I have a SizeGenetics extender with Autoextender Vac mod. Couldn't stand the noose or strap, but the vacuum mod makes it nice and comfy, can wear for hours no problem. I gotta think any vac extender is the way to go for comfort - penimaster pro, vacextender, etc... I wrap the base with athletic wrap to cushion it where it meets my pubic bone and scrotum - this helps a lot for me. I tried the various gel base pads, but didn't find they worked well for me. I think some creativity, trial and error and persistence will get you to the best combination of comfort/effectiveness for you. Good luck!