For younger guys who will need multiple surgeries throughout their lives - what are the risks of choosing IPP over MPP?

[JohnnyBorg]

Hey everyone! I’ve just wrapped up an ultrasound with Dr Hakky’s team that confirmed I’ve had a venous leak - likely my whole life! I’m trying Trimix over the next few weeks but anticipate that I’m going to just pull the trigger on an MPP or IPP.

I’m in my early thirties - I haven’t had a chance to deep dive into the risks and long-term strategy of implant surgery with Dr Hakky just yet (I have my next appointment in early October) and I intend to ask him all the questions that I have… but until then, I wanted to get some thoughts and feedback from the guys here.

The big question: for younger guys who need an implant, does the MPP make more sense than an IPP? What are the arguments for and against for each, in the context of a younger patient who will need multiple surgeries throughout his lifetime?

Dr Hakky did tell me today that with the IPP - assuming no device issues - that a patient should GENERALLY anticipate needing a surgery every 8 - 12 years.

Assuming an IPP lasts me on the lower end (8 years ish), that’s 6 - 7 surgeries throughout my lifetime I’m anticipating (assuming I’m lucky enough to live to see my 80’s!). That’s a lot of surgeries - and I think it’s fair to assume that there WILL be some complication along the line (at least one of those IPPs might fail early, etc).

With the MPP, I know that it’s simpler and there’s way less risk surface area (less infection risk, less failure risk. Erosion risk may be marginally higher). Hakky implied these might last more like 15-20 years. That would only yield 3-4 surgeries throughout my lifetime. Not bad!

Taking into account a bit more significant recovery timeline required + a higher out of pocket cost if insurance won’t cover it, it has me wondering: is the juice worth the squeeze?

Make no mistake - I do suspect in my case, an IPP could be AMAZING. For starters, I’m on the smaller side both length and girth wise. Hakky did feel that I could actually improve my length and girth overall with an IPP, on account of the nature of my ED (the venous leak has likely prevented me from EVER reaching my full erection potential). This is a very attractive thing to me! I know the analogy on these forums tends to be that the IPP is the “Ferrari” of implants, whereas the MPP is the old reliable car that isn’t fancy but will get you there. I have to ask myself - would I be super happy with an MPP? Am I attracted to the potential gains from an IPP purely from an emotional standpoint? That I want to absolutely maximize the performance of my implanted penis after spending my whole life without “good wood” ? At this stage, it’s really hard to say - I’d feel obviously so bummed out if I pulled the trigger on an IPP only to have an early failure. At that point, I’d be REALLY wishing I had just gone for the damn MPP.

Then I know there’s the argument that the IPP is much easier to conceal. That all sounds fine, but to be honest that doesn’t worry me too much if I go with the MPP route, especially since I’m slightly smaller to begin with.

For my case personally, I do think there’s a chance that the implant is covered by insurance. I have Anthem BCBS PPO, I’ve tried pills, am trying shots, and have diagnostic proof that my ED is physiologic in nature. This definitely complicates things for me, because originally I was planning out of pocket payment and was leaning HEAVILY towards MPP. But if insurance would cover the IPP? That does make it more appealing to maybe take a chance on it.

Anyways, I’m sorry for the word-vomit gentleman. I’ve been obviously really thinking about all this today after my diagnostic appointment. It’s exciting and terrifying all at once! I read the success stories from both the IPP and the MPP bionic brothers, and it all seems very encouraging. I just want to make sure I adopt the right long term thinking and strategy. I know there’s no “one size fits all” when it comes to the implant strategy. Just need to really start weighing out the options and facts.


Thoughts?

[Tuscan_Order]

For my case personally, I do think there’s a chance that the implant is covered by insurance. I have Anthem BCBS PPO, I’ve tried pills, am trying shots, and have diagnostic proof that my ED is physiologic in nature. This definitely complicates things for me, because originally I was planning out of pocket payment and was leaning HEAVILY towards MPP. But if insurance would cover the IPP? That does make it more appealing to maybe take a chance on it

I have Anthem BCBS PPO and my IPP was covered in-network. It did require pre-approval, which the doctor obtained. Since you have the diagnostic proof, that should not be an issue if you've also gone the pills/shots route. In my case, the shots worked, but I had had enough of them and they were causing scarring. I have heard that ED due to RALP is almost almost automatically covered by insurance, as was my case, but I have no personal knowledge. Good luck!

[JohnnyBorg]

For my case personally, I do think there’s a chance that the implant is covered by insurance. I have Anthem BCBS PPO, I’ve tried pills, am trying shots, and have diagnostic proof that my ED is physiologic in nature. This definitely complicates things for me, because originally I was planning out of pocket payment and was leaning HEAVILY towards MPP. But if insurance would cover the IPP? That does make it more appealing to maybe take a chance on it

I have Anthem BCBS PPO and my IPP was covered in-network. It did require pre-approval, which the doctor obtained. Since you have the diagnostic proof, that should not be an issue if you've also gone the pills/shots route. In my case, the shots worked, but I had had enough of them and they were causing scarring. I have heard that ED due to RALP is almost almost automatically covered by insurance, as was my case, but I have no personal knowledge. Good luck!

That’s great to know, thanks Tuscan. Also what does RALP stand for? Is that for venous leak?

Best

EDIT: please disregard, I googled it!

[Thisworld]

This is the main question all young guys ask themselves. A potential strategy could be start with an ipp during young years and then when older switch to an mpp for avoid too much surgeries. I just wonder if there cuold be any flag in this reasoning

[LetoMan]

I know the analogy on these forums tends to be that the IPP is the “Ferrari” of implants, whereas the MPP is the old reliable car that isn’t fancy but will get you there.

I think that analogy regularly comes from an account that does a Foghorn Leghorn cornpoke routine. It’s likely an alt account using AI of a notorious anti-IPP troll on this board. This topic is fairly likely to produce some crazy anti-IPP responses, which will unfortunately make it difficult to discern valid advice from craziness.

If I were you, I would talk to Hakky about the pros and cons, and ignore the advice, either for or against. There’s too much axe grinding (and a lot of it appears to be done by one dude with multiple accounts).

Be well,
Leto

[Wooody]

This is the main question all young guys ask themselves. A potential strategy could be start with an ipp during young years and then when older switch to an mpp for avoid too much surgeries. I just wonder if there cuold be any flag in this reasoning

I think this is a good option, especially to try to gain or at least maintain size for the first and potential future revision implants (IPP or MPP). And who knows, maybe he gets lucky and the IPP lasts 20+ years

[AussieGuy81]

I knew it wouldn't be long before 'Tooyoung' would be here with his anti IPP sentiments.

I don't have an implant, yet, I'm waiting for my insurance to clear next year so I can't give you advice.
'Tooyoung' doesn't have one either so I would take his recommendations about MPP's with a grain of salt. All his posts are anti IPP, I'm sure he'll reply to this with the same anti big pharma rhetoric we've all heard before
Remember, he doesn't have an implant, just take advice from the guys that do

[ElbowRoom]

I have Anthem BCBS PPO and my IPP was covered in-network. It did require pre-approval, which the doctor obtained.

Same insurance and same result. Hakky got it covered and I’m scheduled for Oct. 21.

[LetoMan]

Haha, I mention Foghorn Leghorn and boom! He appears. Even though he hadn’t been active for months.

The funny thing about pumpless/Foghorn/tooyoung is that if you go back and look at his posts, last year (2024) he was a seemingly normal pre-implant guy, though he was genuinely curious about the malleable/IPP debate and was thinking about a malleable. But he asked questions in a normal voice.

BUT. For some reason he went back and edited all those former posts, replaced them with a period (“.”). But we can still read what he originally wrote, because he is quoted by other guys that captured his original posts.

He thus edited/deleted all his normal posts. But then in February of 2025 suddenly he adopted the Foghorn Leghorn persona, and started posting about how IPPs break down all the time and malleables are reliable. Those posts are unedited, and are all that remain in his profile. Foghorn Leghorn kept it up for February/March/April/May, last post (until today) was in June.

Curiously, tooyoung joined in February of 2025, too, but started posting in March. His first screed was - you guessed it - super anti-IPP... no intro, no nothing. Just straight into posting, and claiming extensive knowledge of implants and that he is a doctor (which is pretty laughable). Foghorn Leghorn and tooyoung were very active throughout the spring, joining the battle on IPPs.

They both seem to have extensive interest about malleable implantation doctors outside the US. They also both seem to have some interest/knowledge of Urofill. Both use the Cadillac vs. Toyota analogy for ipp vs. mpp. As far as I can tell neither actually has an implant. Foghorn was pre-malleable last year, it was only when he adopted the Foghorn persona that he started to -seemingly- claim being implanted, but there is no posts about what that was like or where he got it or whatever. It’s also curious that he has the handle he has, given that he does not appear to have any sort of implant. Tooyoung variously claims he has one or claims he does not, also claims he is a doctor.

Anyway. It’s pretty insane to spend time going back and looking at these two profiles posts, but it’s even more insane that someone is bothering to go back and delete old posts that don’t fit their current persona, and that that persona is clearly an AI- generated “make this post sound like a southerner” but otherwise the same anti-IPP nonsense.

Why? Who knows. Maybe anger at how expensive IPPs are for those paying cash outside the US? Tooyoung’s first post refers to some class warfare issues.

All I know is that neither of these profiles are reliable for much of anything. It would all be just silly if it weren’t for the fact that they are likely influencing guys with very bad advice.

Anyway. Brothers… please don’t amplify or take these profiles seriously.

Be well, Leto

[fucked0ne]

There is a really good post by niceguy1 who went from IPP to MPP and back to IPP. While acknowledging the limitations of the IPP, he still preferred it over the malleable (which kept buckling on him and decreased his girth).

Rodsmen has a CX which he has literally put through THOUSANDS of cycles without problem. He might be someone to talk to about IPP durability.

I’m in the “younger” bracket of implant patients as well and am also looking at some future revisions. What needs to be remembered is that there will probably be improvements in that time, like Coloplast FINALLY fixing their fucking tubing for instance.