Alex's "purse string" surgery
This page will feature a DTR user from Europe known as Alex who had a second touchup surgery known as a "purse string"
Alex is truly a pioneer with trying to get the most realistic restored foreskin.He had a touchup surgery in the summer of last year 2012. Last winter 2012 he decided to do another surgery called a purse string. Again this is another surgery that is sometimes talked about but very rarely is any information available online about it. I can't thank him enough for allowing me to share this information with all of you.
A brief description on how the purse string touch up surgery works is a suture is inserted at the end of the foreskin.  The suture acts just like a cinch on a pouch.  The suture is pulled tight and then tied off.This creates a ring inside the skin at the very end of the foreskin.
The suture will dissolve after about six weeks. During this period the body reacts to the suture as a foreign object and begins to grow skin tissue around the suture.  This is the same thing that happens with body piercings such as a simple ear piercing.  The body reacts by making a skin tube around the foreign object so it is no longer inside the body.Even though the suture dissolves the skin tube will remain.
The end result is very close to a rigid band that most intact men have.
Day one:  swelling from the procedure as expected.
Date 10: as days passed the swelling went down. Alex did tell me that nocturnal erections were a slight problem since it did cause discomfort due to the erection putting pressure on the wound.
Possibly if Alex had more overhang this might be avoided. Because the skin would not be as tight with an erection, although because of swelling this might be temporarily unavoidable.
As the swelling went down some bruising did appear.
With the suture still in place and healing continuing the results start looking better as each day passes.
This is a picture with the suture dissolved, the skin tube that was created around the suture is still intact.
Another picture of Alex fully erect and the skin staying over the glands all on its own.
Flaccid you can see how the end of the foreskin  has a much tighter tip.
The blue line shows we're the " rigid band " created by this touch up surgery is located.
Alex told me the cost of the surgery was $550 US.He will be providing me with updates as the months pass.
Touchup surgeries are not mandatory for anyone restoring but it does give somebody more options if they're looking for a more tapered tip to their foreskin if they are not satisfied with their results from restoring.
My only caution for anyone thinking about doing a touchup surgery is to be sure to have enough skin to do so. It's always better to have more skin than not enough.  I think even better results would be seen when somebody has enough skin where they have overhang.
Alex has informed me that he has done another pursestring surgery. This time with a suture that takes up to six months to dissolve and is much thicker. The end result should produce a thicker rigid band.
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This is after 2 1/2 months worth of healing
Another picture at 2 1/2 months of healing.
It refers to the letter from the patient about this circumferential purse string method. This concerns to tight the foreskin by using an absorbable thread like a circular suture between the outer and inner foreskin layers. This is granted on the condition that he himself is responsible for any consequences of the procedure By sterile washing and local infiltration anesthesia, one Vicryl 2.0 thread on needle be insert about 12 o'cl position on the foreskin and enters the distal part of the skin so that the needle cuts through the outer and inner layers in the circumference around. Thighten and then making it a usable but tight opening compared to earlier.

To the left is some of the doctors notes and information at where the surgical procedure was performed. The Doctor that preformed this procedure is retired now.
These were sent to me jan 2015 for an update.
This message is from Alex:
 I favour the purse string suture. My final assessment is that the advantages of the purse string suture are inferior or equal  to the tissue removal techniques:

- the purse string suture provides a unique fashion not seen in the same extended degree as with the other methods; the recreation of the structure and function of the ridged band

- it is one of the least complicated methods. The circular thread can be inserted with a relative easy method.

- it leaves no visible scar, neither on the outer layer of the foreskin nor the inner layer

- it doesn't involve any actual surgery by removing tissue. The risk of "going too far" is little.

- it is the cheapest procedures. I paid US$ 350 to the doctor to get this performed. A more complicated tissue removal to thighten the foreskin costs about the twice, around US$ 700.

- the risk of complications associated with the purse string suture are marginally. A safety valve is that if complications should occur, such as that the thread was tied off too thight so it becomes too difficult to urinate, the thread can easily and quickly be removed within the first days, before it grows into the tissue.

Actally I had an insertion of the purse string suture Jan 11th 2017. The surgeon tied the thread off too thight so I couldn't barely urinate at all. I had to remove the thread. and I simply removed the thread by myself and the foreskin instantly returned to its state before the insertion of the thread, and I could urinate as normal. I called the surgeon, and he inserted a new thread a week later, Jan 18th 2017, without charging me any additional cost.

This is an excellent example of that even if such complications should occur, it is simply to remove the thread - in which is easy to do by yourself - and get a new thread inserted.

 - the purse string suture creates a mimic of the intact ridged band in a sense that the ridged band created from this method behaves as an intact ridged band. It constricts when the penis is in its flaccid state, and expands when you become erected.

- you will discover much less pain, swelling and discomfort which is more noticeable with the tissue removal techniques.

The disadvantages of the purse string suture method is equal or inferior to the other methods.

- this method seems to create a lesser degree of thightening of the foreskin compared with the other methods, so it will not be sufficient to only take this method if you need a high degree of thightening to achieve permanent coverage

- you have to leave the foreskin and the thread in place for up to months

- it requires a bit more effort to clean sufficient unerneath the foreskin, since the foreskin, due to the thread, appears non-retractable during the healing period.

- the effeciacy of the method takes a long time to occur and it's a bit more uncertain than for the other methods. However, another urologist I heared of, favours this method and claims that he has very promising and pleasing results with this particular method.


 My overall assessment is that the purse string method is an effective method in creating the sensation of the function of the ridged band, but it seems to provide less degree of thightening of the foreskin than what is current for the tissue removal techniques.

I know this, because if I hadn't taken a tissue removal techique before the insertion of the purse string suture, I hadn't achieved the results as I have gotten today.

My foreskin was far too baggy that the purse string alone could have created sufficient results. I simply had to remove excess foreskin by surgery first.

Therefore I both recommend initially to take a tissue removal technique or the transverse suture method to thighten the foreskin, and so take the purse string finally.Conclusion