Your friend needs to lose weight in a healthy planned manner before any surgicl intervention can be decided upon.
Tightening of the foreskin (phimosis or paraphimosis) will need surgical intervention to prevent further complications.
This can be achieved either by circumcision or by minor surgery that involves freeing the foreskin without excising it.
This will need to be discussed further with your surgeon, based on how you want to proceed.
" * Circumcision is the traditional surgical solution for pathological phimosis, and is effective. Serious complications from circumcision are very rare, but minor complication rates (e.g., having to perform a second procedure or meatotomy to revise the first or to re-open the urethra) have been reported in about 0.2-0.6% in most reported series, though others quote higher rates.
* Preputioplasty, in which a limited dorsal slit with transverse closure is made along the constricting band of skin can be an effective alternative to full circumcision. It has the advantage of only extremely limited pain and a very short time of healing relative to the rather more traumatic circumcision, together with no cosmetic effects"
"High rates of success have been reported with several nonsurgical measures:
* Application of topical steroid cream for 4-6 weeks to the narrow part of the foreskin is relatively simple and less expensive than surgical treatments. It has replaced circumcision as the preferred treatment method for some physicians in the U.K. National Health Service.
* Stretching of the foreskin can be accomplished manually, sometimes with masturbation, also known as the Beaugé method. The stretching can also be accomplished with balloons placed under the foreskin skin under anaesthesia,or with a tool. The tissue expansion promotes the growth of new skin cells to permanently expand the narrow preputial ring that prevents retraction"
Noncorrection of the phimosis can result in complications such as balanitis and predispose to cancer as well.
Do keep us posted on your doubts and progress.
Penile intassuception? Does that term describe the conundrum of penile retraction or "turtle in the shell". Try urinating with that!