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Male circumcision is not a precise operation. There are few, if any, guidelines to direct the surgeon on how much skin should be removed. The surgeon has to guess at how much skin should be removed. If excessive skin is removed, the patient will have tight, painful erections. In extreme cases, there may be insufficient skin to allow the shaft of the penis to expand to its full length. Taylor et al. (1996) said "[s]kin and mucosa sufficient to cover the penile shaft was frequently missing from the circumcised penis." They reported "an estimated shortfall in shaft skin of 20-25%."<ref>{{TaylorJR LockwoodAP TaylorAJ 1996}}</ref>
[[Tissue expansion]] has been found to be effective in relieving erection pain and to allow in allowing full expansionof the [[penis]]. Tissue expansion is accomplished by the patient through manual [[stretching]].
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