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Use a VED before surgery. Here's why:

When pre-operative VED is used, SPL could increase by a
mean of 0.80
0.38 cm. In addition, the surgeon is provided
with better opportunity to restore longer penile length that replicates
an appearance more consistent with the patient’s natural
erection. Ease of corporal dilation allows for an appropriate size
cylinder to be inserted, and thus helps to maximize patient satisfaction
post-operatively. There were no negative intraoperative
complications associated with the use of pre-operative VED, and
therefore, if patients have access to it, VEDs can safely be recommended.
Future studies among larger samples will help assess
the long-term outcomes and outline the role of VED as a valuable
intervention prior to PP implantation.

Canguven, O., Talib, R. A., Campbell, J., De Young, L., El Ansari, W., & Al-Ansari, A. (2017). Is the daily use of vacuum erection device for a month before penile prosthesis implantation beneficial? A randomized controlled trial. Andrology, 5(1), 103–106. https://doi.org/10.1111/andr.12258

Use a VED after surgery too. Here's why:

Penile shortening after inflatable penile prosthesis placement for erectile dysfunction is a common postoperative patient complaint and can reduce overall satisfaction with the procedure. In this prospective study we report our results regarding penile dimensions and patient satisfaction outcomes after 1 year of follow-up from AMSTMLGX700® penile prosthesis implant with 6 months of vacuum erectile device therapy. Seventy-four selected patients with medically refractory erectile dysfunction underwent AMSTM LGX 700® IPP placement. Postoperatively, patients were assigned vacuum device therapy for 5 min twice daily. Follow-up continued for 1 year after surgery. Dimensional and functional results were assessed. Baseline median preoperative stretched penile length and girth were 14 cm (range 10-17) and 9 cm (range 7-12), respectively. At the end of the study penile median dimensional outcomes were 17 cm (range 13-23) for length and 11 cm (range 10-13) for girth while a median number of 24 pumps (range 18–29) to fully inflate the device was seen. Baseline median International Index of Erectile Function (IIEF-5) score was 9 (range 5-11), at 6 months 20 (range 18-26) and at 1 year was 25 (range 20-27) (p<0.0001). Median Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) score at the end of the follow-up was 74 (range 66–78). Our postoperative rehabilitation program is feasible and should be recommended after prothesis surgery in order to increase overall satisfaction with the procedure. Penile postoperative dimensional outcomes were statistically significant improved and complications were negligible.

Antonini, G., De Berardinis, E., Busetto, G. M., Del Giudice, F., Chung, B. I., Conti, S. L., Ferro, M., Musi, G., Fragas, R., De Cobelli, O., Sperduti, I., Gross, M. S., & Perito, P. E. (2020). Postoperative vacuum therapy following AMSTM LGX 700® inflatable penile prosthesis placement: Penile dimension outcomes and overall satisfaction. International Journal of Impotence Research, 32(1), 133–139. https://doi.org/10.1038/s41443-019-0125-z

It is interesting reading these forums how many of you cite how one doctor said to do this and one doctor said to do that. Honestly, that's not the only way we learn things anymore. The research is consistent that a VED should be used to allow your penis to return to its original size. Your current sizes after years of erectile dysfunction and aging are not relevant to this situation, because this study refers to average sized penises pre-implant.

It's my opinion you should believe the research and by science, not by what Doctor John L. told you. My doctor told me a VED wouldn't do me any good. What I realized after two months is that it won't do me any bad either. It's helped since then.

If your doctor tells you specific reasons your penis cannot safely use a VED, consider not using one. What my admittedly uneducated (but fairly well researched) brain can safely argue is that your penis is gonna be able to survive a VED - for one, the research says it will, and for two, over the past tens of thousands of years, dicks have been through much worse than damn penis pumps. Your dick will thank you if you do.

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Editing into this post in early January 2023 to add these two sources that I think are worth reading for anyone out there who wants to learn first...

This is how they work:

VED, which are traditionally a closed end plastic cylinder placed over the penis, use negative pressure via a battery or hand-operated vacuum suction to increase penile blood flow via distension of corporal sinusoids. This negative pressure subsequently induces arterial blood flow into the sinusoidal spaces of cavernosal tissues. Doppler studies have shown nearly a 2-fold increase in cavernosal artery diameter with use of VED.¹ Notably, VED can stimulate oxygenation of corpora without need for an intact nerve supply, a benefit vs pharmacological options for erectile dysfunction such as PDEi-5.

Mehr, J., Santarelli, S., Green, T. P., Beetz, J., Panuganti, S., & Wang, R. (2022). Emerging Roles of Penile Traction Therapy and Vacuum Erectile Devices. Sexual Medicine Reviews, 10(3), 421–433. https://doi.org/10.1016/j.sxmr.2021.12.003

Here's why they're safe:

The vacuum erection device (VED) is the oldest therapy used for male sexual function among all approved modalities. It was introduced for erectile dysfunction (ED) nearly 150 years ago, cleared by U.S. Food and Drug Administration in 1982 and adopted by American Urological Association (AUA) in 1996 as a standard of care.¹ Significant amount of clinic evidence has proven the effectiveness of VED for ED since the early 1980s.

Wang, R. (2022). Is There Still a Role for Vacuum Erection Devices in Contemporary Sexual Medicine? The Journal of Sexual Medicine, 19(5), 682–685. https://doi.org/10.1016/j.jsxm.2022.02.013

Use a VED and show me how I'm wrong.

I got my implant in early March of this year. No issues or problems whatsoever. I am entering my 4th month post op and I wanted to ask if I can start using a VED to help gain length and girth.

1- Any suggestions as to which VED has been successful?
2- How often should I use it?
3- Should I use it while inflated or flacid?

I have no complaints whatsoever when it came to resuming sex with my wife. Obviously, it's too early to feel like before, but I am at 75% as to what is used to be. I know it is going to get so much better.

Don't get me wrong, I am thrilled to death compared as to when I got ED after having my prostate removed and I had to do 39 sessions of radiation, plus the Lupron shots.

I just want to gain a little size and girth if that is possible.

But, if this is the best it can get, I will not complain. I am over the moon compared to 3 years ago.

Any help would be deeply appreciated.

Blessing to all my fellow potential implanters and post implanters

I wanted VED to work for me, but it caused me stinging pain regardless of how lightly I used it. Maybe I was doing it wrong, and I am willing to give it a another go if one of the top docs recommends that I do so. Eid didnt recommend it at the time of my surgery. There are also some people here who think VED caused them damage, although it seems to be a minority.

I think this thread would be a good place for some of the experienced VED users to chime in and let us know which VED models have or haven't worked well for them.

Cnidium wrote:I wanted VED to work for me, but it caused me stinging pain regardless of how lightly I used it. Maybe I was doing it wrong, and I am willing to give it a another go if one of the top docs recommends that I do so. Eid didnt recommend it at the time of my surgery. There are also some people here who think VED caused them damage, although it seems to be a minority.

I think this thread would be a good place for some of the experienced VED users to chime in and let us know which VED models have or haven't worked well for them.

Did Eid elaborate on why he doesn't recommend VED? I've seen accounts of people hurting themselves with VED but if it's not done aggressively, is it still a danger?

nuance wrote:

Cnidium wrote:I wanted VED to work for me, but it caused me stinging pain regardless of how lightly I used it. Maybe I was doing it wrong, and I am willing to give it a another go if one of the top docs recommends that I do so. Eid didnt recommend it at the time of my surgery. There are also some people here who think VED caused them damage, although it seems to be a minority.

I think this thread would be a good place for some of the experienced VED users to chime in and let us know which VED models have or haven't worked well for them.

Did Eid elaborate on why he doesn't recommend VED? I've seen accounts of people hurting themselves with VED but if it's not done aggressively, is it still a danger?

I cant remember as it was ~5 years ago. I'll be asking Hakky and Cordon soon.

Cnidium wrote:I wanted VED to work for me, but it caused me stinging pain regardless of how lightly I used it. Maybe I was doing it wrong, and I am willing to give it a another go if one of the top docs recommends that I do so.

I first used a VED two months after my procedure. I don't think I'd call it "stinging pain," but I would say it was extremely uncomfortable, more so than I expected. I had to contact someone to make sure I wasn't gonna break my dick. Cause it felt like a VED was gonna break my dick. But it didn't. Because they don't. Your dick will be all right.

nuance wrote:Did Eid elaborate on why he doesn't recommend VED? I've seen accounts of people hurting themselves with VED but if it's not done aggressively, is it still a danger?

Of course you've seen accounts of people hurting themselves with a VED. Because the people who didn't hurt themselves don't report anything. Also, their accounts are not medical proof of any real injuries that happened; they are men complaining online about their dicks hurting. I would not recommend basing your decision to use a VED on the outliers you read online, many of which aren't legitimate injuries, and are concerning easily available and I believe FDA approved devices.

2435tjklAS wrote:

Cnidium wrote:I wanted VED to work for me, but it caused me stinging pain regardless of how lightly I used it. Maybe I was doing it wrong, and I am willing to give it a another go if one of the top docs recommends that I do so.

I first used a VED two months after my procedure. I don't think I'd call it "stinging pain," but I would say it was extremely uncomfortable, more so than I expected. I had to contact someone to make sure I wasn't gonna break my dick. Cause it felt like a VED was gonna break my dick. But it didn't. Because they don't. Your dick will be all right.

nuance wrote:Did Eid elaborate on why he doesn't recommend VED? I've seen accounts of people hurting themselves with VED but if it's not done aggressively, is it still a danger?

Of course you've seen accounts of people hurting themselves with a VED. Because the people who didn't hurt themselves don't report anything. Also, their accounts are not medical proof of any real injuries that happened; they are men complaining online about their dicks hurting. I would not recommend basing your decision to use a VED on the outliers you read online, many of which aren't legitimate injuries, and are concerning easily available and I believe FDA approved devices.

I have since reimplemented VED, and I have found that it does have a host of nice benefits when used daily. Generally more fluffy, healthy-feeling dick. No pain, and I don't pump beyond 5hg on my gauge. I would recommend it to those who use it reasonably.

I have since reimplemented VED, and I have found that it does have a host of nice benefits when used daily. Generally more fluffy, healthy-feeling dick. No pain, and I don't pump beyond 5hg on my gauge. I would recommend it to those who use it reasonably.[/quote]

I thought I was nuts! Exactly, "fluffy" is a great way to put it. After VED I have a soft bulge below the head like before implat (I'm circumcised)

Agree with Cnidium. Do not exceed 5hg and you will be fine. It is very good for your penis health and size.

Cnidium wrote:I wanted VED to work for me, but it caused me stinging pain regardless of how lightly I used it. Maybe I was doing it wrong, and I am willing to give it a another go if one of the top docs recommends that I do so. Eid didnt recommend it at the time of my surgery. There are also some people here who think VED caused them damage, although it seems to be a minority.

I think this thread would be a good place for some of the experienced VED users to chime in and let us know which VED models have or haven't worked well for them.

I have specifically asked Dr. Eid about using a VED and he doesn't believe in them and says that they can cause more harm than good (although, as you know, many posters here claim success) I would think that some exercise stretching of the penis (just a bit) would be good, but what do I know?...I am still titrating with injections and have yet to have a successful shot