact]] penis with the [[foreskin]] covering the [[glans penis]]. [[Jim Bigelow]] (1995) listed aesthetics, sensitivity of the glans, sexual stimulation and sexual function of a restored foreskin, and sense of wholeness as reasons that men give for desiring foreskin restoration.<ref>{{REFbook |last=Bigelow |first=Jim |author-link=Jim Bigelow |year=1994 |title=The Joy of Uncircumcising!: Exploring Circumcision: History, Myths, Psychology, Restoration, Sexual Pleasure, and Human Rights |url=https://www.amazon.com/Joy-Uncircumcising-Circumcision-Psychology-Restoration/dp/093406122X |editor= |edition=2 |volume= |chapter=Why Men Today Want to Uncircumcise |pages=113-4 |location= |publisher=Hourglass Book Pub |isbn=978-0934061223}}</ref> Foreskin restoration techniques are most commonly undertaken by men who resent having been [[circumcised]] as children, or who have sustained an injury.<ref name="ozer2020">{{REFjournal
|last=Özer
|first=
|DOI=10.1038/s41443-019-0223-y
|accessdate=2022-10-14
}}</ref> They are also used by [[intact]] men who simply desire a longer [[foreskin]] and by [[regret men]].
== History ==
=== Ancient history ===Foreskin [[stretching ]] (called "uncircumcision," or ''[[epispasm]]'') appears to have been a common practice among Hellenized Jewish men in Hellenistic and Roman societies,<ref name="Rubin">{{REFjournal
|last=Rubin
|first=Jody P.
|publisher={{UNI|Oxford University|Oxon}} Press
|isbn=0-19-517674-X
|quote=Foreskin [[stretching ]] (called "uncircumcision," or epispasm) appears to have been a common practice among Hellenized Jewish men...
|accessdate=2011-09-23
|note=
}}</ref>
Key features of Hellenistic culture were athletic exercises in gymnasia and athletic performances in public arenas, where men appeared in the nude. While the [[penis]] sheathed in an [[intact]] foreskin was normal and acceptable, ancient Greeks and their Hellenistic successors considered the [[circumcised]] penis to be offensive, as it was perceived as a vulgar imitation of [[erection]], unfit for public display. The ancient Greeks and their Hellenistic successors considered the "ideal prepuce" to be long, tapered, and "well-proportioned." Removing it was considered [[mutilation]]. Men with a short foreskins[[foreskin]], a condition known as ''lypodermos'', would wear a leather cord called a ''kynodesme'' to prevent its accidental exposure.<ref>{{REFjournal
|last=Hodges
|first=Frederick M.
}}</ref>
The sight of [[circumcised]] genitals at public baths or gymnasia would inspire laughter and ridicule. Jewish men who wished to gain acceptance in the larger social world gave themselves a presentable appearance by pulling the remaining [[foreskin]] forward as far as possible, and keeping it under enough tension to encourage permanent [[stretching ]] toward its original length. Using a fibular pin or a cord, they pierced the front of the remaining foreskin, drew it forward, and fixed it in place; sometimes they would attach a weight to maintain tension. Over time the foreskin stretched and restored at least some of the appearance of an [[intact]] organ.<ref>{{REFbook
|last=Glick
|first=Leonard B.
|accessdate=2011-09-23
|note=
}}</ref> Up until the 2th century, [[Jewish circumcision]] involved only partial foreskin removal. Rabbis of the 2th century mandated ''[[Periah| peri’ah]]'', or the complete ablation of the [[foreskin ]] in order to prevent Jewish men from engaging in foreskin restoration.<ref>{{REFbook
|last=Glick
|first=Leonard B.
|note=
}}</ref>
=== Modern history ===
During World War II, some European Jews sought out underground foreskin restoration operations as a way to escape Nazi persecution.<ref name="Tushmet">{{REFjournal
|last=Tushmet
}}</ref>
The National Organization of Restoring Men ([[NORM]]) was founded in 1989 in San Francisco, as a non-profit support group for men restoring the appearance of a [[foreskin]]. It was originally known as RECAP, an acronym for the phrase Recover A Penis. In 1994 UNCIRC was incorporated into this group.<ref name="NORM history">{{REFweb
|quote=
|url=http://www.norm.org/history.html
[[Image:Foreskin restoration diagram.jpg |thumbnail|right|550px| A series of steps for non-surgical foreskin restoration. ]]
Nonsurgical foreskin restoration is the most commonly used method of foreskin restoration. It is accomplished through [[tissue expansion]] and involves pulling on the remnants of the [[foreskin]]. Both the skin of the penile shaft and the [[mucosa]]l inner lining of the [[foreskin]], if any remains after [[circumcision]], may be expanded. The skin is pulled forward over the [[glans]], and tension is applied manually, by using weights or elastic straps. In the latter two cases a device must be attached to the skin; surgical tape is often used.
[[Image:Tlctugger applied.jpg|thumbnail|left|150px| TLCTugger device applied to a [[circumcised]] penis for non-surgical foreskin restoration.]]
An example of a device using elastic straps is the T-Tape method, which was developed in the 1990s with the idea of enabling restoration to take place more rapidly. Many specialized [http://intactwiki.org/wiki/Category:Foreskin_restoration_devices restoration devices] (like the [[TLC-X|TLC Tugger]] shown in the picture) that grip the [[skin]] with or without tape are also commercially available. Tension from these devices may be applied by weights or elastic straps, by pushing the skin forward on the [[penis]], or by a combination of these methods.
The amount of tension produced by any method must be adjusted to avoid injury, pain or discomfort, and provides a limit on the rate at which new tissue can be grown. There is a risk of damaging tissues if excessive tension is used, or if tension is applied for too long. Websites about foreskin restoration vary in their recommendations, from suggesting a regimen of moderate amounts of tension applied for several hours a day,<ref name="NORM regimen">{{REFweb
|date=1997-10-15
|accessdate=
}}</ref> Unlike conventional skin expansion techniques, however, the process of nonsurgical foreskin restoration may take several years to complete. The time required depends on the amount of [[skin ]] available to expand, the amount of skin desired in the end, and the regimen of [[stretching ]] methods used. Patience and dedication are needed; support groups exist to help with these (see External links section). The act of [[stretching ]] the skin is often described informally as "tugging" in these groups, especially those on the Internet.
[[Intact]] men who would like to have a longer [[foreskin ]] may use these same techniques of [[tissue expansion]] to lengthen a short [[foreskin]]. Benefits include improved protection of the [[glans penis]], improved [[gliding action]], and improved physical appearance.
It is impossible to predict how long it will take one to restore because there are many variables. The time is measured in years, but the time to enjoy one’s restored foreskin is measured in decades.
|accessdate=
|note=
}}</ref> cannot be recreated. Restored foreskins can appear much looser at the tip and some men report difficulty in keeping the [[glans ]] covered. Surgical "touch-up" procedures exist to reduce the orifice of the restored foreskin, recreating the tightening function of the band of muscle fibers near the tip of the foreskin, though they have not proven successful in every case.<ref name=Joy-touchup>{{REFbook
|last=Bigelow
|first=Jim
As the [[shaft skin]] expands and gets longer the [[circumcision scar]] will travel down toward the tip and eventually turn under and be concealed inside the restored foreskin.
When the [[glans penis]] is habitually covered by the regrown foreskin, the increase in protection, plus moisture and oil from [[transudation]] provided by the new [[foreskin ]] will result in [[Keratinization#De-keratinization_treatment| de-keratinization]] of the [[glans penis]] and increase in sensation.
== Surgical techniques ==
}}</ref> Such techniques are costly, and have the potential to produce unsatisfactory results or serious complications related to the skin graft.
British Columbia resident [[Paul Tinari]] was held down and [[circumcised ]] at eight years old, in what he stated was "a routine form of punishment" for [[masturbation]] at [https://www.thecanadianencyclopedia.ca/en/article/metis-experiences-at-residential-school residential schools]. Following a lawsuit, Tinari's surgical foreskin restoration was covered by the British Columbia Ministry of Health. The plastic surgeon who performed the restoration was the first in [[Canada ]] to have done such an operation, and used a technique similar to that described above.<ref name="Tyee article">{{REFjournal
|last=Euringer
|first=Amanda
The natural foreskin has three principal components, in addition to blood vessels, nerves and connective tissue: [[skin]], which is exposed exteriorely; [[mucosa]], which is the inside surface in contact with the [[glans penis]] when the [[penis]] is flaccid; and a layer of [[Dartos| muscle]] fibers under the foreskin. The [[ridged band]] is just inside the tip of the [[foreskin]].
Generally, the skin grows more readily in response to [[stretching ]] than does the mucous membrane. The ring of muscle which normally holds the foreskin closed is completely removed in the majority of circumcisions and cannot be regrown, so the covering resulting from [[stretching ]] techniques is usually looser than that of a natural foreskin. According to some observers it is difficult to distinguish a restored foreskin from a natural foreskin because restoration produces a "nearly normal-appearing prepuce."<ref name="Goodwin">{{REFjournal
|last=Goodwin
|first=Willard E.
==Generally recognized benefits of foreskin restoration==
# ''An end to tight and painful [[erection]]s''. Increasing the quantity of skin results in longer skin and less tension when the [[penis ]] is erect.
# ''Gliding mechanism'': the [[gliding action]] is beneficial because it facilitates [[masturbation]] and sex by reducing friction and providing a stimulating sheath that pleasurably slips back and forth over the [[glans]], thereby decreasing the need for artificial lubrication. This provides for more enjoyable intercourse for both partners and avoids problems with vaginal dryness.<ref name="warren1994">{{REFjournal
|last=Warren
|accessdate=2021-05-13
}}
</ref> The motion of the [[penile skin]] by the [[gliding action]] stimulates the [[Meissner's corpuscles| nerves in the skin]] which are sensitive to motion and [[stretching]].# ''Moist glans penis'': A restored foreskin keeps the [[glans penis ]] moist and oily by [[transudation]] in the same manner as a natural [[foreskin]].# ''Appearing and Feeling whole'': The [[circumcision scar]] has turned under the restored foreskin and is invisible. The presence of the restored foreskin causes one to look and feel [[intact]], whole, complete, and normal.# ''Coverage of the glans'': this is beneficial because (a) it protects the [[glans ]] from uncomfortably rubbing up against things, and (b) by keeping the glans moist and protected, it leads to [[dekeratinization]], which subsequently increases sensation.# ''More sensation'': It is true that non-surgical foreskin restoration cannot restore the [[ridged band]] or the [[frenulum]], but a restored foreskin does have some nerves in it. Those nerves are stimulated by the [[Gliding action| gliding]] of the foreskin, so it is quite pleasurable to have a restored foreskin. Some men who were [[circumcised ]] as adults and subsequently restored have estimated that they got back about 80 percent of what they had lost in sensation.
# ''Increased comfort'': The head of one's [[penis]] is protected by [[foreskin]] as nature intended.
# ''Decreased'' [[keratinization]] of the [[glans penis]].
== Emotional, psychological, and psychiatric benefits ==
Foreskin restoration has been reported as having beneficial emotional results in some [[circumcised]] men.<ref name="Greer"/><ref name="Goodwin"/><ref name="Penn">{{REFjournal
|last=Penn
|first=Jack
|date=1963
|accessdate=2019-09-29
}}</ref><ref name="Boyle">{{BoyleGJ GoldmanR SvobodaJS FernandezE 2002}}</ref> Watson & Golden (2017) recommend non-surgical foreskin restoration as a treatment for negative feelings in some many adult men about their involuntary infant [[circumcision]].<ref name="watson2017">{{REFjournal
|last=Watson
|first=Lindsay R.
== Foreskin coverage indexes ==
In an effort to provide men partaking in foreskin restoration a reference to the extent of their circumcision skin loss, various foreskin coverage indexes have been created. Coverage indexes may be used by both [[circumcised ]] and [[intact ]] men to describe the extent of their coverage. All three systems are in use.
===Original coverage index===
Books, websites and numerous articles have been published about foreskin restoration. See our compiled list of [[literature about foreskin restoration]].
== Regeneration of the foreskin ==
Recently [[Foreskin regeneration| there has been growing interest in regenerative medicine ]] as a means to regenerate the human male [[foreskin]]. This is a completely different process from foreskin restoration by [[tissue expansion]] as described above. This option, unlike non-surgical foreskin restoration, would result in a true human male foreskin being regrown.
In early 2010, [[Foregen]], a non-profit organization dedicated to funding a clinical trial for the purposes of regrowing the human male foreskin, had been founded. A clinical trial had been scheduled for late 2010, but there were insufficient donations to follow through.<ref>{{REFweb
}}</ref>
The proposed method would involve placing the patient under general anesthesia. The [[penile skin]] would be opened at the [[circumcision scar]], while the scar tissue is surgically debrided. A biomedical solution would then be applied to both ends of the wound, causing the foreskin to regenerate with the DNA in the patient's own cells. A biodegradable scaffold would be used to offer support for the regenerating foreskin.<ref>{{REFweb
|title=Clinical Regen Trial
|url=http://www.foregen.org/projects/
}}</ref>
Foreskin regeneration is only theoretical as of 20222024. No foreskin has ever been regenerated. There is no assurance that foreskin regeneration would actually be successful, if attempted.
[[Foregen]] has had announced its desire to conduct trials on human volunteers in April 2023, but it has not yet happened.<ref>{{REFweb
|url=https://www.foregen.org/research
|title=Research
== Conclusion ==
Timmermans et al. (2021) report reported that "non-surgical foreskin restoration methods yield good results."<ref name="timmermans2021">{{REFjournal
|last=Timmermans
|first=
|url=https://www.researchgate.net/profile/Floyd-Timmermans/publication/350881409_A_review_on_the_history_of_and_treatment_options_for_foreskin_reconstruction_after_circumcision/links/607d5ae9881fa114b41189e1/A-review-on-the-history-of-and-treatment-options-for-foreskin-reconstruction-after-circumcision.pdf
|archived=
|quote=Nonsurgical methods of reconstruction are rarely mentioned in literature. Nonetheless, nonsurgical methods, such as manual [[stretching ]] and device-assisted tissue expansion, are commonplace among those who pursue foreskin reconstruction. Although the nonsurgical methods have yielded good results with minimal adverse effects, no proper medical research has been performed to quantify these outcomes.
|pubmedID=33854205
|pubmedCID=
* [[Epispasm]]
* [[Foreskin]]
* [[Foreskin Restoration - video]]
* [[Gliding action]]
* [[Literature about foreskin restoration]]
* [[Psychological issues of male circumcision]]
* [[Restoration]]
* [[RestoringMan]]
* [[Ridged band]]
* [[Surgical foreskin restoration]]
* [http://www.norm.org NORM - National Organization of Restoring Men (U.S.)]
* [http://www.cirp.org/pages/restore.html CIRP Foreskin restoration for circumcised males]
* {{REFweb
|url=http://www.savingsons.org/2009/10/foreskin-restoration.html
|title=Foreskin restoration
|publisher=Saving Our Sons
|accessdate=2023-12-17
}}
* [https://foreskinrestoration.men/ Foreskin restoration information website]
* [https://drive.google.com/file/d/1_eBZN-MBow5XrMIN_PdM4JPU4nFqMrtp/view Benefits of Foreskin Restoration]
|date=
|accessdate=2022-11-30
}}
* {{REFweb
|url=https://drive.google.com/file/d/1jFXHq45OB8Jbu176xHeD6tCkW8nY23ti/view
|title=Foreskin Restoration
|last=Anonymous
|first=
|init=
|publisher=Google
|date=
|accessdate=2023-05-25
}}
* {{REFweb
|accessdate=2021-06-15
}}
* {{{REFweb
|url=https://drive.google.com/file/d/1jFXHq45OB8Jbu176xHeD6tCkW8nY23ti/view
|title=Foreskin Restoration
|date=1996-06-25
|accessdate=2020-06-23
|quote=Foreskin restoration is a slow process of [[stretching ]] the [[penile skin]] over the naked glans, and can take several years. Many men, however, report an improvement in comfort and sensitivity after only a couple of weeks.
}}
* {{REFweb