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'''Tissue expansion''' is a technique used by plastic, maxillofacial, and reconstructive surgeons to cause the body to grow additional [[skin]], bone, or other tissues. <ref name="whyitworks2021">{{REFweb |url=https://www.phimostretch.com/blogs/news/phimosis-stretching-why-it-works |title=Phimosis -Why stretching totally works (Science explained) -Phimostretch |last= |first= |date=2021 |accessdate=2021-07-28}}</ref> Other biological phenomena such as tissue inflammation can also be considered expansion.

==Skin expansion==Skin expansion is a common surgical procedure to grow extra skin through controlled mechanical overstretch. It creates skin that matches the color, texture, and thickness of the surrounding tissue, while minimizing scars and risk of rejection.

When [[Skin]] expansion is a common surgical procedure to grow additional [[skin is stretched beyond its physiological limit, mechanotransduction pathways are activated]] through controlled mechanical overstretch. This leads to cell growth as well as to the <ref name="whyitworks2021" /> It creates [[Mitosis| formation of new cellsskin]]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" /> 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, but will contract to some degree when California |publisher=Hourglass Book Publishing |ISBN=0-934061-22-X |quote=The gain in sensitivity is the tension is removedfirst and most consistent benefit of restoration. |accessdate=2023-08-15 |note=}}</ref>

[[Stretching]] the [[skin ]] beyond normal expansion invokes several mechanotransduction pathways which increase [[mitosis| mitotic]] activity and promote collagen synthesis. <ref name="whyitworks2021" /> As a result, the [[skin ]] surface area increases.<ref>{{REFjournal

== Applications == ===Relief of phimosis or tight foreskin=== Tissue expansion by manual [[stretching ]] effectively widens the [[foreskin]] to treat [[phimosis]] or [[paraphimosis]].<ref>{{REFjournal

}}</ref> <refname="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

====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.

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"/>{{REFjournal |last=Beaugé |init=Michel |author-link= |last2= |init2= |author2-link= |url=http://www.cirp.org/library/treatment/phimosis/beauge2/ |title=The causes traditional way of adolescent phimosis addressing this issue was to consult a [[Issues with American urologists and the practice of male circumcision|journal=Br J Sex Med urologist]] and get a [[Adolescent and adult circumcision|date=1997 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|volume= |issue=September/October |pages=26 |accessdate=2021-04-21}}</ref> circumcision]].

===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

Non-surgical tissue expansion techniques can expand one's surviving [[penile skin]], making it a longer tube so it can function like a [[foreskin]].<ref name="collier2011">{{REFjournal

}}</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

|first=Tim |init=T |author-link=Tim Hammond

|website=[[NOHARMM]]

|format= |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

|trans-title= |language= |last= |first= |publisher= |website=Circumcision Information and Resource Pages[[CIRP]]

===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]].

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 [[=== Excessive circumcision]]. They may also experience tight, painful erections. In such cases, tissue expansion may help to get full length and relieve pain during erection.===

===Short natural foreskins===Intact men Men who have a short natural been [[foreskincircumcised]] may use tissue expansion sometimes report that there is not enough [[skin]] left to lengthen their allow full [[erection]] of the [[penis]], so the [[foreskinpenis]] is shorter than before [[circumcision]]. It frequently results in They may also experience tight, painful [http://acroposthion[erection]]s.com/ancient-greeks-and-the-foreskin/ improved appearance] as well as increased comfort In such cases, tissue expansion may help to get full length and sensation with improved relieve pain during [[gliding actionerection]]. One uses the same techniques as used for for non-surgical foreskin restoration.

* {{REFweb* [ |url=http://phimosisjourneyacroposthion.com/ A Phimosis Journey]the-tip-at-the-end/ |title=The ‘Tip’ At The End |publisher=Acroposthion |date= |accessdate=2023-01-15}}* [http{{REFjournal |last=Zöllner |first=Alexander |init= |author-link= |last2=Tepole |first2=Adrian Buganza |init2= |author2-link= |last3=Kuhl |first3=Ellen |init3= |author3-link= |etal=no |title=On the biomechanics and mechanobiology of growing skin |trans-title= |language= |journal= J Theor Biol. |location= |date=2012-03 |season= |volume=296 |issue= |article= |page= |pages=166-175 |url=https://willywellbeingwww.comncbi.nlm.nih.gov/pmc/articles/forumsPMC3278515/forum |archived= |quote= |pubmedID=22227432 |pubmedCID=3278515 |DOI=10.1016/phimosisj.jtbi.2011.12.022 |accessdate=2022-frenulum08-breve24}}* {{REFjournal |last=Razzak |first= |init=MA |author-circumcisionlink= |last2=Hossain |first2= |init2=MS |author2-foreskinlink= |last3=Radz |first3= |init3=ZB |author3-retractionlink= |last4=Radz |first4= |init4=MA |author4-link= |last5=Czernuszka |first5= |init5=J |author5-link= |last6=Rahman |first6= |init6=MT |author6-link= |etal=no |title=Cellular and Molecular Responses to Mechanical Expansion of Tissue |trans-title= |language= |journal=Front. Physiol |location= |date=2016-11-15 |season= |volume=7 |issue= |article= |page=540 |pages= |url=https://www.frontiersin.org/articles/10.3389/fphys.2016.00540/ full |archived= |quote= |pubmedID=27899897 |pubmedCID=5111402 |DOI=10.3389/fphys.2016.00540. eCollection 201 |accessdate=2022-08-20}}* {{REFweb |url=http://phimosisjourney.com/ |title=A Phimosis, Frenulum breve, Circumcision, Foreskin retraction discussion forum]Journey |last= |first= |init= |publisher= |date= |accessdate=2023-12-24}}{{REF}}