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Key West Necktie 

A sexual maneuver popular in island communities populated by chain-smoking men with tiny penises, the recipient is mounted and subsequently fucked in their tracheostomy hole-- typically with enough force and velocity to cause the expulsion of dentures as the erect penis continues on its path out of the oral cavity.

Occasionally, after long sessions repeatedly entering the tracheostomy stoma and exiting the recipient's mouth, the penis can become entrapped, as the engorged head of the penis is unable to retract beyond the recipient's gumline. This condition is known as a Reverse Columbian Necktie.
"Tyler was humiliated and laughed at by his recently-crippled girlfriend and her nurses because his small penis couldn't penetrate during attempts at vaginal sex, and someone posted a video of him falling off her when his penis popped out while attempting a Columbus Side Car.

Swearing off women forever, Tyler decided that he would immediately break up with Jessica, quit his job, and move to Key West that very night.

Jessica started on him as soon as Tyler walked into her room to tell her goodbye, but he didn't care. As a parting gift, Tyler gave Jessica a Key West Necktie, walked out, and since he had a few hours before his flight, proceeded to have a few beers celebrating the first--and last--time he was able to leave a woman speechless.”
Key West Necktie by Scoggy July 19, 2019
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