Foreskin restoration: tugging, tape and the CI scale

Some cut men grow their hood back, slowly, with tension and patience. How it works, what it cannot give back and how restorers measure progress

Some circumcised men decide they want their hood back. Not by surgery, mostly, but by patience: pulling the remaining shaft skin forward, a little every day, until it covers the head again. It sounds like a joke the first time you hear it. It is not, and the men who do it have built tools, forums and even their own measuring scale.

How it works

Skin grows when it is kept under steady, gentle tension. Plastic surgeons rely on the same principle when they stretch skin to cover a defect, and restorers apply it to the shaft. The tension gives the tissue time to make new cells, so the skin gets longer rather than just thinner. Over months the loose skin increases; over years it can reach the rim, then cover the head, then overhang it.

The key words are steady and gentle. Restorers aim for many hours of mild pull rather than short bursts of strong pull, and the usual routine is a stretching device worn for four to eight hours a day. The process can take several years.

Hands, tape and gadgets

The methods fall into three families. The simplest is manual: pulling the skin forward by hand for a few minutes at a time, several times a day. Next comes tape, used to hold the skin forward over the head so that it stays under tension. Then come devices: cones and tubes that grip the skin and pull it with elastic straps, or weights that hang from it. One of the early gadgets, from the restoration pioneer Wayne Griffiths, was two steel balls joined by a rod and weighed a few hundred grams.

There is also a surgical route, which moves skin from elsewhere on the body to the shaft. A review of the operations called the results poor, and the doctors who have done them describe them as complex and cosmetically disappointing. That is why almost every restorer goes the slow way.

The CI scale

To track progress, restorers use the Coverage Index, or CI, a picture scale from 0 to 10 that rates how much the skin covers the head, soft and hard. It was created inside the restoration community in the early 2000s and is shared on its websites. It is not a medical tool: no doctor uses it to diagnose anything and nobody has validated it. But it is handy, and it works on any cock, cut or not.

• CI-0 to CI-1: a tight cut. No loose skin; hard, the skin is stretched and may even pull on the balls.
• CI-2 to CI-3: some loose skin wrinkles behind the rim when soft, and reaches it at CI-3. Little or no slack when hard.
• CI-4 to CI-5: soft, the skin rides over the rim and covers part of the head. Hard, it bunches behind the rim.
• CI-6 to CI-7: soft, most or all of the head is covered, with the opening visible at CI-7. Hard, it starts to cover the rim.
• CI-8 to CI-10: soft, the skin overhangs the tip, from a little to a lot. Hard, it covers half the head or more, and at CI-10 it still overhangs.

Men who were never cut usually land somewhere in the upper part of the scale, and where exactly varies from man to man, which is a nice reminder that natural foreskins vary as much as anything else on this site. The Foreskin chapter has drawings of the main types.

Who does it and why

Nobody knows how many men restore. The organised movement is decades old, with groups such as NORM in the United States and members in Canada, Australia and the United Kingdom, and doctors interviewed about it say the interest is greater than you would expect. The reasons are personal, and the doctors who have looked into it describe them as largely psychological. For many, it is about owning a decision that someone else made for them.

For gay men there is an extra twist, since in bed the other guy sees exactly what you have. That can work both ways: some partners prefer cut, others prefer uncut, and a restored foreskin is a third thing again.

For the other side of the story, how a circumcision is done and why cut cocks differ so much, see Circumcision styles.