Vacuum heads are better than straps at avoiding strangulation.
I personally don’t think extenders are a good way to do PE. Using an extender to the point of loss of tug back causes me to lose about .25” erect length for a few days. Maybe they are useful for people who use them in a more moderate way, but they’re so uncomfortable and difficult to keep warm in that I don’t plan to use them anymore.
A light weight hanger, .5 lb., keeps the tissue elongated, but doesn’t cause loss of tug back or retraction the next day. They’re much easier to modify so they don’t cut off circulation too badly and after wearing one for a few hours, you can definitely feel it stretching things inside the penis.
Penis pumps are great and easy if used with the right inHg and time. Gaining girth with a penis pump is ridiculously easy in my experience. 20 minutes every other day at 5 inHg seems to produce sustained gradual growth without injury. It takes less time than getting ready in the morning and you can watch porn at the same time.
Starting: 7"bplx5.2" 2017 (shrunk from disuse)(originally 8"bplx4.5", gained to 9"bplx6")
Current: 9.0"bplx6.125" 2020
Goal: 11.5"bplx7" 2021.