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The founder of modern plastic surgery, Johann Friedrich Dieffenbach (1795-1847, Berlin), dedicated a whole chapter in both of his surgical textbooks, from 1829 and 1845, on the problem of how to restore the [[Foreskin| prepuce]]. He entitled this operation "posthioplastice".<ref name="schultheiss1998" /> After recapitulating Celsus methods, he offered technical improvements to prevent postoperative failure.

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" />

According to the literature, there were Polish doctors who devised hasty, crude surgical techniques to help Jews in occupied areas of Europe avoid detection. Some of these procedures were surprisingly reminiscent of those described by Celsus nearly 2000 years earlier. There is no evidence that any of these methods was continued after the collapse of the Nazi regime.<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 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" />

}}</ref> His article and the ones of the following years failed to give detailed information on the patient's motivation, and the authors were to a certain extent criticized for performing such a procedure at all. Penn from Johannesburg, after performing a proximal circular incision and pulling forward the [[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" />

In 1981, [[Paul C. Mohl]] presented the first detailed analysis of psychiatric aspects in a group of eight patients seeking prepuce restoration . He described several psychological disorders in these patients as narcissistic and exhibitionistic body image, depressions, major defects in early mothering, and ego pathology. Nowadays the understanding of the psychological motivations for uncircumcision is increasing, and the problem is dealt with more seriously.<ref name="watson2017" />

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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" />