Foreskin restoration or foreskin reconstruction refers to the process of recreating the

foreskin In male Human body, human anatomy, the foreskin, also known as the prepuce (), is the double-layered fold of Human skin, skin, Mucous membrane, mucosal and Muscle tissue, muscular tissue at the distal end of the human penis that covers the glans ...

of the

penis A penis (; : penises or penes) is a sex organ through which male and hermaphrodite animals expel semen during copulation (zoology), copulation, and through which male placental mammals and marsupials also Urination, urinate. The term ''pen ...

, which has been removed by

circumcision Circumcision is a procedure that removes the foreskin from the human penis. In the most common form of the operation, the foreskin is extended with forceps, then a circumcision device may be placed, after which the foreskin is excised. T ...

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.

History

In the

Greco-Roman world The Greco-Roman world , also Greco-Roman civilization, Greco-Roman culture or Greco-Latin culture (spelled Græco-Roman or Graeco-Roman in British English), as understood by modern scholars and writers, includes the geographical regions and co ...

, uncircumcised genitals, including the

, were considered a sign of beauty,

civility Civility may denote orderly behavior and politeness. Historically, civility also meant training in the humanities. Developmental model Adolf G. Gundersen and Suzanne Goodney Lea developed a civility model grounded in empirical data that "stresse ...

, and masculinity. 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 In classical antiquity, the Hellenistic period covers the time in Greek history after Classical Greece, between the death of Alexander the Great in 323 BC and the death of Cleopatra VII in 30 BC, which was followed by the ascendancy of the R ...

ideal of gymnastic nudity. Men with short foreskins would wear the kynodesme to prevent exposure. As a consequence of this

social stigma Stigma, originally referring to the visible marking of people considered inferior, has evolved to mean a negative perception or sense of disapproval that a society places on a group or individual based on certain characteristics such as their ...

, an early form of foreskin restoration known as ''epispasm'' was practiced among some

Jews Jews (, , ), or the Jewish people, are an ethnoreligious group and nation, originating from the Israelites of History of ancient Israel and Judah, ancient Israel and Judah. They also traditionally adhere to Judaism. Jewish ethnicity, rel ...

Ancient Rome In modern historiography, ancient Rome is the Roman people, Roman civilisation from the founding of Rome, founding of the Italian city of Rome in the 8th century BC to the Fall of the Western Roman Empire, collapse of the Western Roman Em ...

(8th century BC to 5th century AD). 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). 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). Some Jews during Antiochus' persecution sought to undo their circumcision. 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 Castration is any action, surgery, surgical, chemical substance, chemical, or otherwise, by which a male loses use of the testicles: the male gonad. Surgical castration is bilateral orchiectomy (excision of both testicles), while chemical cas ...

and say nothing about banning circumcision. According to rabbinic sources, during the

Bar Kokhba revolt The Bar Kokhba revolt (132–136 AD) was a major uprising by the Jews of Judaea (Roman province), Judaea against the Roman Empire, marking the final and most devastating of the Jewish–Roman wars. Led by Simon bar Kokhba, the rebels succeeded ...

, Jews who had engaged in foreskin restoration were recircumcised (either voluntarily or by force). Again, during

World War II World War II or the Second World War (1 September 1939 – 2 September 1945) was a World war, global conflict between two coalitions: the Allies of World War II, Allies and the Axis powers. World War II by country, Nearly all of the wo ...

, some European Jews sought foreskin restoration to avoid Nazi persecution.

Non-surgical techniques

Tissue expansion

Non-surgical foreskin restoration, accomplished through tissue expansion, is the more commonly used method. Tissue expansion has long been known to stimulate

mitosis Mitosis () is a part of the cell cycle in eukaryote, eukaryotic cells in which replicated chromosomes are separated into two new Cell nucleus, nuclei. Cell division by mitosis is an equational division which gives rise to genetically identic ...

, and research shows that regenerated human tissues have the attributes of the original tissue.

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. 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 In Organosilicon chemistry, organosilicon and polymer chemistry, a silicone or polysiloxane is a polymer composed of repeating units of siloxane (, where R = Organyl group, organic group). They are typically colorless oils or elastomer, rubber ...

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 Grafting or graftage is a horticulture, horticultural technique whereby tissues of plants are joined so as to continue their growth together. The upper part of the combined plant is called the scion () while the lower part is called the roots ...

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.

Results

Physical aspects

Restoration creates a facsimile of the prepuce, but specialized tissues removed during circumcision cannot be reclaimed. Surgical procedures exist to reduce the size of the opening once restoration is complete (as depicted in the image above), or it can be alleviated through a longer commitment to the skin expansion regime to allow more skin to collect at the tip. The natural foreskin is composed of smooth dartos muscle tissue (called the ''peripenic muscle''), large blood vessels, extensive innervation, outer skin, and inner mucosa. 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. 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.

Organizations

Various groups have been founded since the late 20th century, especially in

North America North America is a continent in the Northern Hemisphere, Northern and Western Hemisphere, Western hemispheres. North America is bordered to the north by the Arctic Ocean, to the east by the Atlantic Ocean, to the southeast by South Ameri ...

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, which was incorporated into NORM in 1994. 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).