Bryant Bedell, M.A.
Introduction
Male circumcision is the most commonly practiced surgery in the world today, affecting approximately 1 billion men worldwide.1 The human foreskin is a unique and specialized organ that is critical for normal sexual function, and its removal has serious negative consequences on sexual health. Fortunately, much of the damage caused by circumcision can be reversed through a process called foreskin restoration, where the remaining skin of the penis is expanded through gentle tension to recreate a new foreskin.
The Foreskin
All male mammals have a foreskin, and its primary function is to protect the glans (head of the penis). The glans is an internal organ, and is meant to be kept in a protected, moist environment when flaccid. The inner part of the foreskin is a mucous membrane and immunological organ that secretes emollients, enzymes, pheromones, and has its own microbiome.2 In Homo sapiens, the foreskin has unique anatomical features that are not found in other primates. One of these features is that at some point during our evolution, the fine touch nerve endings, called Meissner’s corpuscles, migrated from the glans to the foreskin itself.3
While Meissner’s corpuscles are also found in the palms of the hand, soles of the feet, and the lips, the highest concentration is in a specialized structure of the foreskin called the ridged band.4 The ridged band is located just inside the tip of the foreskin at the mucocutaneous junction of the outer and inner foreskin. The frenulum, which anchors the foreskin to the underside of the glans, is also a highly innervated and erogenous area.5
Another unique feature of the human foreskin is its mechanical function. The ability of the foreskin to glide up and down the shaft of the penis serves several important functions during intercourse. The muscles of the vaginal wall grip the foreskin, and the penis glides in and out of its own skin, rather than the vagina itself. This reduces friction inside the vagina, creating a movable pressure sensation that is pleasurable for both the man and woman.6 The slack skin and reduced friction also prevents natural lubrication from being pulled out of the vagina.7
The Circumcised Penis
When the foreskin is removed, the glans is no longer protected from the external environment. The glans dries out from exposure to air, reducing sensitivity. Exposure to air and excess friction causes a layer of keratin to form over the glans, which creates a rough texture and reduces sensation even more.8 The remaining inner foreskin, now the area between the glans and the scar line, also dries out and loses sensitivity, and stops functioning as a mucous membrane.
The circumcised penis has little to no movable skin, with the skin being tight on the shaft when erect. In many cases, there is not enough skin to fully accommodate an erection, and can cause tightness, curvature of the shaft, pain, and bleeding.9 When there is not enough skin to fully accommodate an erection, part of the erectile tissue gets pushed back into the pelvis. Because of this, circumcised penises are on average 1 centimeter shorter in length than intact penises.10 The lack of slack skin also reduces the girth of the penis, particularly at the base of the glans where the foreskin normally bunches up.
With the lack of slack skin in the circumcised penis, there is little to no gliding motion during intercourse. This causes excessive friction and irritation on both the penis and walls of the vagina.11 The rough, dry, keratinized texture of the glans is also irritating inside the vagina. Without slack skin bunching behind the glans, it tends to scrape and remove lubrication from the vagina.12 In one survey, 60% of women were able to achieve vaginal orgasm from an intact partner, but only 30% from a circumcised partner.13
There are different estimates about how many nerve endings are removed during circumcision, but about half of the skin of the penis is removed, including the ridged band, and in most cases the frenulum.14 Part or all of the frenulum is sometimes left intact. The reduction of nerve endings reduces the overall sensitivity and sexual pleasure in the penis. To compensate for the lack of sensitivity, more friction is needed to achieve orgasm, compounding the issues due to friction stated above.15
Myths About Circumcision
Proponents of circumcision claim that it reduces the risk of sexually transmitted diseases (STD’s), yet the evidence just doesn’t hold up. The United States has both the highest percentage of circumcised males who are sexually active, and the highest rate of STD’s, genital cancers, and AIDS of any first world nation.16 In fact, it is hypothesized that the increased amount of friction during intercourse caused by circumcision is more likely to induce tearing of mucosal barriers and bleeding, leading to an increased risk of sexually acquired diseases.17 Regardless, these diseases are largely preventable through safe sex practices.
Foreskin Restoration
Non-surgical foreskin restoration is the process of expanding the remaining skin of a circumcised penis by applying gentle mechanical tension. Over time, a new tube of skin can be grown that looks and functions much like a natural, intact foreskin. Foreskin restoration has been practiced for over 2,000 years, dating back to the time of Alexander the Great. In Greek culture, men competed in athletics nude, and it was considered barbaric for a man to have his glans exposed. Men who were either circumcised or had a naturally short foreskin would wear a kynodesme, which is a small string that would hold the penis skin over the glans.18 Over time, men noticed that the tension from the kynodesme actually caused the skin to lengthen, to the point where it would naturally cover the glans on its own and appear intact. This later led to men using stone hanging weights to restore their foreskin.
Men restoring their foreskin today use the same process, though with a little more advanced equipment. The skin is gripped with either medical tape or a silicone foreskin restoration device (a list of device manufacturers can be found at restoring-man.com/devices). Tension is then attached using measured weights, or more commonly an elastic strap that is anchored to a leg or around the waist. This applies a gentle tension to the remaining penis skin, typically between 8 and 16 ounces. Gentle tension can be worn all day hidden under the pants and does not interfere with everyday life. Restoring at night while sleeping is not recommended due to the risk of injury from nocturnal erections.
As the amount of skin removed during circumcision can vary widely from person to person, so does the amount of skin that needs to be grown to where it can recover the glans. Foreskin restoration is a slow process, and one can expect to grow 1 to 2 mm of skin length per month. At this rate, it typically takes anywhere from 2 to 5 years to complete foreskin restoration. It is never too late to start, and men in their 70’s and 80’s have successfully restored their foreskin.
What Can Be Restored?
When enough skin is grown to recover the glans, it returns to its normal state. Once the glans is continuously protected in a moist environment, the layer of keratin sloughs off, and the glans once again becomes smooth and sensitive. The inner foreskin also resumes its function as a mucous membrane, creating lubricants and emollients that protect the glans and reduce friction during intercourse.
As more and more skin is grown, the gliding action of the penis is restored.19 Improvements in gliding action can be felt early on in restoration, even in as little as a few months. Tightness and pain from the lack of skin to accommodate an erection will also improve early on in the restoration process. It is also not uncommon to gain about 1 centimeter of length as the new slack skin allows for the full protrusion of the erectile tissue. When enough skin is grown to bunch up behind the glans when erect, this also restores girth to the end of the penis. Although in most cases there is no frenulum left to anchor the skin to the underside of the glans, a fully restored foreskin has more or less the same gliding action as an intact foreskin.
The reason why it is called restoration and not regeneration is that a restored foreskin does not have all of the same structures as a natural foreskin. The ridged band and the frenulum do not grow back. However, the new skin will grow new nerve endings at the same density as the remaining skin it is expanded from. Men who have restored report that the newly grown skin is highly sensitive. More importantly, restoring the covering of the glans and the gliding motion significantly improves the sensitivity of the remaining nerve endings of the penis, greatly improving overall sensitivity and erotic sensation.
A fully restored foreskin looks very much like a natural foreskin.20 Many men who have restored have been able to fool a urologist into thinking they are intact. In a casual setting like a locker room, a restored foreskin is almost indistinguishable from a natural foreskin.
Men who were circumcised later in life as adults and later restored, typically report that a restored foreskin is anywhere from 70 to 90 percent as good as an intact foreskin in terms of sexual function. Although men who were circumcised at birth cannot compare to being intact, they still report great improvements in sexual function. Men commonly report that restoration is not only one of the best things they have done to improve their sexual fulfillment, but also their life as a whole.21 Although not a perfect solution, the majority of the sexual function that is lost from circumcision can be restored, making foreskin restoration a very worthwhile endeavor.
1. Polonsky J, Bailey R, Hankins C, Halperin D, Schmid G (2007). Male circumcision: global trends and determinants of prevalence, safety, and acceptability (PDF). Geneva: World Health Organization. ISBN 978-92-4-159616-9. OCLC 425961131. Archived (PDF) from the original on 22 December 2015.
2. Fleiss P, Hodges F, Van Howe RS. Immunological functions of the human prepuce. Sex Trans Inf 1998;74(5):364-7.
3. Cold CJ, McGrath KA. Anatomy and histology of the penile and clitoral prepuce in primates. In Male and Female Circumcision, Denniston GC, Hodges FM, Milos MF (eds.) Kluwer Academic/Plenum Publishers, New York, 1999.
4. J.R. Taylor, A.P. Lockwood and A.J. Taylor. The prepuce: Specialized mucosa of the penis and its loss to circumcision. British Journal of Urology, Volume 77, Pages 291-295, February 1996
5. McGrath, K. (2001). The Frenular Delta. In: Denniston, G.C., Hodges, F.M., Milos, M.F. (eds) Understanding Circumcision. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-3351-8_11
6. Taves D. The intromission function of the foreskin. Med Hypotheses 2002;59(2):180.
7. Bensley GA, Boyle GJ. Effect of male circumcision on female arousal and orgasm. N Z Med J 2003;116(1181):595-6.
8. C.J. Cold and J.R. Taylor. The Prepuce. British Journal of Urology, Volume 83, Suppl. 1: Pages 34-44, January 1999.
9. Pang MG, Kim DS. Extraordinarily high rates of male circumcision in South Korea: history and underlying causes. BJU Int 2002;89:48-54
10. Park JK, Doo AR, Kim JH, Park HS, Do JM, Choi H, Park SC, Kim MK, Jeong YB, Kim HJ, Kim YG, Shin YS. Prospective investigation of penile length with newborn male circumcision and second to fourth digit ratio. Can Urol Assoc J. 2016 Sep-Oct;10(9-10):E296-E299. doi: 10.5489/cuaj.3590. Epub 2016 Sep 13. PMID: 27695583; PMCID: PMC5028213.
11. O’Hara K, O’Hara J. The effect of male circumcision on the sexual enjoyment of the female partner. BJU Int 1999;83 Suppl 1, 79-84.
12. Bensley GA, Boyle GJ. Effect of male circumcision on female arousal and orgasm. N Z Med J 2003;116(1181):595-6.
13. O’Hara K, O’Hara J. The effect of male circumcision on the sexual enjoyment of the female partner. BJU Int 1999;83 Suppl 1, 79-84.
14. Park JK, Doo AR, Kim JH, Park HS, Do JM, Choi H, Park SC, Kim MK, Jeong YB, Kim HJ, Kim YG, Shin YS. Prospective investigation of penile length with newborn male circumcision and second to fourth digit ratio. Can Urol Assoc J. 2016 Sep-Oct;10(9-10):E296-E299. doi: 10.5489/cuaj.3590. Epub 2016 Sep 13. PMID: 27695583; PMCID: PMC5028213.
15. Jim Bigelow. The Joy of Uncircumcising! Restore Your Birthright and Maximize Sexual Pleasure. 2003. PDF.
16. Fleiss P, Hodges F, Van Howe RS. Immunological functions of the human prepuce. Sex Trans Inf 1998;74(5):364-7.
17. Fleiss P, Hodges F, Van Howe RS. Immunological functions of the human prepuce. Sex Trans Inf 1998;74(5):364-7.
18. Jim Bigelow. The Joy of Uncircumcising! Restore Your Birthright and Maximize Sexual Pleasure. 2003. PDF.
19. Jim Bigelow. The Joy of Uncircumcising! Restore Your Birthright and Maximize Sexual Pleasure. 2003. PDF.
20. Jim Bigelow. The Joy of Uncircumcising! Restore Your Birthright and Maximize Sexual Pleasure. 2003. PDF.
21. Jim Bigelow. Uncircumcising: Undoing the Effects of an Ancient Practice in a Modern World. Mothering, Pages 56-61, Summer 1994.
Published May 18, 2024
About the Author
Bryant Bedell graduated from Washington State University with a degree in Anthropology. He is the author of The Complete Guide to Foreskin Restoration and founder of restoring-man.com, a website dedicated to helping men restore their foreskin.