I do not use this device because it does not allow the precision I think is necessary to create an outcome that is crafted to the patient’s unique anatomy. These clamps do not allow careful visualization of both the outer and inner skin surfaces of the foreskin. It is difficult, if not impossible, to ascertain that the proper amount of skin is being pulled through the clamp before crushing the skin. I have dealt with some men who have attempted self-circumcision using this device and have removed inadequate or excessive amounts of skin. An adult circumcision has to be very carefully crafted to result in a nice cosmetic as well as a functional result. It is a big mistake for a man to attempt self-circumcision using one of these devices.