Touch-up Surgery
One of my goals when I started the process of foreskin restoration was to appear as opposite of circumcised as I possibly could. If I could grow a foreskin that hung down to my knees, I'd totally do it. Unfortunately, restoration progress is extremely slow.
I reached a point where I had enough skin to cover the glans if I gently pulled it forward, but it wouldn't stay covered. Restoration can re-grow skin, but it will never re-create the special elastic band at the end that a real foreskin has. Some guys who restore seem to have better tapering than others, but regardless the shaft skin probably won't be pulled forward and held in place as well as with a real elastic band of tissue at the tip. My experience with cone-shaped restoration devices like TLC Tugger is that my skin looks puckered and tapered for the first few minutes after the device comes off, but then the skin would relax, widen, and go back to not covering the head as much. I think photos of nice puckered restoration results online can often be very misleading, since many are taken during that time period shortly after the cone was removed. My coverage also varied drastically between when I was sitting and when I was standing.
To be clear, I think my goals for foreskin restoration are somewhat different than many guys who restore. I hated looking cut because I think foreskin is very sexy, but also because of all the ugly motivations used to justify circumcision. I felt like I was branded by those things, and forced to represent them with my body in a very personal way.
I researched surgical touch-up options because I wanted to look as close to "uncut" as possible. There unfortunately isn't much information available, since it hasn't been done many times. My primary source of information was a webpage hosted by the maker of the DTR. A page on that site documents the experience of a restorer named "Alex". He has had multiple surgeries to tighten and lengthen his regrown foreskin. I wanted similar results, and I am extremely grateful to both "Alex" and "Chuck T" for documenting it.
When I thought I had plenty of skin to get the surgery, I booked an appointment at the urology clinic at a local hospital here in Boise. I explained the process of foreskin restoration to the urologist, and my feelings about being cut. He was very critical of the idea of a v-plasty touch up surgery. Without even asking how wide of a wedge I wanted removed he told me that the surgery could create scarring that would lead to phimosis, which would have to be corrected with re-circumcision. After only a couple minutes discussing the idea with him, it was very clear that he wasn't willing to give it any serious consideration since it wasn't a procedure that he already had experience with.
In his medical notes (which I obtained later), the doctor wrote: "[Patient] feels that if he had been given the choice he would have wanted to remain uncircumcised." I guess the best way for a doctor to deal with the cognative dissonance of performing circumcisions and then being confronted with a man who deeply hates being circumcised is to wonder if I would've wanted circumcision all along if it hadn't been forced on me. As if that alternative reality is relevant or comparable in any way to the reality that actually exists.
I booked another appointment at the other major Urology clinic in town, with a different doctor. It blew me away how opposite that experience was. The Urologist I met with listened to my description of how I had re-grown skin, why I didn't like being cut, and what kind of surgery I wanted. He was so unconcerned with my proposal that I was nervous proceed with him, especially compared with the reaction from the previous doctor. But most of the things I had read about him were positive, and it seemed like a simple idea to me too. So I made an appointment for surgery on November 9, 2016. It was a Wednesday, so I had three days off work plus the weekend to recover. That was about right.
A natural foreskin is very stretchy. It can stay covered and taper down to a small diameter when soft, but widen many times larger to retract when hard. A circumcised man can grow shaft skin to cover the head like the foreskin used to do, but it isn't the nice stretchy skin that the foreskin was made of. I came to the conclusion that removing a wide enough wedge to make it look and act the way I wanted it to while soft would have to also prevent it from retracting while hard. So I made sure that I had grown enough skin that it could cover the head when I'm erect without lots of tension. Before I went in for surgery, I used my green pen to mark where I wanted the wedge to come from, and how much I thought I wanted removed. It wound up being a diamond shape that, at the widest point, was removing almost half the circumference of the new foreskin I had grown.
It was probably a little bit risky to take as much width as I did. Taking too much could be dangerous, because if something goes wrong during the healing process (like an infection or re-opening of the wound), there are limited options for accessing the inside part to fix it. And if the wound had to be re-closed, they may have to shave off a bit more, which was almost no longer an option because of how much was taken originally. For me, the opening was reduced enough that I couldn't retract my skin at all for about a month after surgery, otherwise it would've put too much tension on the sutures. I had to rinse inside it using a rubber tip syringe.
For a couple months after surgery, the skin wouldn't retract when hard. It was difficult but possible to retract it when completely flaccid. Over time, it has continued healing and maybe stretched/widened a bit. Then, for a few years, it became uncomfortable but possible to retract when hard, and very easy to retract when soft. Now, it is mostly easy to retract when hard. It has significantly widened over the past 5 years, but is still tapered and holds it self in place much much better than before the touch-up.
I don't regret the size of wedge that I chose to take out at all. If anything I would like the opening to be smaller. Like I said before, my main goal is to be as opposite of circumcised as possible. I would like to restore a foreskin that is very very long, and narrow at the opening. It would be much more ideal to have a real foreskin with a stretchy opening. That would allow the foreskin to be held in place to protect the head, without being uncomfortable to fully pull back during sex. But the lack of easy mobility is a price I'm personally willing to pay to have a more highly tapered result. In the future, I will probably pursue some other form of tightening procedure, probably the transverse incision (no tissue removal) method described by Alex in the site linked above.
Personally, I am very happy with the results. But I would only recommend this procedure to restoring men who are willing to deal with discomfort when the skin is pulled back while hard, and are ok with the possibility of not being able to retract well at all. If your desired goal is to re-grow skin to protect the glans, increase skin mobility, and improve sex, you can get all those benefits without any touch-up surgery. Also, the surgery cost about $2,500 in 2016, and is probably not something insurance is going to foot the bill for (mine didn't). If you're worried about scarring, you probably shouldn't opt for this procedure since I think it would be very difficult to cope with unexpected results after already resenting being cut once.
I do wish I would have waited longer to have this performed. I should've grown more skin length first. It is more difficult to restore after this touch up because the opening is narrowed and it is undesirable to see it widen out again during later stretching. Later restoration is also complicated by scar tissue, which will not grow like the tissue around it. If a person considers a surgery like this, I would highly highly suggest waiting until after they are sure they have as much foreskin as they will ever want to restore.
1 day after surgery
2 days after surgery
4 days after surgery
7 days after surgery
14 days after surgery
17 days after surgery
17 days after surgery
7 weeks after surgery
9 weeks after surgery
7 months after surgery
Thankfully the scaring is continuing to fade. I was worried for the first couple months, because the foreskin opening was pretty tight and difficult to retract. But it continued to loosen for a few months, and now can be retracted very easily. It does stay in place when I don't purposefully retract it. I'd actually like it to be tighter now that I've seen the final results as-is. My plan is to continue gradual lengthwise skin growth by stretching with my TLC Tugger. Some day, when I have a lot more skin, I'll probably have the opening tightened further.
See the progress pictures page for more pictures in the years after the surgery