Does Name Brand Surgeon Matter?

The final frontier. Deciding when, if and how.
Courage
Posts: 14
Joined: Thu Oct 26, 2023 8:51 pm

Re: Does Name Brand Surgeon Matter?

Postby Courage » Tue Nov 19, 2024 9:52 am

Masonjames wrote:You risk significant size loss and worse at the hands of a surgeon who has little experience.
Just my two sense worth


Thanks for the responses from you and everyone else. I do get the importance of a good surgeon, which is why I'm doing a lot of thinking.

To clear up something that a few people have commented on. The local guy I'm considering is a Center of Excellence guy at a very large hospital. He does other reconstructive urological procedures, but I'm pretty sure he does a fair number of implants. I'm not saying that's the equivalent of a high volume implant surgeon, but it's more than a "little experience."

I guess it's like with so much of life: we have to decide without certainty or perfect information.
Last edited by Courage on Tue Nov 19, 2024 10:07 am, edited 1 time in total.
50 with lifelong ED. Doppler showed absence of major artery in left corpora ("I haven't seen that before" -- Doctor).

Courage
Posts: 14
Joined: Thu Oct 26, 2023 8:51 pm

Re: Does Name Brand Surgeon Matter?

Postby Courage » Tue Nov 19, 2024 10:02 am

Gt1956 wrote: I suggest to try searching FT using the names of larger cities near you. If members see you searching. Frequently they'll contact you with their experience. I received several good reports of my dr that way.


Thank you. I did post asking about my area some months ago and a few people mentioned this guy, although I don't know if they'd used him. Someone reached out to endorse him, albeit he had had an implant done elsewhere and had a much more complicated surgery with this doctor.
50 with lifelong ED. Doppler showed absence of major artery in left corpora ("I haven't seen that before" -- Doctor).

Hope84
Posts: 66
Joined: Mon Aug 15, 2022 11:01 am

Re: Does Name Brand Surgeon Matter?

Postby Hope84 » Tue Nov 19, 2024 4:08 pm

Courage wrote:
Masonjames wrote:You risk significant size loss and worse at the hands of a surgeon who has little experience.
Just my two sense worth


Thanks for the responses from you and everyone else. I do get the importance of a good surgeon, which is why I'm doing a lot of thinking.

To clear up something that a few people have commented on. The local guy I'm considering is a Center of Excellence guy at a very large hospital. He does other reconstructive urological procedures, but I'm pretty sure he does a fair number of implants. I'm not saying that's the equivalent of a high volume implant surgeon, but it's more than a "little experience."

I guess it's like with so much of life: we have to decide without certainty or perfect information.


You should ask him how many implants he does per year. Though not a perfect metric (there is no such thing, even the superstars (Eid, Perito, Hakky etc.) can make mistakes), it should give you a good indication of his skills. I'd say anything above 50/year is good, over 100 would be even more reassuring. My understanding is that you should avoid surgeons who do a few implants per year.

But I am a firm believer in the law of diminishing returns, such that a surgeon doing 400 implants/year will not be 4 times better than one who does 100. In particular if the surgeon is old enough to have practiced many of those surgeries. The surgeon who will do my implant on December 5th does about 100/year, but has done over 1500 implants in his life, so I'd say this is comfortably high enough.
30 years old French with ED caused by priapism episodes at the age of 15. Pills have lost most of their potency, injections work but are painful and not a long-term solution. Scheduled for an AMS 700 CX on 05/12/2024.

jwdetails
Posts: 83
Joined: Thu Oct 12, 2023 4:43 pm

Re: Does Name Brand Surgeon Matter?

Postby jwdetails » Tue Nov 19, 2024 4:17 pm

Hope84 wrote:
Courage wrote:
Masonjames wrote:You risk significant size loss and worse at the hands of a surgeon who has little experience.
Just my two sense worth


Thanks for the responses from you and everyone else. I do get the importance of a good surgeon, which is why I'm doing a lot of thinking.

To clear up something that a few people have commented on. The local guy I'm considering is a Center of Excellence guy at a very large hospital. He does other reconstructive urological procedures, but I'm pretty sure he does a fair number of implants. I'm not saying that's the equivalent of a high volume implant surgeon, but it's more than a "little experience."

I guess it's like with so much of life: we have to decide without certainty or perfect information.


You should ask him how many implants he does per year. Though not a perfect metric (there is no such thing, even the superstars (Eid, Perito, Hakky etc.) can make mistakes), it should give you a good indication of his skills. I'd say anything above 50/year is good, over 100 would be even more reassuring. My understanding is that you should avoid surgeons who do a few implants per year.

But I am a firm believer in the law of diminishing returns, such that a surgeon doing 400 implants/year will not be 4 times better than one who does 100. In particular if the surgeon is old enough to have practiced many of those surgeries. The surgeon who will do my implant on December 5th does about 100/year, but has done over 1500 implants in his life, so I'd say this is comfortably high enough.


Agree, I don't think there is any benchmark. I think there's a lot of folks on here that have gone to the big four (Eid, perito, hanky, clavell), but lots that have had excellent outcomes with others. I think more than 100/year sounds reasonable for high volume. In terms of age, if you compare Eid vs Clavell, both excellent reputation, but don't think major difference in skills although Eid has probably done 5000 more implants in his life. Comes down to the other things (travel, pre-post-op care, bed-side manner, troubleshooting). Why I think a solid local surgeon especially in most major cities is a good option (more than 100/implants, center of excellence, in the professional societies, etc). These things break - you need someone in your corner that is going to fix any problem at any point - think long-haul. You can also ask the rep for coloplast or boston scientific for your area - they are going to send you to the best to ensure you have the best outcome and happy with their product.
62 year old, ED+PD, Coloplast Titan 22 cm no RTE in 2019 with Dr. Irwin Goldstein => failure, now with plaque excision/tunical expansion to Coloplast Titan 26 no RTE in 2022 by Dr. Darshan Patel, now with classic pump 2024 :D

Madecov
Posts: 56
Joined: Tue Sep 03, 2024 10:41 pm
Location: Houston, Texad

Re: Does Name Brand Surgeon Matter?

Postby Madecov » Tue Nov 19, 2024 4:29 pm

My first two surgeries a local guy who claimed to be high volume. Things did not go well. I later noticed he was NOT a CEO doctor, but was listed on both the Coloplast and Boston Scientific websites. My third implant was done by Dr. Clavell who I found by being a Uber of both the reddit and Facebook groups. I'm at 5 months post surgery and doing very well.

I thoroughly am convinced that experience matters.
Retired door kicker.

Prostate surgery 1999. Implant July 2023, went bad twice. Third implant June 2024.
Now, Robo Cock in the house.

LastHope
Posts: 722
Joined: Sun Feb 18, 2024 1:26 am

Re: Does Name Brand Surgeon Matter?

Postby LastHope » Tue Nov 19, 2024 7:51 pm

I agree that it's our one and only dear penis and the implant Gods can redeem them.

The idea that "only surgeons like Hakky, Perito, Kramer....are the best" is a nice sentiment, but it also risks sounding like a blind, almost religious belief. I'm guilty of this sentiment to be honest.

What about a Dr. So-and-So, who delivers excellent outcomes, works at a reputable hospital, and doesn’t rely on a YouTube channel or social media campaign to attract patients?

Such a surgeon might be easily overlooked simply because they aren't a CEO or as well-known as Kramer or Eid or the big five.

Instead of relying on popular reputation alone, I wish there are independent, objective, and measurable metrics to evaluate surgeons.

That said, I completely agree that there is no substitute for experience. Complications from the "big five" might even be underreported, potentially sidelined as a 1% "normal" statistic. Many may not even be users of FT to report their experiences!

LetoMan
Posts: 88
Joined: Tue Apr 09, 2024 1:25 pm

Re: Does Name Brand Surgeon Matter?

Postby LetoMan » Thu Nov 21, 2024 2:38 am

My two cents is that you want someone who at least does it regularly, and then you want someone who is really an excellent surgeon. My doc was an excellent surgeon that had done 15-20 a year for over ten years. He reported only one infection in that time, which is significantly better than average, and likely attributable to being an all around great surgeon working out of hospital and not a private facility. He was recommended by AMS, too.

If you are near a name brand, why not? But I think choosing someone local, or in your insurance network, makes sense so long as they have enough experience. What’s enough experience, though?

For me, a guy doing one or more a month for over ten years was fine - and the solid below-average infection record was a big selling point.

There have been some studies on this, and they show that “high volume implanters” have significantly higher success rates. However, the studies define high volume as more than 25 or 31 in a year. Eid was an author for at least one. Notably, there are no studies that I am aware of that show an increase in effectiveness if you are one of the few “super high volume” implanters that do hundreds a year. I suspect that if the data showed there was a big benefit there, Eid or someone else would publish it! I think the real benefit kicks in with competence, not with hyper-specialization. You don’t need to do three a day to be competent. But twice a year isn’t competent either.
49. Implanted 5/21/2024 at Kaiser SSF. AMS 700 CX 21cm, 3cm RTE. Penoscrotal. Venous leak my whole life. Pills helped, but hated the side effects; worked less as I aged. Skipped injections. Grateful to bionic brotherhood that helped me make this decision.

Courage
Posts: 14
Joined: Thu Oct 26, 2023 8:51 pm

Re: Does Name Brand Surgeon Matter?

Postby Courage » Thu Nov 21, 2024 5:00 am

LetoMan wrote:He was recommended by AMS, too.


Thank you. I've seen people mention "recommended by AMS" or "talk to the AMS rep." How does one get in touch with the local AMS rep?
50 with lifelong ED. Doppler showed absence of major artery in left corpora ("I haven't seen that before" -- Doctor).

LetoMan
Posts: 88
Joined: Tue Apr 09, 2024 1:25 pm

Re: Does Name Brand Surgeon Matter?

Postby LetoMan » Thu Nov 21, 2024 6:35 am

I saw it on their website, they have certain doctors they recommend. You can poke around the website and find it.
49. Implanted 5/21/2024 at Kaiser SSF. AMS 700 CX 21cm, 3cm RTE. Penoscrotal. Venous leak my whole life. Pills helped, but hated the side effects; worked less as I aged. Skipped injections. Grateful to bionic brotherhood that helped me make this decision.

LastHope
Posts: 722
Joined: Sun Feb 18, 2024 1:26 am

Re: Does Name Brand Surgeon Matter?

Postby LastHope » Thu Nov 21, 2024 10:46 am

Here's an example for AMS 700 center of excellence surgeon. I would only start with the ones with COE seal as they do a minimum of 25-30 AMS 700s per year.
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