Producing an outcome of a circumcision procedure which suits the aesthetic preferences of a patient when the penis is flaccid and allows for a comfortable erection is my goal with each procedure I perform. Removing the proper amount of skin is an important aspect of achieving this. I mark the skin incision lines on both the outer surface of the foreskin as well as on the mucosal (inner) surface and then stretch the penis while using a forceps to move these incision points together. This provides an accurate assessment that incisions made along these two lines will result in a final outcome which will accommodate a full erection. I have tried using erection induced by injection of medication into the penis to compare to the method of stretching. The method of stretching I use is superior for three reasons in my experience. First, there is much more bleeding during circumcision performed n an erect penis because the veins are dilated. Second, once the erection is induced it is not possible to go back and forth comparing the incision points between erect and flaccid states the way I am able to compare stretched and unstretched locations of the incision points. Third, the outcome of circumcision performed on an erect penis tends to remove an inadequate amount of skin because it is technically more difficult to close the wound when it is under tension as it will be with erection.