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Are rear tip extenders elective or used at the doctor's discretion?

Do they make dick longer?

Any feedback from guys who have RTE''s?

RTEs have two purposes. First, and the more important of the two, is to make the implant fit into your penis' Tunica Albuginea.

An implant too short to properly fit your Tunica is bad enough. This causes "floppy head" syndrome, also known as "SST Syndrome". This is inconvenient for penetrative sex.

An implant too long for your Tunica results in either the "S" curve deformity or erosion of the implant tips out your glans. The one is extremely inconvenient for sex, the other requires removal of the implant and surgical repair of you penis before another implant can be inserted. Not sure if really bad erosion might result in an unimplantable penis. Like the Seinfeld "Soup Nazi" says (paraphrased), "No sex for you!"

The other reason for RTEs is to allow the tubing to come out of the incision site with enough length to let the pump be positioned properly in the scrotum.

So, they are elective in that the doctor may choose an 18cm implant with 3 cm of RTEs or a 21 cm implant with none, either one can fit the tunica) but the more proximal location of the 21cm implant's tubing would result in a higher-in-the-scrotum pump location, given a particular incision site. Now if my surgeon had placed the incision lower down, I might have been able to have no RTEs instead of the 3 cm I have. But the range of elections your surgeon has is strictly constrained by the patient's anatomy. So discretion is maybe not the right word. The surgeon's judgement might be a better way to put it. But the ultimate determinant is your anatomy and the surgeon just has to elect the right combination of implant size, incision placement, RETs and pump placement to get a good result.

I saw some information on this in reference to AMS and Coloplast. If I remember correctly the tubing exits the cylinders farther away from the pubic end on the Coloplast than the AMS. The Coloplast is made in more sizes than the AMS. The Coloplast RTE are larger in diameter but are shorter in size range than AMS.

So if you have an AMS implant you may need a longer RTE to position the tubes coming out of the cylinders and or to bridge the gap between the sizes to get the best fit. The Coloplast is I think more often to be used without RTE due to additional available sizes and the location of the tubes for pump. But RTE are available and used for both Coloplast and AMS cylinders.