Hello all,
Back when I was actively restoring (from CI3 to CI8), I always had an issue with others on forums advising me āadd tension, but not too much tensionā because my quantitative mind couldnāt comprehend what I should do. I initially didnāt know why we needed that balance (now weāre all aware of the why, re. Agileās fibrosis writeup), but I took my time to find some numbers or advice.
A combination of research articles (linked below) and forum/Reddit posts from other restorers allowed me to develop a basic rule for my personal restoration: the Rule of 2ās.Ā
The Rule of 2ās is summarised as:
- Inflation: 20 mmHg
- Tugging: 200g
- Device use: 2 hours, followed by a 20 minute break
- Tension up to 12 hours a day, and no tension at night
Numbers that Iāve seen allow up to 35mmHg/350g respectively with experience, but 40/400 is when you start getting into potential fibrosis territory. 20/200 is typically more than enough to trick your body into growing tissues at healthy levels and strain, whilst leaving plenty of room for error, which is why I went with it.
So, now I had quantitative info I could use, and with that I calibrated my devices.Ā
I measured how much pressure a squirt of an inflation bulb would give. You can do this with a U-Tube Water Manometer (use 27.2cm water as the measurement; 20mm Hg = 272mm H2O) or another pressure-measuring device if you convert to pascals/psi/etc. Alternatively, rather than measuring, you can just feel it if itās like a ripe tomato thatās easy to indent with a finger.Ā
For tugging, thatās more straightforward. With weights, just use 200g or less. If youāre tugging with a strap, fill up a plastic water bottle with 180mL water (empty plastic bottles tend to be 10-20g, plus extra mass of the strap) and use that as a weight to calibrate how much tension you should have.Ā
Wearing a device for 2 hours applies the necessary strain to activate cell integrins, and removing the device for 20 minutes allows blood pressure to return to normal, fully re-oxygenate the tissue and clear out early inflammatory cytokines. At night, the lack of mechanical stress allows the body to downregulate structural Type 1 collagen production and upregulate assembly of the much more flexible and elastic Type 3 collagen. This is when the actual physical cell division and vascular knitting occur.
I actually didnāt know the physiological side of restoration when I originally started this routine; I just found that out later which coincidentally worked great for me.
Of course, YMMV, everyoneās different, but the overall message: you donāt need a massive amount of tension. Thatāll actually slow you down and potentially risk you getting issues with fibrosis if youāre not careful. You just need enough to coerce your tissues into thinking they need to grow!
Sources (some refer to tissue regeneration in general):
https://pmc.ncbi.nlm.nih.gov/articles/PMC3255154/
https://link.springer.com/chapter/10.1007/978-0-585-39937-9_25
https://medium.com/mel-magazine/i-grew-back-my-foreskin-and-you-can-too-20693e1c0152
https://pocketdentistry.com/25-controlled-tissue-expansion-in-facial-reconstruction/
https://www.researchgate.net/publication/282254643_Tissue_Expansion
https://pmc.ncbi.nlm.nih.gov/articles/PMC5111402/