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The surgeon that I am going to use, Dr Kansas here in Austin Does all infra pubic installations and Uses almost always the AMS.

I had an appointment with him last week and he informed me that he would use the Titan if I wanted which I think I am going to do. My concern is that i understand that infra pubic is more difficult to size well than Scrotal. He does about 100 of these a year or so all infra pubic. I am concerned that he may not have the expertise to size the Titan accurately or perhaps am I over thinking this a bit?

He says that recoop time with infra pubic can be much easier as well which would be nice.

What are the good and bad with these 2 types of installation?

I am wanting to do the Titan to try and keep my girth of 6.5" circumference as best as I can. I am also wondering if I should go to a doctor that does more of the Titans and penal scrotal or if the guy does 100 a year then he should be skilled enough to know what to do. Once again sizing is the concern as with most everyone I think.

He says his primary reason for the AMS is the more natural feel of the penis and Auto filling is a problem in about 2% of the cases requiring revision.

Is he willing to ask former patients to contact you with testimonials for his expertise?

How many Titan implants does he do? 100 a year for Titans or is that for both the AMS and Titan models?

Recovery discomfort is temporary. The complications possible with infrapubic are permanent (nerves are easier to damage, routing the tubing is a little more complex, etc) For a highly skilled and experienced surgeon, this is not a scary factor and 8 per month is not particularly low volume. An extremely dedicated surgeon who dos 100 a year may well produce better outcomes than a 400 a year surgeon who cares less about his patients' full satisfaction. I would put 100 perfect outcomes up against 400 merely satisfactory "good enough" outcomes any day.

Investigate his track record. Infection rate is very telling and not as subjective as "patient satisfaction".

Make sure he understands and buys into your desires totally. Otherwise, find a surgeon who does. I did (and took 14 months to do it) and and happy I did.

As a data point. Dr. Karpman does around 100 per year & to the best of my knowledge uses the infra pubic incision. Generally comes with decent reccomedations.
I agree that it seems to me that measuring for cylinders during an infa pubic surgery might be tricky. But consider the surgeons experience into the equation. There is a good chance that he might add a cm to account for bending the penis downward. Compare outcomes, not how he gets there.

I vote for the peno-scrotal approach.
In my opinion which isn't worth much, the tubing from cylinders to pump would be a lot less noticeable,
and the incision would be not as visible.

I think it may be more difficult to install the reservoir.
All-in-all, I think the doctor only cares about ease of installation.

Thoughts?

tomas1 wrote:I vote for the peno-scrotal approach.
In my opinion which isn't worth much, the tubing from cylinders to pump would be a lot less noticeable,
and the incision would be not as visible.

I think it may be more difficult to install the reservoir.
All-in-all, I think the doctor only cares about ease of installation.

Thoughts?

Ok so this is what I was wondering. So the doctor likes the Infra Pubic because it is easier to install for him and probably faster recovery for the patient. However this does line up to Dr Eid that does penile scrotal for the best results but a longer recovery time. The fear is that the surgeon is not so very skilled. I have surgery scheduled for August 13th. Looking to get another opinion from another doctor. I have a one hour consult online with Dr Eid on the 25th. However i do not think I can get in to see him for like 3 to 4 months from now.

tomas1 wrote:I vote for the peno-scrotal approach.
In my opinion which isn't worth much, the tubing from cylinders to pump would be a lot less noticeable, and the incision would be not as visible.
I think it may be more difficult to install the reservoir.
All-in-all, I think the doctor only cares about ease of installation.
Thoughts?

Here is my thought. All of the implant parts end up in basically the same places with either method. So how is the tubing routed differently? The pump is still in the sack! Reservoir is still in the body. Cylinders are in the penis. There isn't enough tubing on the parts to get very far away from either methods final placement.
The infra pubic approach supposedly heals faster, so some say.

I looked in to both ways and from a mechanical stand point the way that Dr. Eid does his surgery is the only way to get the optimum result as far as healing time is concerned. Sex at 21 days i think his healing time is as good as it gets and as for skill there is no comparison he wrote the book on his no touch method lowest infection rate there is sizes things to the highest standard . Why not wait 3 months for a happy ending.
Dave

I asked my doc for the scrotal approach and he seemed lukewarm to it. He said we'll see which is best for you.
I was surprised to wake up with the scrotal incision. I actually healed fast, but even when I self-treat pretty bad cuts, I usually heal fast and have never had an infection.

Don't know why I added that.

I do find that the hardest part of my recovery was where the reservoir gets through a puncture.
I still get a twinge there at times. I think it feels like a hernia which I've never had.

i used kansas in 2016. this was my experience:
viewtopic.php?t=6743

i was 8"x6.25" pre-ed. now i'm exactly 7x5. i expected to lose some length from all the years of ed but lost more than an inch of girth on the operating table simply bcz of kansas' negligence. if you have to use the guy make sure he gives you exactly what you want.