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I still do not have an ADS yet, but I am thinking about getting the vac-ext. There are many pics of different positions that you can use with this product. I was wondering which way is the most effective to use for ADS?

Also do people still use/recommend a magnetic wristband for when not using your regular ADS?

In my opinion straight-down is probably the most effective direction to use an ADS, although there is no hard evidence to support this position (or any other).

I wear and recommend a wristband/elbow-wrap for non-ADS times. It helps to keep the penis slightly extended away from the body.