That thin noose looks a bit uncomfortable
You can, of course, make the noose thicker. I showed a 3/8” noose at the noose section of the tutorial but my personal preference is slightly thinner than that (1/4”).
Any attachment system is going to be uncomfortable at first, like a new pair of shoes. As long as you are not getting excess skin trapped or folded in the attachment area you shouldn’t experience pain.
Just to clarify, again, the noose is not flexible like a rubber band or like most commercial extender nooses. When the pipe stretcher is sized right it wont cut in the longer you wear it like a flexible noose. It is a solid loop, much like like an OK grip with your own hand, you squeeze till you get down to a certain size the hold at that size.
Think of the pipe stretcher attachment system like poking your head through the railing and getting stuck like a kid, you got your head though by twisting at a certain angle, but by pulling at a different angle your head is stuck between the bars. You can still breath, but your head is stuck. Which in this particular case is a good thing.
Alternatively, a traditional flexible noose is more like having a bungee strap wrapped tight around your neck, and breathing is not so easy.
The biggest hurdle I’ve met has been preconceptions about the noose. People see it and automatically think of what they have read about how bad they can be and blindly disregard it, which is their loss I suppose.
Keep an open mind and a closed wallet... unless it's open to making a donation!