I am a woman with short hair -- so a mask extender/adjuster that requires a ponytail to fit does not apply.My husband & I both use the flat, plastic ones. They keep the elastic mask straps from pushing directly on the back of our ears. For me, it also helps snug the masks to fit my small-boned face more securely. Personally, I use the 3rd adjustment, which was a bit tricky to adjust the second side of the elastic of the mask behind my head. However, I recently realized that I could VERY easily trim off the 1st & second adjustment "grabbers" with an easy snip of scissors. Now, the extender/adjuster is much easier to put on quickly. For me, they stayed on through a rigorous aerobics class. Plastic is smooth, so shouldn't hurt skin if your hair is not between you & it.
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