Q. 

I received my Tugahoy this morning (hilariously called a Chinese Shell Puzzle -- nice touch!), and I am very pleased already.  It took ten minutes or so to get used to putting it on, and it's amazing, just amazing, how it stays there.  I re-read the hows and whys of its working on the website, and it's stunningly complex and simple all at the same time.  Are you a scientist, or just someone for whom it was a case of "Necessity is the mother of invention"?

A.  Thanks for the wonderful message.  I love that "stunningly complex and simple all at the same time".  Thanks.  With total immodesty, I agree.  I am a medical doctor (quit practicing January, 1995), and also have a Masters Degree in biomedical engineering.  But more to the point, I am a tireless tinker.  I do a lot of fiddling, and I tried hundreds of things before I hit on this embodiment.  The actual inspiration for this type of device came when I would hold down on the end of my penis with the tip of my right thumb, and then use my left hand to pull up skin around my thumb.  It became clear that this invoked a self-clasping mechanism, which essentially tightens up more as you pull out with your thumb.

Q.  From the pictures, I'm having trouble understanding how the outer shell stays in place.  It looks like there is nothing holding it.  How can that work?

A.  Don't be surprised that you don't understand how the TA works and stays on. Most people don't understand how and why it works even after they have seen it and even used it on themselves. Here is a more detailed explanation.  I Hope this explains it well enough.

You're right, Bill, there is nothing external holding the outer shell against the skin. There is a very detailed description of the exact mechanism by which the device functions, taken from my patent application, under "Details".

Most people are amazed when they see that the damned thing actually works, because it looks like it couldn't. The mechanism is quite subtle and complex. The Tug Ahoy® would not work, or would barely work with a lot of effort on, say, a tube of leather of the proper size. The TA exploits the everting (outward turning) and gliding/lubricating function of the foreskin.

Consider what happens when you place the inner shell over the glans, pull skin up over the shell, and then pull a little bit on the wire strut attached to the inner shell. This causes the skin against the shell to move away from the body. Some of the skin everts, so that it is now facing away from the shell. The outer layer of skin is anchored at the body wall, so it doesn't go anywhere. 

Now imagine what happens when you have the skin-covered inner shell, and the outer shell is placed over it. The outer shell stays put over that outer layer of skin, while the inner shell, along with its overlying inner layer of skin, is pulled away from the body. So you have a tapered outer shell which is stationary, and an inner shell which is being pulled into it. Because the skin everts and glides, pulling on the inner shell causes the two shells to grip the skin between them. The harder you pull, the tighter it grips. Relax the tension and the gripping pressure is relaxed.

People find it startling to see that it actually works very well.

Q.   There are a lot of scams on the internet.  How do I know that if I order a Tug Ahoy, I will really receive it and that your claims for it are accurate?

A. You can check with any of the restoration groups on the internet, and you will find that I have a reputation for reliability.  Check out the restore list.  To subscribe, send an e-mail to: restore-list-request@eskimo.com and put the word "subscribe" in the subject line.  You will also see that there is a link to my website from the NORM (National Organization of Restoring Men) website at http://www.norm.org/devices.htm.  

Also, if you live anywhere where there are NORM meetings, go to a meeting and ask about the Tug Ahoy.  You will find out that I am legitimate.  Also, the Tug Ahoy is mentioned and recommended in the book, "Sex As Nature Intended It" by Kristin O'Hara.  She wouldn't recommend it if it were a ripoff.

Q.  How long does the Tug Ahoy last?

A.   The warranty extends up to six months.  (See "How to Order" for details.)  As of this writing (May 2003), the Tug Ahoy has been on the market for three years and two months.  To the best of my recollection, there has not been a single TA part returned for warranty replacement in more than a year.  

Very recently, I have begun to get some orders from some men who bought their TA's two or three years ago and are just now ordering new ones.  

To be more specific, the strap sets, which would seem to be most likely to fail, generally last three years.  That is because we are very meticulous and thorough about how we sew these.  (I am not including the rubber band "safety strap" in my longevity estimate.  Although I provide a spare rubber band, I believe you will probably need to replace the rubber band, maybe in a year or two.)  

The blue and white outer shells (large and smaller size), which are made of vinyl, will last three years, although it is better to replace them after about two years or so, because they gradually become stiffer and slicker, so they don't grip as well.  The black (smallest) outer shells have only been used for 1 1/2 years or so.  They are made of rubber and don't seem to last as well as the other outer shells.  Their average longevity is probably a year or two.  

The inner shells generally last over two years, and may very well last three years.  We have made several modifications in how these are made, so there hasn't been a long enough track record to be certain, plus I can't find my notes about when these changes were made.  Two and a half years ago or so, there were some failures due to 1) loosening of the wire strut and 2) delamination of the rubberized coating.  Perhaps two years ago, we changed the way the wire struts are anchored.  With the new method, the struts become virtually an integral part of the inner shell, so the problem of loosening seems to have been eliminated.  

Beginning perhaps 2 1/2 years ago, we began to very thoroughly sand the entire inner and outer surfaces of the inner shell using very coarse sandpaper (36 grit).  This has eliminated the delamination problem, as well as insuring even better adhesion of the wire strut.  

There also were previously a very few cases of the rubberized coating becoming soft.  This seems to have been caused by contact with oil or grease or too vigorous cleaning.  (It is recommended that only soap and warm water be used for cleaning.  It appears that repeated use of peroxide, alcohol, or bleach may lead to this softening problem.  Any oil-based lubricant or other oil-based products, such as ointments, should be thoroughly washed off before applying the TA.)
    
Q.  It would appear that the device must be removed for urination. Is that correct?

A.  Yes, that's correct. It goes on and off in a few seconds.

   I received my tugahoy [1 1/2 months ago] and have been loving it.  I just wish I had taken a picture before I started using it b/c I was very snug cut and after only about 6 weeks of use I have a little bit of skin that is able to roll over the rim of the crown of the head with minimal pressure when holding my penis in my hand. 

Recently after having the tugahoy applied there are a few drops of urine that come out while it is attached.  Is this a normal thing that happens?

Q.  A good number of testimonies made claim of faster stretching of the foreskin than other methods. Why would this be so using your device? I do apply a tight tension on my film tube by means of elastic attached to a Velcro knee strap and from the pictures, the tension seems to be applied in a similar fashion. Though every case is different, can I expect a more rapid increase of foreskin?

A.  I think that most men, especially initially, see more rapid progress with the Tug Ahoy than with other methods. One reason is the more consistent use of the TA because of its greater comfort and convenience. Secondly, I believe greater tension can safely be applied using the TA. Only one man has reported skin damage using the TA, and that was due to abnormal skin thickening at the site of an old scar. It seems that nearly everyone gets skin damage from tape, for instance.  With T-tape and pill tubes, there is a concentration of tension along the proximal edge of the tape.  That is where the skin tears usually occur.  With the Tug Ahoy, pressure is applied over a large area, approximately 4 square inches.  The grip is such that the skin is not held rigidly between the two shells.  Rather, some sliding occurs so that there is a differing level of tension on the skin:  As one proceeds proximally along the skin being gripped, there is a progressively increasing level of tension on the skin at any point.  Thus, in contrast  with tape, there is no point at which the tension suddenly increases.  Therefore, with the TA, greater total tension can be used safely and comfortably.

Q.  After using the Tug Ahoy for a year, the suspender clip sometimes slips off.  Can this be fixed, or do I need to buy a new strap?

 A.  This is an easy problem to fix, although a little difficult to describe.  With thick socks, this problem can occur with just a year or so of use, whereas with thinner socks, it doesn't seem to be a problem for several years.  

To understand the problem, hold the clip by your left thumb and index finger, gripping it where the elastic strap attaches, and with the smooth side up, so its "mouth" points to the right, and open it up.  Notice that as you close it, the center member (having downward-pointing teeth) moves down.  This is where the problem lies.  This center member gradually gets bent upward, leaving a wider gap.  So the solution is to bend this center member back down, to narrow the gap.  To do so, jam something (I use the fairly narrow tip of my auto ignition key) in to the space just below the center member (and above the wire clip that attaches to the elastic strap).  If done properly, if you now squeeze down the center member, it will bend, thus narrowing the gap.  A little trial and error may be required to get the key jammed in at just the right angle and to bend it enough but not too much.

Q.  Is it preferable to grip a small amount or a large amount of skin between the two shells?

A.  One can think of good reasons to do it either way. With a lot of skin pulled up and gripped between the two shells, you can comfortably apply greater tension, so greater expansion of the non-gripped skin would then be expected.

On the other hand, the skin being gripped has little or no tension on it, so this would argue for gripping less skin. 

Overall, I would suggest the best solution would be to grip a fairly generous amount of skin so that more tension can be applied.

Q.  Does the Tug Ahoy work when the foreskin is capable of extending past the end of the penis? Would this be a matter of laying the foreskin on the shell up to the wire extension, place the outer shell over and then applying the pressure?

A.  Good question. In my own case, after using the TA for about nine months and having nearly full coverage (never used any other method), I noticed that the TA began falling off at times and I was making less rapid progress. For a couple of months, my progress slowed a lot. Then I discovered the cause and solution to both of these problems: "packing" the inner shell with a foam disk approximately 1 1/4" in diameter by 1/2" thick. This causes the inner shell to be spaced further away from the tip of the glans. The action of the disk is to effectively reduce the length of the foreskin, so that when the device is applied, there is greater tension applied to the skin, and the tension remains more consistent, even when one moves around. Maintaining more consistent tension increases the security with which the device stays in place and speeds up progress. Now that I have some overhang (at 15 months of TA use), I use a disk between 3/4" and 1" thick.

The disk I use (and which I have supplied with all new TA's for the past 3 months) is cut from a "Nerf Arrow," available at Toys R Us. I believe it is a closed-cell polyethylene foam. It can be anchored to the inner shell using hot melt glue. I am in the process (as of 6/26/01) of making tools which I can use to make disks from other kinds of foam. It seems that a softer, perhaps latex, foam would work better.

Q.  How long does foreskin restoration take?

A.  Up until now, foreskin restoration has usually required several years to complete.  But with the Tug Ahoy®, things go much faster.  Virtually everyone using the Tug Ahoy® reports much more rapid progress than with other methods.  In my own case, for example, I have 75 to 90% coverage when flaccid, after using the Tug Ahoy® for just four months.  (I used nothing prior to that).  Others are reporting similar rates of re-covery with this innovative new system.  I expect the whole process to be completed in well under one year. 

Q.  What are the most important points that need to be emphasized about using the Tug Ahoy®?

A.  The mistakes which people most often make are three.  First, it is important to begin, as the photos show, with the the tip of the wire strut being firmly gripped through the outer shell.  This allows counter traction to be applied so that the skin can be pulled up further over the inner shell.  The second point is that the skin must be held firmly, between the (left) thumb and forefinger, beyond the inner shell, as shown in the photos, while the outer shell is placed over the skin on the (right) side.  Thirdly, it is important to very carefully and thoroughly push the skin under the left side of the outer shell.  Simultaneously pushing inward on the wire strut helps facilitate this.  Getting these three points right allows the gripping area to be wider so that the device is both more comfortable and stays in place better.  The strut and the wide gripping area are two of the points which make the Tug Ahoy® different and better.  

  Q.  Do you need a lot of loose skin to begin using the Tug Ahoy?  Can guys who are tightly cut and missing a lot of shaft skin start right off using it? 

 A.  Nearly anyone can use the Tug Ahoy.  I have heard that some men with very tight circumcisions might have trouble with it, but, so far, among the 150 men using it, that hasn't been a problem.

It seems clear that anyone who has enough skin to get an erection without pain can use the TA.

Here's how you can check to see if you have enough skin. Hold your penis gently at mid shaft with the left hand wrapped around it. Press down on the tip of the glans with your right index finger while sliding the skin up with your left hand. If you can, without discomfort, roll the skin up to the tip of the glans, then you have enough skin to use the Tug Ahoy.

Q.   I am flying to New York tomorrow. I guess I won't wear my Tug Ahoy through the security checkpoint. I think it would be a little embarrassing to explain to a security guard if I set off the alarm.  Do you know whether it would be detected? Know anyone who has passed
through unnoticed?

A.  No, but I know a guy who tried wearing his Tug Ahoy through the metal detector at the airport. Set it off!   : (
After he had taken off his watch, ring and belt and took out his wallet, the alarm still rang. Then the female security guard went over him with the hand-held metal detector. It kept going off every time she passed over his crotch, and nowhere else. He got redder and redder (and I suspect she did too) each time the damn thing buzzed. I guess the other passengers were heartily enjoying the whole scene, and must have been hoping to see him strip searched.
As he was trying to figure out how he was going to explain to her what he was wearing, she finally let him go through, "because it was only detecting a little bit of metal." 
If they find it in your luggage, it is just a "Chinese shell puzzle."

Q.  I developed a red rash on the head of my penis.  I used the Tug Ahoy for several months with great results and no problems.  I took a break, and then started using it again.  When I removed the TA the first day, the head of my penis (at the very top near where urine comes out) was red and blotchy.  On the second day it was a bit worse.  Today, Wednesday, when I removed the TA at lunch time, the area near the top was bleeding slightly.  It appears as if it is a "hickey". 

 A.  I'm sorry you are having a problem with the Tug Ahoy. It sounds like you could have a yeast infection. Yeast is everywhere, and it will cause an infection if the conditions are right. Yeast loves a moist environment. It is more likely if you are on antibiotics or are diabetic, but can occur without these predisposing factors. One cause is too-frequent washing and inadequate drying. Another cause is few drops of urine remaining present after urination. The natural secretion, smegma, has anti-yeast and antibacterial factors, so not being too fastidious in removing this is helpful. Just a rinse with plain water followed by thorough drying is best. Any of the topical anti-athlete's-foot preparations from the drugstore will help clear it up if yeast is the cause.

Q.  I have not been concerned as of yet about a POE. Should I be concerned? 

A.   I don't think there really is such a thing as a single "point of equilibrium". As one increases tension on the foreskin from zero to high, the "POE" (the point of folding of the skin at which the inner and outer layers have the same tension) moves more and more proximally along the shaft, so there can be no such "point".  The Tug Ahoy® can be put on so that it pulls more on either the inner foreskin or the outer shaft skin.  See "Applying the TA".  The more important point is the actual level of tension on the two skin layers.   Since, with the Tug Ahoy®, you can comfortably and safely apply higher tension, the rate of restoration will thereby be optimized.

It could be argued either that it is better to tug so that there is more tension on the inner skin layer (to  minimize pulling up hairy shaft skin) or, on the other hand, that it is better to pull harder on the outer skin (because the length of new skin growth is proportional to the length of the skin being pulled on).  I guess the POE is a useful concept with T-tape, so that you avoid having the tape fold over on itself, but with the Tug Ahoy, it's not a useful concept.

Q.  I'm having trouble with my Tug Ahoy slipping off.  What can I do to correct this problem?  [Also see the last question below about more slippage after using the Tug Ahoy for several months.]

A.  First of all, please read the question above about points which need to be emphasized in applying the Tug Ahoy.  Not gripping enough skin in the first place is one of the most common causes  of slippage.  Another possible cause of this problem is that the edge of the outer shell can be caught between one's clothing and leg and then pushed off with repeated sitting, standing and other movements.    

In the past, I had some problem with this, and found that, if I felt my TA start to slip, I could simply rearrange my clothing to remove pressure on the outer shell, then tug on the wire strut through my clothing to tighten the grip, and the problem would be solved.
Another possible solution to the slippage problem caused by catching clothes that some guys have used is to cut off the toes from a baby's stocking and put this over the outer shell and your penis. This prevents tight clothing from catching the edge of the outer shell.

If it seems that the fit is too loose, the inner shell can be made to be, in effect, a little larger, by applying tape to the outside of the inner shell.  A tape which works well for this is 3M Microfoam tape, which is thick enough to make a difference, stretchable enough to conform, and has a high enough coefficient of friction to reduce slipping.  To use, apply the 1" tape with about 1/4" extending past the edge of the shell; pull it quite tightly, stretching it so it goes on straight, with 1/4" free all the way around.  then fold the free edge and stick it to the inside of the shell.)

Another thing that can cause slipping is accumulation of oils from the body, especially on the outer surface of the inner shell. Washing the shell every day or two with soap and water should solve that problem.  It seems that exposure of the TA to body oils over a period of several months can cause a sort of glazing effect to occur, with an increased slipperiness.  Washing the TA with laundry detergent should eliminate this problem.

Another situation which has caused slipping for some men has been the fact that the skin sometimes gradually becomes thinner as it elongates with tugging.  If this occurs, then either using tape as described above or changing to a smaller outer shell will usually solve the problem. 

[From a User]: I have had it pull off several times but found a possible solution. Wrap some athletic tape backwards (sticky side out) around 2 fingers and clean the inner surface of the outer ring--thus  leaving some of the tape adhesive on the surface. Makes it stay on much more securely.

 Q.  When I first use the Tug Ahoy it is comfortable for several hours and then I start to feel discomfort in various spots on what feels to me like the inner foreskin. This occurs even with no tension on the strut. Pressing inward on the strut helps but the discomfort soon returns.
When I remove the Tug Ahoy to urinate, there is discoloration on the
foreskin where pressure has been applied. The discoloration soon goes away with the removal of the device.

A.  It sounds like you're probably getting too much concentrated pressure on the inner foreskin.  One possible solution would be to ensure that you get a lot of foreskin between the two shells.  How to do this is described above in the question about points that need emphasis.

Another helpful solution would be to apply the TA so it pulls less on the inner skin, especially on that part where the pain occurs. This is a simple thing to do, although a little difficult to explain. Say you want to pull more on the outer layer of skin (and less on the inner layer), on the dorsal (top) side of the penis. To do this, begin by pulling up a little skin onto the glans on the dorsal side, and then put on the inner shell so that it is sitting on the skin dorsally and on the glans elsewhere. Then pull up the skin over the inner shell and apply the outer shell in the usual manner. By experimenting with this, you can vary the tension on the skin where you want to, and between the inside and outside layers.

Q.  Can it be worn with an around-the-waist strap? I am used to taping with a tension strap around the waist so I am used to that, and I wear  bermuda shorts most of the summer so down the leg would be too public.

A.  Sure can. It works fine that way.  A good way is to also wear undershorts, and to have the penis extend out through the fly, say to the right.  The elastic strap is wrapped around the waist, and the clip is secured to the left side of the fly of the undershorts.  Alternatively, a sort of sling can be made from a handkerchief.  For example, if you want the penis to be pulled around to the right, you pass the sling around the right side of the penis at the base, with the tips of the handkerchief pointing to the left.  The elastic strap goes around the waist to the right and fastens to the ends of the handkerchief sling.  The sling functions pretty much like the fly of the shorts does, to allow counter traction to be applied to the base of the penis, so that tugging can occur in the opposite direction.

 Q.  Is it possible to order a tugahoy with a longer depth than the standard one I have already been using ?
I would like to order one with a inner shell which covers the whole corona. I will send the dimensions if it's possible.

A.  Yours is a question which has come up several times.
Having an inner shell which covers the whole glans may sound like a good idea at first. 

But think what that would imply. For the inner shell to cover the whole glans, the inside of the inner shell would have to be, say, 1 1/2" in diameter, the outside of the inner shell 
1 3/4". Adding two skin thicknesses brings that to 2". Plus two outer shell thicknesses brings the total diameter to 
2 1/4".

Take a look at a ruler and see if you want to have a lump 2 1/4" by about 2" in your pants.

Probably not. But even if you would like to have that much stuff hanging from your dick, notice how your foreskin would necessarily be stretched out. It would resemble a too-large, loose shirt sleeve, rather than the tight foreskin we all want, and which you can get with the Tug Ahoy as it is. 

That's why the Tug Ahoy is designed to not usually cover the entire glans.
 
Q.   I now have a moderate amount of foreskin.  When I use the Tug Ahoy, I put the edge of the inner into sulcus at the proximal edge of the glans.  Particularly, this is not a very good way to increase the area of inner  skin.
I have seen a device made at home by a tugger. It is only slightly concave and the glans enters the cone only during application. As soon as tension is applied, the glans sort of retreats as the skin is pulled forward.

A.   I believe that you are saying that with this device, the skin is gripped more distally, further away from the sulcus [groove along the proximal edge of the glans], so that there is more inner skin being exposed to the full tension, so that you would expect more inner skin growth than with the Tug Ahoy tucked into the sulcus. I agree with that idea.

But there is another way to apply the TA.  With sufficient skin, as you have, you can apply the TA "loosely" rather than tucked into the sulcus. To get more inner skin exposed to tension, do this:
First, begin by pulling some skin part way up on the glans. Then place the TA inner shell upon that skin. 
Next, pull skin up over the Tug Ahoy and apply the outer shell. Now, when you apply tension, there will be some space between the edge of the inner shell and the sulcus. That is, more inner skin will be under tension.

 Q.  Can the Tug-Ahoy® be worn with jockey style undershorts rather than
  boxers? Taping with an around-the-waist strap with jockey undershorts has
  worked fairly well for me even though the shorts are pulled askew.
 
A.  Yes, that works fine, too.

Q.  Is the Tug-Ahoy® recommended for 24/7 wear? I have done OK with 23/5
  with taping. But I have seen that all night wear is not recommended for
  the RECAP-EZ. I would like to know what sort of daily wear time is
  recommended or proven satisfactory with the Tug-Ahoy®.

A.  The TA works fine with nearly 24/7 use. That's how I usually wear it.

Q.  In my homemade Tug Ahoy® imitation, I made a small vent hole, like the real Tug Ahoy® has, but now it won't stay on.  It needs the suction to stay on.  Can you explain this?

A.  First of all, what [a user] said about the Tug Ahoy® vent hole is basically right. At first, there was no tiny vent hole, but now they all have one. First, the vent hole does not appreciably diminish the gripping efficiency of the Tug Ahoy®. If someone's homemade TA doesn't grip with the vent hole, then their device misses the hole point, the whole function, of the actual TA. And if the vacuum is all that's holding on your TA wanna be, then it's not doing its job.

Secondly, the original reason for the vent hole was that with prolonged wearing (all day), the vacuum would tend to temporarily distort the glans and sometimes suck out some "pre cum". The glans distortion would go away in a few minutes, but it seemed better to prevent it.

Thirdly, it later became apparent that a vent hole helps to ensure that no delamination of the coating occurs.

The fourth point I'd like to make about the hole is that with the real TA it works better to make the hole with a heated sewing needle held in a pair of pliers. A drill can loosen the coating.

 A.  (From a Tug Ahoy® user):  
> It took me about a week of experimenting to get the skin in the best
> position before applying tension. Now that I've "mastered" that, the grip
> is reliable even when I jog for an hour on the treadmill.
> 
> Two techniques that work for me are: 1) Wash and blot the skin just before
> installing the Tug-Ahoy®. 2) After pushing the internal cone over the glans,
> roll the skin over the outside and then pull on it all around to seat the
> cone at the sulcus. Then the outer cone will encompass a larger area of
> skin. 
>When I get it right I can tug hard all day without discomfort. If
> not, it starts to hurt after an hour or so.

This is a critical point. Thanks for pointing it out. Your procedure is especially important for men who don't have a lot of skin.

 Q.  Would you please comment on tension: high vs low, and continuous vs intermittent?

A.  A  This is an extremely important subject about which we have only limited information.  I think a good way to approach this subject is to consider skin expansion techniques as practiced in plastic surgery. 

I saw a TV show in which the surgeons wanted to separate siamese twin infants which were joined at the pelvis.  If the twins were just cut apart, then there would result a skin defect of perhaps four inches across in each child.  Open areas such as that would be expected to lead to infection and probable death.  So the surgeons made open tunnels under the skin, perhaps 1" wide and 5" long.  (This can be done by making a 1" incision and pushing a blunt instrument 5" through the subcutaneous tissue, usually without significant bleeding.)  A deflated, thick-walled sausage-shaped rubber balloon is then pushed into the space.  The balloon has an attached small rubber tube used for inflation.  The skin incision is then closed around the rubber tube, and the balloon is filled with saline until the skin is stretched to the point of pain, yet not so much that the skin blanches from lack of blood flow.  

Since the saline is non-compressible, while the skin has significant compliance ("give" or stretch), the volume of the balloon remains the same, while the skin stretches and moves so that the tension gradually is reduced, over a period of hours.  As described below, the stimulus of the skin tension causes the skin to react by growing, so that after a period of a week or so, there is perhaps 1/2 to 1" of new skin.

These rates of skin elongation achieved in plastic surgery seem phenomenal when viewed from the perspective of traditional foreskin restoration using taping methods, in which restoration usually takes one to three years or so.  It seems to me that we have some lessons to learn from this.  My suspicion is that the primary reason they get such amazing results surgically compared with foreskin restoration is that they simply use much higher stress (tension) on the skin, at least transiently or intermittently.

Although we are in the dark about many factors involved in skin expansion, I would like to comment on intermittent tension. In the abstract posted by D.L., an experiment was done in which individual skin cells were stretched. If the stretch was continuous, then there was only a transient short-lived rise in molecules which signal new skin cell growth. But when the stretch was cycled 10 times per minute, the level of these molecules remained high. If these results can be extrapolated to whole skin, then probably intermittent tension is better, based on these results.

There is another reason to suspect that cyclic tension has advantages. Movement of soft tissue enhances circulation of blood and lymph (the fluid which accumulates outside cells and outside blood vessels and is recycled back into the blood by special lymphatic vessels). Thus with movement or changing tension, there is enhancement of both the supply of nutrients and oxygen, and the removal of toxic metabolic products, thereby producing happier skin. Happier skin can grow better.

I think that perhaps the association of all these cell-division-associated-molecules with strain of cells is primarily of interest because it confirms what we really knew already: that strain on skin cells causes intracellular signaling which results in an adaptive response to this stimulus--cell division resulting in skin elongation. 

In summary, non-injurious tension (intermittently fairly high) on skin sets up a cascade of intra- and inter-cellular signaling which results in the growth of new keratinocytes (ie skin cells) which yields new normal skin.  This suggests that intermittent tension, such as using an elastic strap down the leg, is best.  Also, sometimes applying short-duration higher tension (short of injury) is also probably best for achieving optimal rates of skin expansion.

Q.  The inside of the inner shell seems to be getting a little...stained.  I'm wondering if that's a  problem and what you would suggest I use to clean it. I've been using ordinary soap.  

A.  I used to recommend using bleach, but over the years, it has seemed that bleach, alcohol, and any oil or grease can soften the coating on the inner shell.  (Water soluble lubes don't cause this problem.)  I'm sorry I don't have a good solution.  Most guys aren't very bothered by this.  

Q.   What happens if you get an erection--especially at night--while wearing the Tug Ahoy?

A.   For some guys, who don't have a lot of skin, the TA may simply come off. For someone with a lot of skin, it just happily stays in place. Since there is little leg motion (which during the day helps pump blood--since varying tension causes changes in gripping pressure) at night, less tension must be used; otherwise discomfort in the form of a dull aching may occur after a few hours due to ischemia (decreased arterial blood flow). So, it's comfortable to use more tension during the day.

Q.   If I don't want to use a leg strap, can I use a weight instead?

A.  Yes, you could use a weight instead of the elastic strap, if you wanted to. But I don't really understand why you would want to. One would ordinarily use around 3-5 pounds of weight; this would be rather cumbersome and conspicuous, compared to the elastic strap.

Q.   I have been using the Tug Ahoy for several months now.  Whereas at first, it almost never came off, and I got very rapid results, now it slips off more often and progress has greatly slowed.  Any suggestions?

A.   I have finally figured out a solution to these two problems which seem to begin to occur after approximately 4 to 6 months of use of the Tug Ahoy (and doubtless other tapeless tuggers).

These problems are: 1) the device slips off more often, and 2) there seems to be a slowing of progress in restoring foreskin. Although at first these problems appear to be largely unrelated, I believe they have a common cause and a common, simple solution.

In the past I have felt that this increased slipping was due to 1) gradual thinning of the skin with restoration, and 2) increased production of oily, moist smegma. Although these are probably contributive factors, I now believe that the most important cause of both slipping and slower progress is something else.

Briefly stated, the cause of both of these problems is an increased amount of skin. The simple solution will be described below. To those who want to know why, I will attempt an explanation. The explanation is somewhat difficult to understand. It may not be worth the effort to understand it. 

As more skin is produced over months of tugging, there gradually results less and less tension being applied by the TA to the shaft skin, when the TA is applied in the usual manner. Most of the tension is applied to the inner layer of foreskin. 

A greater proportion of tension being applied to the inner foreskin produces two results. First, there occurs less overall skin growth. This is because the rate of new skin growth is (approximately) proportional to the level of tension. There is much more shaft skin (compared to inner foreskin), so that when tension on it is greatly reduced, less overall skin growth occurs. [Although there is probably some increase in the rate of inner skin growth due to the higher tension there, this effect is overwhelmed by the effect mentioned above.]

Why less tension on the shaft skin causes the device to slip off more often is more difficult to understand. (If you don't understand precisely how the TA works, you won't understand this, either.  A detailed description of how it works is given under the button, Details, as well as one of the questions above.)  It is the tautness of the shaft skin (especially dorsally, on the top of the shaft) that activates the gripping mechanism (by holding the outer shell in place while the overlying layers of skin are wedged into it by pulling on the inner shell).  So it is the very laxity of the shaft skin--due to successful restoration--that prevents this mechanism from working.

So, the solution to both problems--slower progress and more frequent slipping--lies in applying the Tug Ahoy in a way that increases tension on the shaft skin, especially dorsally. This is done by, in effect, "shortening" the shaft skin. This can be accomplished quite simply as follows. In applying the TA, rather than applying the inner shell directly to the glans, first roll up a little skin so that it partially covers the glans dorsally (on top). Then apply the inner shell so that dorsally it is sitting on top of that pulled-up skin, but everywhere else it is sitting directly upon the glans. Now, roll up skin to cover the inner shell, and apply the outer shell in the usual manner. When you now pull on the wire strut, you will see that you have more tension on the dorsal shaft skin than there was when you applied your TA in the usual manner. And you will see that the device stays in place better than before. Try it; you'll like it. 

This new method of applying the device is only for those who have enough skin to make it useful and possible, those with perhaps half to three-quarters of the glans covered. With less skin, it is both easier and more effective to apply it in the usual manner. Exactly how much skin to pull up before applying the inner shell can be determined by trial and error: If you have more skin, pull up more to start; if you have less, pull up less. The goal is to have moderate tension on the dorsal shaft skin while tugging.  The reasons for emphasizing the dorsal skin are twofold.  First, it is primarily the dorsal skin which activates the gripping mechanism.  Second, the primary limitation to the degree of restoration is the amount of dorsal skin available; skin on the lateral and ventral aspects of the penis will pretty much follow the lead of the dorsal skin.  So increasing the tension on the dorsal skin will speed restoration.

Q.  I feel pretty stupid about this, but I am afraid I took off all the straps from my Tug Ahoy and can't figure out how to put them back on.