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Hi guys,

Like I said, I'm already scheduled for IPP surgery with Dr. Hakky next month. There are three things about it that I'm unclear on.

1 - Dr. Hakky proposed a suprapubic incision, saying that it would heal about 1 week faster, but that the scar would be much more visible. My wife says she's OK with it, but I can't help thinking that a week is just a week, but a scar is forever. Does anyone know where I could find pictures of a fully healed suprapubic scar? My google-fu is usually pretty good, but I haven't really had any luck finding images of healed scars. I know it's a big ask, but is anyone willing to share a pic of their scar? It doesn't even have to be NSFW - I'm really just curious what the scar itself looks like. Also, any other thoughts on the incision site are welcome.

2 - Just as I was leaving my most recent appointment, Dr. Hakky asked if I wanted him to go for a little extra length when he's implanting. My first thought was "Is this a trick question?", but I guess there are implications to it. I am already using a vacuum pump 2x per day pre-op as he suggested in order to maintain length, and if he implants the larger cylinders I think there's some kind of aggressive cycling program post-op to make it all work. Do you guys have any experience with this?

3 - How big a problem are "dog ears"? I think Dr. Hakky wants to use the Titan which I believe has more of a problem with this. Is it really a thing?

Thanks to everybody for the help on this. I learned a lot just by lurking and now it's great to be able to ask questions directly.

I think he probably said "infrapubic", although there may be a "suprapubic" I've never heard of.

There are 2 schools of thought on IP vs PS (infrapubic vs penoscrotal). Dr. Perito claims that at the 6 month mark the outcomes should be identical, no matter which surgical approach you use. Very well known high volume doctors seem to disagree on which one is best. Eid will only do penoscrotal (and is vocal as to why it's the best option), Perito recommends infrapubic. Clavell does penoscrotal, Karpman does infrapubic. My guess is they can all do the other approach if necessary, but they all must have good reason to choose the approach they do.

If you're committed to Dr. Hakky, and he is most familiar with IP, then that's what you go with.

I interviewed with Dr. Clavell, and he prefers PS. I chose PS because I did not want the visible scar (wife and I have frequented nudist resorts and I'm closely trimmed, people would know I was cheating), I didn't want to risk nerve damage from going in around the dorsal nerve bundle(which is extremely rare, but possible), I wanted the pump placed in the scrotum right where it belongs at time of surgery (IP is a tougher placement in the scrotum and often requires you to pull it down into position over time), and I didn't care as much if there was a higher possibility that the reservoir was palpable or not (I have plenty of coverage there already). Infrapubic is tougher to place the pump, penoscrotal is tougher to place the reservoir. I choose pump placement in my scrotum over reservoir in my gut.

The IP surgery is faster, the reservoir is easier to place, the time to start cycling and eventually use it on someone can be weeks sooner. Eid claims that IP can retard full extension of the penis.

Generally, I believe the recovery is easier with IP, but some here on FT have had terrible experiences with both approaches. Each person heals differently.

As for which implant, they too both have their pros and cons. I found Dr. Clavell's video comparison very helpful:
https://www.youtube.com/watch?v=vMyIOsHJoUs

I'm choosing the AMS 700 CX, and one main reason is the dog ears and 'crinkling' of the Titan you mentioned. The AMS is reportedly much more comfortable in the flaccid state. I don't know about you, but I'll (unfortunately) be in the flaccid state 99% of the time I have left on this earth. The CX is comparable to the Titan in rigidity, and I'm not worried about regaining or generating some missing girth. The biggest factor was that Dr. Clavell leaned that way for my application, and again, I'll defer to his judgment in regard to which is best. I know he installs both types, and my own research supports his recommendation for the AMS product. Your situation may be entirely different, especially if you have an underlying condition that would be better addressed with a specific implant.

As for sizing, you want a surgeon that rounds up and pushes the envelope, within reason. Your body can stretch to accommodate more length as you cycle the implant. Studies show that men who have to have a revision for whatever reason almost always are implanted with a larger size than they started with, as their body has stretched over time.

Bottom line is, if you're team Hakky, then you do what he recommends. You shouldn't pick a surgeon you trust and then second guess his experience and expertise, but it's good to ask questions and educate yourself.

Paul,

Dr. Hakky did my implant about 7 months ago and its great. Would be glad to talk if you want. Just send me a PM with your number and a time. I'm free this week.

Jage64 wrote an excellent post regarding the pros/cons of infrapublic (IP) vs penoscrotal (PS).

I'm a "naturist" (not nudist) and go to a clothing optional resort each year for a few months to get a full body tan.

So, I also didn't like the idea of the IP scar but I still chose IP because the estimated recovery time was shorter (3 vs 6 wks) and also because I had a hernia repair w/mesh that would make PS more problematic than w/IP.

Some people have already told me that they don't like me saying this but I also chose IP over PS because, based on what I read, there are more reports of serious pain/discomfort during recovery w/PS than w/IP.

This is not a judgement. It's a factual report of what I've read/heard which was also confirmed by both of the docs that I consulted -- one who does PS and the other do does IP.

However, as with most things there are always exceptions. Not everyone who gets a PS has such problems and not everyone who gets an IP does not.

---------------------------------------------------

I'll try to take/post of pic of my scar (which is now only 13 days post surgery) for you to see.

I frankly don't like the way it looks. It will always be visible because I lasered all of my hair off down there (and everywhere else on my body) where it could be done w/o extreme pain (like in the perineum).

I just hope that the incision scar fades over time & in the meantime, is made less noticeable by my annual tan.

However, if you still have hair down there, it really shouldn't matter because it should be completely (or at least mostly) hidden after your pubic hair regrows.

PaulBunyan wrote:Hi guys,

Like I said, I'm already scheduled for IPP surgery with Dr. Hakky next month. There are three things about it that I'm unclear on.

1 - Dr. Hakky proposed a suprapubic incision, saying that it would heal about 1 week faster, but that the scar would be much more visible. My wife says she's OK with it, but I can't help thinking that a week is just a week, but a scar is forever. Does anyone know where I could find pictures of a fully healed suprapubic scar? My google-fu is usually pretty good, but I haven't really had any luck finding images of healed scars. I know it's a big ask, but is anyone willing to share a pic of their scar? It doesn't even have to be NSFW - I'm really just curious what the scar itself looks like. Also, any other thoughts on the incision site are welcome.

2 - Just as I was leaving my most recent appointment, Dr. Hakky asked if I wanted him to go for a little extra length when he's implanting. My first thought was "Is this a trick question?", but I guess there are implications to it. I am already using a vacuum pump 2x per day pre-op as he suggested in order to maintain length, and if he implants the larger cylinders I think there's some kind of aggressive cycling program post-op to make it all work. Do you guys have any experience with this?

3 - How big a problem are "dog ears"? I think Dr. Hakky wants to use the Titan which I believe has more of a problem with this. Is it really a thing?

Thanks to everybody for the help on this. I learned a lot just by lurking and now it's great to be able to ask questions directly.

I had infrapubic about 8 months ago and unless you’re down on a level with my crotch you can’t see the scar, and I shave it clean.It’s just a faint line.
As far as aggressive sizing, you’ve got a great Dr so sure if wants to step up a hair if it’s between sizes than sure all day. I can only speak about infrapubic and my recovery was very easy. Had almost zero swelling in scrotum after surgery. The pump was placed perfectly low and center and I only pulled down occasionally. I was gently adding a pump and releasing it by the 12 day and fully pumping by the third week and had sex just before my 4th week. I’ve read of many problematic surgeries with scrotal as well as infrapubic. I personally think it’s the surgeon that makes the difference. A friend of mine had scrotal done and he’s going back in for a revision because the Dr got the tubing way too long and it bulges out the side. Again it’s more the skill of the surgeon and if you have one that does it one way he won’t likely do it any other as that’s the way he’s good at. Eid and perito as opposite and both are world class surgeons and both have an extremely good record. I chose a Dr that did infrapubic and was trained under the Perito method and didn’t even use a catheter because it only takes less than 30 minutes! That n itself is a big advantage in my book. Many issues are avoided by not using a catheter. As for dogears. They are a bit painful at first but within a few weeks you get toughened up to them and you forget they are there. Even at the worst they aren’t noticeable unless I manually fold my dick almost over on itself. When walking around nude you simply put a couple pumps in to fill it out just a bit and it still hangs about 5oclock, and is smooth and totally natural looking, with the exception that it’s just a lot bigger now when flaccid. Never looks excited just a shower now and never shrivels up no matter how cold it gets!

Rider1400 wrote:I chose a Dr that did infrapubic and . . . it only takes less than 30 minutes!

This is another reason why I chose IP. The time estimates I got for PS I got was 2.5 hours (150 mins) vs 30 mins for IP. Since both are done under general, the shorter the time of anesthetia to me, the better.

My doc still used a cathether but I stayed overnight & it was removed the day after. Given the amount of pee that I passed and the # of times the nurses had to empty the reservoir, I'm glad it was used. Same for the drain that was also installed overnight and removed the day after.

sswinsfba wrote:Since both are done under general, the shorter the time of anesthetia to me, the better.

Not necessarily true that both are done under general anesthesia.

A nerve block and 'twilight' anesthesia also does not require intubation as one under general would very likely require.

I don't know who told you that the PS surgery is 2.5 hours, but that's wildly inaccurate. Clavell states clearly from the time you go to sleep from the time the surgeon is done is less than 1 hour.

This video will start right as he addresses this:
https://youtu.be/ChClScRW3Zg?t=596

Jage64 wrote:

sswinsfba wrote:Since both are done under general, the shorter the time of anesthetia to me, the better.

Not necessarily true that both are done under general anesthesia.

A nerve block and 'twilight' anesthesia also does not require intubation as one under general would very likely require.

Ok. Let me qualify. This is what I was told by the IP & PS surgeons that I spoke with.

Anyone who want to do PS and is worried about the length of the surgery should ask if a "nerve block & 'twightlight' anesthesia" is or can be used instead.

I heard Perito mention that he uses a local and IV anesthetic but he's doing IP which should be shorter anyway.

I was implanted two years ago by Dr. Hakky. He prefers the scrotal incision, usually. Is there a reason that he doesn't want to use this approach on you?
He is an excellent surgeon so I feel confident that he has a reason. I'm very happy with what he did for me.

I am also scheduled with Dr Hakky for March! During my consultation he asked me if I had a preference for IP or PS and explained the pros and cons of each. I asked him what he typically does and he said he does roughly 50/50 and the approach is up to my preferences. I told him I'd like to avoid a scar and he said then the PS approach it is.

As far as Titan vs AMS. He certainly seems to have a preference for Titans. I asked him some questions concerning his opinion of failure rates and he said in his opinion is that neither one is better than the other when it comes to failures. He mentioned dog ears are much more likely with the Titan, but for younger people he typically suggests Titans for the rigidity and girth potential. From what I've read those benefits may be a tad overrated. I think people are generally happy with either assuming a good surgeon. I still haven't made up my mind...