Foreskin restoration#History

Image:Foreskin Restoration in general.jpg

Foreskin restoration or foreskin reconstruction refers to the process of recreating the foreskin of the penis, which has been removed by circumcision or injury. Foreskin restoration is primarily accomplished by stretching the residual skin of the penis, but surgical methods also exist. Restoration creates a facsimile of the foreskin, but specialized tissues removed during circumcision cannot be reclaimed. Some forms of restoration involve only partial regeneration in instances of a high-cut wherein the circumcisee feels that the circumciser removed too much skin and that there is not enough skin for erections to be comfortable.{{cite journal | vauthors = Lerman SE, Liao JC | title = Neonatal circumcision | journal = Pediatric Clinics of North America | volume = 48 | issue = 6 | pages = 1539–57 | date = December 2001 | pmid = 11732129 | doi = 10.1016/s0031-3955(05)70390-4 }}

History

In the Greco-Roman world, uncircumcised genitals, including the foreskin, were considered a sign of beauty, civility, and masculinity.{{Cquote|Circumcised barbarians, along with any others who revealed the glans penis, were the butt of ribald humor. For Greek art portrays the foreskin, often drawn in meticulous detail, as an emblem of male beauty; and children with congenitally short foreskins were sometimes subjected to a treatment, known as epispasm, that was aimed at elongation.|author=Jacob Neusner|source=Approaches to Ancient Judaism, New Series: Religious and Theological Studies (1993), p. 149, Scholars Press.}} In Classical Greek and Roman societies (8th century BC to 6th century AD), exposure of the glans was considered disgusting and improper, and did not conform to the Hellenistic ideal of gymnastic nudity. Men with short foreskins would wear the kynodesme to prevent exposure.{{cite journal | vauthors = Hodges FM | title = The ideal prepuce in ancient Greece and Rome: male genital aesthetics and their relation to lipodermos, circumcision, foreskin restoration, and the kynodesme | journal = Bulletin of the History of Medicine | volume = 75 | issue = 3 | pages = 375–405 | year = 2001 | pmid = 11568485 | doi = 10.1353/bhm.2001.0119 | publisher = Johns Hopkins University Press | s2cid = 29580193 }} As a consequence of this social stigma, an early form of foreskin restoration known as epispasm was practiced among some Jews in Ancient Rome (8th century BC to 5th century AD).{{cite journal | vauthors = Rubin JP | title = Celsus' decircumcision operation: medical and historical implications | journal = Urology | volume = 16 | issue = 1 | pages = 121–4 | date = July 1980 | pmid = 6994325 | doi = 10.1016/0090-4295(80)90354-4 }}

Foreskin restoration is of ancient origin and dates back to the Alexandrian Empire (333 BC). Hellenized Jews stopped circumcising their sons to avoid persecution and so they could participate in the gymnasium. Some Jews at this time attempted to restore their foreskins, which caused conflict within Second Temple Judaism, some Jews viewed circumcision as an essential part of the Jewish identity (1 Maccabees 1:15).Barry, John D., David Bomar, Derek R. Brown, Rachel Klippenstein, Douglas Mangum, Carrie Sinclair Wolcott, Lazarus Wentz, Elliot Ritzema, and Wendy Widder, eds. The Lexham Bible Dictionary. Bellingham, WA: Lexham Press, 2016. Following the death of Alexander, Judea and the Levant was part of the Seleucid Empire under Antiochus Epiphanes (175-164 BC). Antiochus outlawed the Jewish practice of circumcision, both 1st and 2nd Maccabees records Jewish mothers being put to death for circumcising their sons (1:60-61 and 6:10 respectively).Aymer, Margaret. “Acts of the Apostles.” In Women’s Bible Commentary, edited by Carol A. Newsom, Jacqueline E. Lapsley, and Sharon H. Ringe, Revised and Updated. Louisville, KY: Westminster John Knox Press, 2012. Some Jews during Antiochus' persecution sought to undo their circumcision.Kaiser, Walter C., Jr., Peter H. Davids, F. F. Bruce, and Manfred T. Brauch. Hard Sayings of the Bible. Downers Grove, IL: InterVarsity, 1996. Within the 1st century A.D., there was still some forms of foreskin restoration being sought after (1 Corinthians 7:18). During the third Jewish-Roman Wars (AD 132–135), the Romans had renamed Jerusalem as Aelia Capitolian and may have banned circumcision; however, Roman sources from the period only mention castration and say nothing about banning circumcision. According to rabbinic sources{{which|date=June 2025}}, during the Bar Kokhba revolt, Jews who had engaged in foreskin restoration were recircumcised (either voluntarily or by force).Ramos, Alex. “Bar Kokhba.” In The Lexham Bible Dictionary, edited by John D. Barry, David Bomar, Derek R. Brown, Rachel Klippenstein, Douglas Mangum, Carrie Sinclair Wolcott, Lazarus Wentz, Elliot Ritzema, and Wendy Widder. Bellingham, WA: Lexham Press, 2016.{{Better source needed|date=June 2025}} Again, during World War II, some European Jews sought foreskin restoration to avoid Nazi persecution.{{cite journal | vauthors = Tushmet L | title = Uncircumcision | journal = Medical Times | date = 1965 | volume = 93 | issue = 6 | pages = 588–93 | url = http://www.cirp.org/library/restoration/tushmet1/ | doi = | pmid = | pmc = | url-status = dead | archive-url = https://web.archive.org/web/20131023040652/http://www.cirp.org/library/restoration/tushmet1/ | archive-date = 2013-10-23 }}{{MEDRS|date=September 2016}}

Non-surgical techniques

= Tissue expansion =

Non-surgical foreskin restoration, accomplished through tissue expansion, is the more commonly used method.{{cite journal | vauthors = Collier R | title = Whole again: the practice of foreskin restoration | journal = CMAJ | volume = 183 | issue = 18 | pages = 2092–3 | date = December 2011 | pmid = 22083672 | pmc = 3255154 | doi = 10.1503/cmaj.109-4009 }}

Tissue expansion has long been known to stimulate mitosis, and research shows that regenerated human tissues have the attributes of the original tissue.{{cite journal| vauthors = Cordes S, Calhoun KH, Quinn FB |title=Tissue Expanders |journal=University of Texas Medical Branch Department of Otolaryngology Grand Rounds |date=1997-10-15 |url=http://www.utmb.edu/otoref/Grnds/tissue-expand.html |url-status=dead |archive-url=https://web.archive.org/web/20041011191210/http://www.utmb.edu/otoref/Grnds/tissue-expand.html |archive-date=2004-10-11 }}

== Methods and devices ==

During restoration via tissue expansion, the remaining penile skin is pulled forward over the glans, and tension is maintained either manually or through the aid of a foreskin restoration device.{{Cite journal |last=Goodwin |first=Willard E. |date=1990-11-01 |title=Uncircumcision: A Technique for Plastic Reconstruction of a Prepuce after Circumcision |url=https://www.auajournals.org/doi/10.1016/S0022-5347(17)39693-3 |journal=Journal of Urology |volume=144 |issue=5 |pages=1203–1205 |doi=10.1016/S0022-5347(17)39693-3|pmid=2231896 |url-access=subscription }}

Image:Dual_Tension_Restorer_(DTR)_applied.jpg|Dual tension restorer applied to a circumcised penis for non-surgical foreskin restoration

Image:T-tape_with_a_leg_strap.jpg|T-tape with a leg strap

Image:Foreskin_restoration_device.png|Silicone device with a one-way valve that allows air to be pumped to inflate and expand the foreskin

Image:Tugahoy1.jpg|Application of a typical restoration device, the TugAhoy, called a 'Chinese puzzle' by its inventor

Surgical techniques

= Foreskin reconstruction =

Surgical methods of foreskin restoration, known as foreskin reconstruction, usually involve a method of grafting skin onto the distal portion of the penile shaft. The grafted skin is typically taken from the scrotum, which contains the same smooth muscle (known as dartos fascia) as does the skin of the penis. One method involves a four-stage procedure in which the penile shaft is buried in the scrotum for a period of time.{{cite journal | vauthors = Greer Jr DM, Mohl PC, Sheley KA |title=A technique for foreskin reconstruction and some preliminary results |journal=The Journal of Sex Research |volume=18 |issue=4 |year=2010 |pages=324–30 |jstor=3812166 |doi=10.1080/00224498209551158 }}

Results

= Physical aspects =

Image:After4yearsRestoring.jpg]]

Restoration creates a facsimile of the prepuce, but specialized tissues removed during circumcision cannot be reclaimed.{{medical citation needed|date=December 2020}} Surgical procedures exist to reduce the size of the opening once restoration is complete (as depicted in the image above),{{cite book | vauthors = Griffith RW | chapter = Finishing Touches to the Foreskin | veditors = Bigelow J| title=The Joy of Uncircumcising! | year=1992 | pages=[https://archive.org/details/joyofuncircumcis0000bige/page/188 188–192] | publisher = Hourglass Book Pub. | edition=1998 | isbn=0-9630482-1-X | chapter-url=https://archive.org/details/joyofuncircumcis0000bige/page/188 }} or it can be alleviated through a longer commitment to the skin expansion regime to allow more skin to collect at the tip.{{Cite journal |last1=Brandes |first1=S.B. |last2=McAninch |first2=J.W. |date=2002-05-27 |title=Surgical methods of restoring the prepuce: a critical review |url=http://dx.doi.org/10.1046/j.1464-410x.1999.0830s1109.x |journal=BJU International |volume=83 |issue=S1 |pages=109–113 |doi=10.1046/j.1464-410x.1999.0830s1109.x |pmid=10349422 |s2cid=37867161 |issn=1464-4096|url-access=subscription }}

The natural foreskin is composed of smooth dartos muscle tissue (called the peripenic muscle{{cite journal | vauthors = Jefferson G |title=The peripenic muscle: some observations on the anatomy of phimosis |journal=Surgery, Gynecology & Obstetrics |volume=23 |issue= |year=1916 |pages=177–81}}), large blood vessels, extensive innervation, outer skin, and inner mucosa.{{cite journal | vauthors = Cold CJ, Taylor JR | title = The prepuce | journal = BJU International | volume = 83 | issue = Suppl 1 | pages = 34–44 | date = January 1999 | pmid = 10349413 | doi = 10.1046/j.1464-410x.1999.0830s1034.x | s2cid = 30559310 | doi-access = free }}

The process of foreskin restoration seeks to regenerate some of the tissue removed by circumcision, as well as provide coverage of the glans. According to research, the foreskin comprises over half of the skin and mucosa of the human penis.{{cite journal | vauthors = Taylor JR, Lockwood AP, Taylor AJ | title = The prepuce: specialized mucosa of the penis and its loss to circumcision | journal = British Journal of Urology | volume = 77 | issue = 2 | pages = 291–5 | date = February 1996 | pmid = 8800902 | doi = 10.1046/j.1464-410X.1996.85023.x }}

In a survey of foreskin restorers (the results of which were published in March 2023), 69 percent of respondents reported increased sexual pleasure and 25 percent reported improved relationships.{{cite journal | vauthors = Hammond T, Sardi LM, Jellison WA, McAllister R, Snyder B, ((Fahmy MAB)) | title = Foreskin restorers: insights into motivations, successes, challenges, and experiences with medical and mental health professionals – An abridged summary of key findings. | journal = International Journal of Impotence Research | pages = 309–322 | date = May 2023 | volume = 35 | issue = 3 | pmid = 36997741 | doi = 10.1038/s41443-023-00686-5 }}

File:Circumcised, Foreskin Restoration and Uncircumcised Compared.png

Organizations

Various groups have been founded since the late 20th century, especially in North America where circumcision has been routinely performed on infants. In 1989, the National Organization of Restoring Men (NORM) was founded as a non-profit support group for men undertaking foreskin restoration. In 1991, the group UNCircumcising Information and Resource Centers (UNCIRC) was formed,{{cite journal | vauthors= Bigelow J | title= Uncircumcising: undoing the effects of an ancient practice in a modern world | journal= Mothering | date = Summer 1994 | volume= | issue= | pages= 36–60 | url= http://www.cirp.org/library/restoration/bigelow1/ | doi= | pmid= | pmc= }} which was incorporated into NORM in 1994.{{cite web | vauthors = Griffiths RW | title = NORM - History | url = http://www.norm.org/history.html | access-date = 2006-08-21 }} NORM chapters have been founded throughout the United States, as well as in Canada, the United Kingdom, Australia, New Zealand, and Germany. In France, there are two associations about this. The "Association contre la Mutilation des Enfants" AME (association against child mutilation), and more recently "Droit au Corps" (right to the body).{{cite web | work = Droit au Corps | title=Qui sommes-nous? | url=http://www.droitaucorps.com/droit-au-corps-presentation | date= 14 May 2013| access-date=29 August 2017}}