Pain and bleeding were easily controlled. I worked without anesthesia. The glans was fixed in such a way that I had free access to the shaft piercing from the inside. The tape kept it very tight and pressed as flat as possible onto the wood. I pushed the punching iron from the inside out between the glans and erectile tissue using hand force. It was only on the last part that I helped with a few light taps of the hammer. I wanted to be sure that the tissue was completely severed. After half a year I repeated the process. It took a while and some care to get the skin to grow to a point where it looks nice. At that time I decided on a 6mm punching iron because I didn't want to injure the erectile tissue. I'm not sure if there's enough space for a larger punching iron.