Why I don’t Recommend Surgical Foreskin Restoration
The biggest obstacle that makes men hesitant to start foreskin restoration is the time commitment. While the amount of active time commitment per day can be as little as 10-15 minutes, it usually takes 2-5 years to complete. The lack of instant results leads to some men asking about ways to surgically graft on a new foreskin. Although there are doctors who offer surgical foreskin restoration, I don’t recommend doing this for a variety of reasons.
1. Tissue Removal
If you are going to graft new skin onto the penis to create a new foreskin, it has to come from somewhere, and that somewhere is usually the scrotum. I don’t think I need to explain why taking a chunk of skin from your scrotum maybe isn’t the greatest idea. Another published technique involves removing all of the skin of the penis, and then sewing in it a forward position over the glans. However, this was done only for religious reasons. The participants only wanted their glans covered, and sexual functionality was not evaluated. Follow up photos showed pubic skin and hair pulled up onto the shaft, which makes sense since no actual skin was added.(1)
2. Lack of Sensitivity
Although no restoration method, can completely regrow all of the lost nerve endings, new nerve endings can be grown through skin expansion. When the inner mucosa is expanded through tension, new Meissner’s corpuscles are grown leading to increased fine-touch sensitivity. The scrotum does not have Meissner’s corpuscles, and so a foreskin created from grafted scrotal skin will not have the same fine-touch sensitivity that expanded foreskin does.
3. Lack of Mucous Membrane
When the inner mucosa is expanded enough to where it is once again an internal structure in contact with the glans, its function as a mucous membrane is restored. This mucous membrane creates emollients, pheromones, peptides, and most likely other substances that are yet to be recognized by science. Scrotal skin that is grafted on will be able to re-cover the glans and restore some of this function through trapping moisture, but it is not a mucous membrane and thus does not have the same functionality.
4. Aesthetics
Because surgical methods involve stitching on skin, the end result has a lot of scar tissue (not to mention the scar from removing skin from the scrotum). Surgically created foreskin ends up looking unnatural with prominent scars. Expanded foreskin gives a much more natural look that is often times almost indistinguishable from an intact foreskin, enough so that many men have fooled urologists. I won’t post any pictures here, but there are photos online of surgically created and expanded foreskin restorations if you want to compare.
5. Risks
Any surgery is always going to have some risks such as infection, necrosis, or failure of the graft to take. Skin expansion on the other hand is very safe as long as you follow the guidelines that I lay out in The Complete Guide to Foreskin Restoration. Injuries are possible with skin expansion, but these almost always happen from using extreme amounts of tension or using devices improperly.
Foragen
Foragen is a company that is developing a way to regenerate foreskin using a combination of cadaver material and autologous (one’s own) stem cells. Theoretically, this would result in a 100% regain in function, including regeneration of the ridged band and frenulum that is not possible through skin expansion. Currently they are conducting animal trial, and hope to soon start human trials, but it is unknown when, or if ever this procedure will be available.
Many men ask, “should I just wait for Foragen?” My answer to this is no, simply because there are too many unknowns at this point in time. Foragen could be available in 1 or 2 years, or it could never pan out. There is a good chance that it never becomes available for a variety of reasons beyond just scientific possibility. One reason is that I just don’t think there is enough demand for it in the current culture, and it will mostly likely be expensive and not covered by insurance.
What we do know at this point in time is that restored foreskin through expansion is about 70-90% as good as being intact, according to men who restored after being circumcised as adults. This result is very satisfactory, and most who have completed it say it is life changing. If you start restoring today, the chances are that you will be done long before Foragen becomes available. Foragen has not confirmed yet whether or not the procedure could still be done on those who have already restored, but I don’t see any logical reason why it couldn’t.
I also want to be clear that I am not against Foragen at all. I actually support the development and hope that it does become available to men in the future. However, I don’t think men should pass up non-surgical restoration in the meantime. Non-surgical foreskin restoration is easy, affordable, available right now, and has very good results.
References:
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297551/
Image: Retama, CC BY-SA 3.0 <http://creativecommons.org/licenses/by-sa/3.0/>, via Wikimedia Commons