barrybj_98 wrote:Thanks Merckx and LS, just 1 follow up please. I guess I am confused on the RTE. my impression is that is the piece(s) that are inside your body? Why do some people have RTE’s and some don’t? Thanks again for all your help
If you have read theis journal, you will know my stance on RTEs, but here goes again, and I'll keep it as short as I can...
RTE means Rear Tip Extender. Name describes exactly what it is. Extenders stacked on the rear end of the implant to adjust length. RTEs are not inflatable, but rather just pieces of plastics stacked to the implant cylinders.
An implant has a part of it which is inflatable and a part which is non-inflatable.
For AMS, the non-inflatable part is 4.5 cm and for Titan it is 5 cm.
In theory, the more of your implant which is inflatable, the better. Has been shown in lab environment to give better rigidity.
So for example, an 18 cm AMS will have 13.5 cm inflatable silicon and 4.5 cm fixed plastics (at the rear end). An 18 cm Titan will have 13 cm inflatable Bioflex and 5 cm fixed plastics.
The fixed plastics is needed to allow the doc to place the rear end deep back in your crus. If it was 100% inflatable, this would be very difficult, if not impossible.
Most of the top docs, definitely Eid and Kramer, believe that the less RTEs the better for the outcome. Why? Because more RTEs give less rigidity, worse angle, and more "wobbly" erections.
This is partly because the RTEs have smaller diameter than the implant itself.
Titan RTEs are 13.5 mm and AMS only 9. Over time, this will, especially with the very thin AMS RTEs, create a less tight fit in the crus. Imagine you have cylinder at a 45 egree angle. Then you stick a long rod into that cylinder. If the diameter of the rod is same as the inner diameter of the cylinder, the rod will extend in the exact same angle as the cylinder. A tight, snug fit.
If the rod has a substantiall smaller diameter, it will hang on the lower edge of the cylinder and come out of the cylinder at a lower angle.
Also, the rod with the tight fit will be very stable, no room for wobbling. The thinner rod will be able to move around and wobble.
This effect will not be pronounced from the beginning, but will gradually present.
My doc told me he has done plenty of revisions of guys complaining that their angle and firmness of the implant has reduced over the years. The solution is to remove the implant and all the RTEs and insert an implant of the correct length with as short RTE length as possible.
Why are RTEs used then?
Main reason should be to adjust the implant length to your dick and crus. Titans come in 2 cm increments, AMS in 3 cm increments. So on average, a Titan dick should have 1 cm RTEs, with a range from 0.5 to 1.5. AMS dicks should have on average 1.5 cm RTEs, with a range from 0.5 to 2.5.
Any doc putting in 2 cm RTE or more with a Titan, and 3 cm or more with an AMS, should have a very good explanation why.
I have been told that in some cases doctors do use RTEs for other reasons than what is best for the patient. Such as:
Their job is easier with long stack of RTEs. Just easier to insert the implant in the crus with longer fixed part in the rear end.
They don't have the right size cylinder at hand.
They insert an implant and then after installation realizes that there was actually room for a larger implant. They just pull out the implant from the crus, add RTEs, and put it back in again. Instead of inserting another cylinder of the right length.
Finally, with AMS, many patients require more RTEs to get the adjust the tubing insertion point so that the pump can be placed at the right height. With Titan, this seems to be a non-existing problem.
The last issue with RTEs is mathematical logic. Nobody wants the joint between inflatable cylinder and fixed part to be in their dick. It would mean that they get a natural bending point in their dick. It would mean that when flaccid, the point where the implant (and the dick) bends will be somehwere along the shaft. Not good. You want the joint as deep inside you as possible.
Already an implant with no RTEs has this joint fairly close to shaft of the dick.
Let us take myself as an example.
My erect dick is about 17.5-18 cm long. Let us use 17.5 cm for this exercise. Cylinder tips reach till about 1 cm from my glans tip. So I have 16.5 cm implant in my dick. It means I have 24-16.5=7.5 cm inside me. Since my implant already without RTEs has 5 cm fixed non-inflatable length, I have 7.5-5 cm = 2.5 cm of inflatable length inside my body only.
If my doc would have given me a 22 cm implant with 2 cm RTE instead, I would have had 7 cm fixed part, and the joint would have been only 0.5 cm inside me.
If my doc would have given me a 20 cm implant with 4 cm RTE, I would have had 9 cm fixed part, and the joint would have been 1.5 cm into my dick! Which would have been crap.
Then of course, at this forum most people are biased towards what they have. Guys with half-foot long stacks of RTE will claim their doc is the champion of the world, that their inflated dicks point to their abs, has no wobble whatsoever and gives them fame, fortune, cures cancer, and make their wives boobs bigger. However, according to the top docs, more RTEs on average equals lower quality erections than with no RTEs.
We can all choose who we believe.
That's all on the RTE issue from me for today...
80 yrs., married 57 yrs. ED for over 20 yrs.