After tearing apart the penile membrane with a probe and making an incision, the plastic bell is placed under the foreskin and over the head of the penis (exposed glans). These glans are meant to be internal. Forceful, early exposure causes immense pain and permanent damage. A piece of suture is tied directly around the foreskin, which cuts off the blood supply to the foreskin. Eventually the sutured foreskin rots off. This method is the most painful and risky of the 3 circumcision procedures.
An incision is made down the foreskin, followed by clamps being attached to the tip of the foreskin. The foreskin is then pulled up and over the bell and a clamp is tightened around it to reduce blood flow to the area. A scalpel is used to cut and remove the foreskin. This procedure is often seen as "quick and painless", despite baby suffering physical and psychological trauma that may not appear until older.
A probe is used to tear the membrane of the penis, separating the foreskin from the glans. A dorsal hemostat is placed to reduce chance of bleeding out, and the foreskin is forcefully pulled upward, away from the head. The Mogen clamp is then placed and locked, stopping blood flow, followed by removal of the foreskin with a scalpel. Tearing of the membrane results in scar tissue and further damage to the glans.