I'm willing to believe that body pillows are a lot more widespread in Japan than in the US, but is it really that easy to get someone's body printed on the cover? I've seen this kind of thing (obsessed crushers with the crushee on their pillow) too many times for it to just be something that someone made up.
I dunno so much about real life, there might be some questions involved depending on where it's done at, but I think in this picture, it's best not to think about it too deeply. It's just part of the joke.
ElGranFracaso said: I'm not certain as to why she needs the tissues ... unless she's a futa and doing a bit of sleeve-banging. Never thought of *that* idea before.
Uh, a girl, depending on the amount of fluids, might want to clean after herself too, you know.