whole again

Restoring the foreskin

Canadian Medical Association Journal

Wayne Griffiths was standing in the doorway of an associate’s office one day in the spring of 1991 when he felt the tape on his penis come undone. The 7-ounce weight that had been attached to the tape slid down a pant leg and hit the floor. Griffiths quickly stooped and picked up the weight, shoving it in his pocket. His associate asked if something was wrong. No, he had merely dropped something, Griffiths assured him.

It is understandable why Griffiths didn’t go into greater detail about what that something was. After all, it would only have raised more questions if he had told his associate that a device of his own making, a small dumbbell he calls Foreballs, consisting of two ball bearings joined by a stainless steel rod, was attached to his penis to stretch his foreskin. Well, at least it had been attached before the tape gave way.

restore

Griffiths is the founder and executive director of the National Organization of Restoring Men, or NORM for short, a group that helps circumcised men restore their foreskins. The organization was launched in San Francisco, California, in 1993 and now has members across the United States and in other countries, including Canada, Australia and the United Kingdom. Some men, including Griffiths, restore their prepuce to improve their sex lives, hoping the glans of their penises will become more sensitive once it is covered. Others do it for emotional reasons, wanting to get back what they believe was wrongly taken from them as infants.

“A good portion of them are extremely angry at doctors and hospitals and their parents,” Griffiths says.

He does not include himself in the latter group. Born in San Francisco in 1933, Griffiths was circumcised just as his father and older brother were before him, and he holds no ill will toward his parents. Even his own sons are circumcised. It wasn’t until he was 56 years old that he began stretching his foreskin, hoping it would remedy the decline in physical enjoyment he was experiencing during sex.

Before he created Foreballs, Griffiths used tape to attach two stainless steel ball bearings to the skin on his penis, allowing gravity to do its work. He wore the weight under his blue jeans at his job as a construction inspector. Eventually, he had enough loose skin to not only cover the glans of his penis when flaccid, but to overhang it by three-quarters of an inch. And it did indeed increase both the sensitivity of the glans and his enjoyment of sex, he says.

Other men have reported similar benefits, physically and emotionally, from restoring their foreskins. Still, the medical community has mostly dismissed such men when they seek the help of physicians, says Griffiths. “Most doctors tell people who want to restore their foreskins to go see psychiatrists.”

Historically, men have sought to restore their foreskins not for health or sexual reasons, but rather, for fear of religious persecution. In his paper “Uncircumcision: A historical review of preputial restoration,” German urologist Dr. Dirk Schultheiss details the history of the practice, which has been around almost as long as circumcision (Plast Reconstr Surg 1998;101:1990–8).

Throughout history, there have been many eras in which Jewish people were persecuted and during those times, circumcised men sometimes attempted to restore their foreskins to avoid harm. In Biblical times, for instance, the practice was popular with circumcised men who participated in athletic events or frequented public baths, both of which required public nudity. There were even times when ruling powers outlawed circumcision, prompting some who had already been cut to seek restoration in hopes of avoiding stigma or improving their social and economic positions.

There are also reports of circumcised men undergoing surgery to regain their prepuce in Germany during Nazi rule, even if they weren’t Jewish, according to Schultheiss’ paper: “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.”

In the modern era, uncircumcision has gained popularity only in the last few decades, mostly in the US. Today, some men do it for sexual reasons, though the nerves lost during circumcision cannot be regenerated. Others do it to achieve emotional wholeness, believing they are victims of genital mutilation. “Many patients really become fixated on this problem,” Schultheiss writes in an email.

Health professionals are getting better at validating and treating the emotional problems sometimes experienced by circumcised men, Schultheiss noted in his paper. “Nowadays the understanding of the psychological motivations for uncircumcision is increasing, and the problem is dealt with more seriously.”

There have always been two means by which men could restore their foreskins: skin expansion or surgery. An early mention of a surgery for “decircumcision” was made by a Roman medical writer named Aulus Cornelius Celsus in the year 50 AD. Many centuries later, Dr. Johann Friedrich Dieffenbach, a German surgeon and pioneer in reconstructive surgery, described operations to restore the prepuce in two of his textbooks, published in 1820 and 1845.

Surgical methods, however, are not very popular today. They require the transplanting of skin, and the new foreskin often differs from the original penile skin in colour and texture. “Most results are cosmetically unsatisfactory,” Schultheiss writes in an email.

Because the results are often disappointing and the procedure itself rather complicated, few doctors perform it, says Dr. Stephen Giunta, a leading US surgeon in the field of phalloplasty (cosmetic surgery on the penis). During the past two decades, Giunta has performed thousand of procedures to enlarge penises but does not offer foreskin restoration, instead recommending hanging-weight techniques to patients who request it.

“There is quite a bit of interest in it, more than you would expect, especially on the west coast of this country, though I rarely get a request for it and don’t do the surgery,” says Giunta, who practises in Alexandria, Virginia.

Patients seeking foreskin restoration surgery may be in for a long search. The procedure remains outside the periphery of mainstream medicine, which is no surprise, says Giunta, because the entire field of genital cosmetic surgery is only now getting recognized.

“We remain a small number, those of us doing it, and mainstream medical societies are now just beginning to accept it,” he says.

Even physicians who do offer foreskin restoration tend to be selective in who they perform it on, mainly because it involves at least two procedures and a lengthy healing period.

“Before I retired, I performed 3 of these complex procedures on specially selected patients,” Dr. Robert Stubbs, a former phalloplasty surgeon in Ontario, writes in an email. Stubbs, who became Canada’s leading penis-lengthening surgeon after learning the technique pioneered in China by a physician whose name was Dr. Long, added that the two-stage restoration procedure he created required a “dedicated patient who prepared to undergo two surgeries and all the follow-up. Healthy and realistic were the two most important pre-requisites.”

Nonsurgical procedures, though time consuming, are more common. They generally involve tape, elastic, weights or some other means of creating tension to stretch the skin on the penis. The National Organization of Restoring Men advises such a slow but safe approach called “A successful restoration regimen” (www.norm.org/regimen.html). It involves wearing a stretching device during the day for four to eight hours and recommends removal if the wearer feels constriction or pain. The device should not be worn at night, so as to allow time for “the shaft tissue (derma and muscle) to perform mitosis and grow additional cells.” The organization also discourages restoration seekers from seeking to speed up the process, which can take several years, by using excessively heavy weights.

“Damage to the tissue and a much longer healing time are the results of excessive tension,” the program states. “As well, it is simply not necessary and will not speed up the process.”

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