What a great gag! It inflates with the squeeze of the inflator bulb, but has a full breather tube through its middle, extending out some 15 inches. The leather head strap is adjustable to hold the gag firmly in place in your mouth as you inflate it. It doesn't take much to fill your mouth. I've always thought it was sexy as the boy's drool starts to drip out the end of the tube because he can't swallow his saliva. The length of the tube can be cut to what ever length you want. This inflatable gag is also sold without the leather gag strap as HT728.