The seat belt adjuster is easy to install and convenient to use. The reason I got it is because my car's shoulder belt adjuster doesn't go down low enough and my shoulder belt goes over my neck and one side of my chest. With the adjuster in place, the angle of the shoulder strap changes enough that it goes over my shoulder and into the middle of my chest. It's much more comfortable and I feel safer. The seat belt lap belt stays in place when the adjuster is in place. I just leave it on my seatbelt when I go out and it's ready to go when I come back. (I would NOT recommend it for children as small children have space in a booster.)
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