My Journal

[Echegollen]

Yeah, as mentioned above, contracting your PC muscles won't help much. This seems to be a misunderstanding on FT that just won't go away. No doc (at least no good one) will measure your penis before surgery and decide what implant size you will get. That might give him a ballpark idea where to start, but there is no way he can know how deep your crus is or how much scar tissue you have in your dick.

Did Dr. Eid write down your penis measurement somewhere when he first measured you, or was it really only to set realistic expectations with you?

My reasoning is that if he writes down the measurements when he first measures a patient, whatever measurements he writes down must somewhat influence his choice of implant before the surgery? Or does he only take into account the measurements he gets while the patient is asleep?

An 18 cm AMS with 5 cm RTE would have:
(18-5)/(18+5)=0.57 - meaning only 57% of the implant is actually inflatable (and hence deflatable), while as 43% is just solid plastic and can neither be inflated nor deflated.
This will also put the inflatable/fixed joint very far out. For someone falling under the rule of thumb saying 1/3 of the total implant length will be inside the body and 2/3 in the dick, this implant setup would have the fixed part extend inside the dick actually. A rigidity factor of 67% would be needed to avoid this.
On the other hand, since I think a lot of people have rigidity factors below 67% (actually I would guess around half of all AMS guys would have), I think the 2/3 rule can be questioned. Otherwise plenty of people would have the fixed part extending into their dicks, which I can't see work well.
In my case, I have a 17.5 cm inflated aroused dick (maybe even a few mm more). I estimate implant to reach 1 cm from my glans tip. This would mean I must have 16.5 cm implant in my dick and 24-16.5=7.5 cm in my crus. 16.5/24=69% which makes me barely pass the 2/3 mark. And that is without any RTEs.

Good info. I'll make sure to remember it whenever I go for the implant, because I see no point in getting an implant if I end up with a wobbling penis.

[merrix]

Yeah, as mentioned above, contracting your PC muscles won't help much. This seems to be a misunderstanding on FT that just won't go away. No doc (at least no good one) will measure your penis before surgery and decide what implant size you will get. That might give him a ballpark idea where to start, but there is no way he can know how deep your crus is or how much scar tissue you have in your dick.

Did Dr. Eid write down your penis measurement somewhere when he first measured you, or was it really only to set realistic expectations with you?

My reasoning is that if he writes down the measurements when he first measures a patient, whatever measurements he writes down must somewhat influence his choice of implant before the surgery? Or does he only take into account the measurements he gets while the patient is asleep?

An 18 cm AMS with 5 cm RTE would have:
(18-5)/(18+5)=0.57 - meaning only 57% of the implant is actually inflatable (and hence deflatable), while as 43% is just solid plastic and can neither be inflated nor deflated.
This will also put the inflatable/fixed joint very far out. For someone falling under the rule of thumb saying 1/3 of the total implant length will be inside the body and 2/3 in the dick, this implant setup would have the fixed part extend inside the dick actually. A rigidity factor of 67% would be needed to avoid this.
On the other hand, since I think a lot of people have rigidity factors below 67% (actually I would guess around half of all AMS guys would have), I think the 2/3 rule can be questioned. Otherwise plenty of people would have the fixed part extending into their dicks, which I can't see work well.
In my case, I have a 17.5 cm inflated aroused dick (maybe even a few mm more). I estimate implant to reach 1 cm from my glans tip. This would mean I must have 16.5 cm implant in my dick and 24-16.5=7.5 cm in my crus. 16.5/24=69% which makes me barely pass the 2/3 mark. And that is without any RTEs.

Good info. I'll make sure to remember it whenever I go for the implant, because I see no point in getting an implant if I end up with a wobbling penis.

I honestly don't remember if he wrote it down. Didn't matter to me. Just him saying it like that was enough of accountability to me.
I don't think it influences his choice of implant in any way.
Implant size is not same thing as dick size. Two 6 inch dicks can have different implant size. Depends on crus depth and how deep the doctor can/will push cylinders into the glans.
His reason for measuring before surgery, I assume, is only for setting expectations. I think he is quite confident in maintaining length for his patients. I also think he is well aware of the fact that a lot of people will think/say their dick is larger than it actually is.
Just saying that you will maintain your length would probably quite often end up in men after surgery saying that they lost length. Measuring that dick, surgeon and patient together before surgery, removes that element. From then on there is a fixed number towards which the post-op length is compared.
Next step for him will be to cut his patient's dick up and determine which implant to insert.

Regarding the second part: Please note my calculation does not say my rigidity factor is 69%. My rigidity factor is (24-5)/24=79%.
The 69% is how many percent of my implant is in my dick, and hence 31% is inside my body. The rule of thumb says 2/3=67% is in the dick, so I was just pointing out I am close to that rule.
I was also trying to make the point that if your rigidity factor is less than 67%, you run a real risk of having fixed parts of your implant in your dick. Which I don't think would be very nice.

[Echegollen]

Makes a lot of sense. Thanks Merrix.

[Alex-Amigo]

6 years’ update – Part IV

Did the implant change my life?
My sex life, yes. My life? More difficult to answer. As I have said in this thread before, my life wasn’t bad. It was actually really, really good. Career, wife, marriage, kids, financial situation. All going well. Very good actually. My dick was no good, definitely not. But I hadn’t gotten to the point where it over shadowed everything. I do however think that I could have ended up there. As I have stated many times before, just recently in the previous parts of this six years’ update as well, something changed just shortly before I decided to go ahead with the implant.
I think it was partly the sclerotherapy which cured my dick, but only for a few weeks. Maybe that was enough to understand what I was missing, and from then on I was maybe never going to accept my ED.
Speculations, but something changed, and I decided to get on with the implant before it would start to really negatively affect me and my life.

As I have said, I have had ED in some form all my life. From my mid teens and up I have never had a proper long lasting full erection which just stayed up for several minutes without manual stimulation. At least not what I can remember. And definitely not from the age I first had sex.
This has of course impacted my brain. It has forced me into a sexual behaviour which has been in many ways built up with the goal of not failing rather than enjoying. Sex has been more about avoiding the negative than achieving the positive.

And when discussing this subject, the issue most important for me to include is how challenging it has been to deal with this heritage. And furthermore, this has been quite a challenge for my wife as well. She has adopted to the same behaviour and goals as well. Making sure my crap dick lasts till I come. That has been the goal for both of us, rather than enjoying the moment. Not saying we haven’t enjoyed sex – we have – just not as wholly and relaxed as we would have without my ED.

Typical sex for us followed some basic principles.

Never spontaneously. I needed my pills 30 minutes before anything was worth trying. Our basic strategy was “every other day”. Great foresight. But not so spontaneous. Once I knew which day (night) it would happen, next challenge was to know what time it would happen. Many were the nights I was surprised by my wife who all of a sudden wanted to go to bed sooner than I thought, and then I hadn’t taken my pill yet. Equally often the other way around. I thought that in 30 minutes it’s time for bed, but she wanted to stay up longer. Double dose of pills was the solution.
I just didn’t want to say the words “Honey, I took my pills 30 minutes ago, we got to go to bed now”.

Not too long foreplay. And never she blowing me first, and then me giving her oral. Then my dick would be down already and once down, always difficult to get up again. So the typical way was for me to give her oral first, making sure she’d come, then her giving me oral to get my crap dick up, and then right at it. Fast, hard, preferably no position change. My wife very rarely can orgasm more than once, and I know she prefers to come from vaginal sex rather than oral. But that was never easy.
She couldn’t enjoy herself, feeling stressed that she had to come before my crap dick went down. So I’d say that it was probably a 1/3 chance that she could orgasm from intercourse. She ended up faking it sometimes just to spare me the shitty feeling of frantically trying, not making her come, and then see my dick go down.
Even though my ED was very much physical, there is of course a mental component to it as well. When I get stressed that she doesn’t come, or that I don’t come myself for that matter which happened sometimes as well (alcohol or just difficult to orgasm with a semi), then of course my dick would tend to go down even faster than it normally would.

So sex was always a fight against the clock. It became both mine and my wife’s goal to make me come before my dick went down. Of course, if we could make her come as well, that was a great bonus.

Did she enjoy having sex with me? And before I answer that question – where does the answer come from? Well, from what she has told me and from what I read from her reactions. After all, I have known her for a very, very long time.
I think she did. But not nearly as much as she would have if this bloody ED didn’t exist. She has told me several times that the pressure, the stress, the race against the clock to avoid failure rather than relaxing and enjoying the moment made it much less enjoyable than it should have been. She also felt bad from seeing me suffer. Especially those time we couldn’t finish, and my dick went down.
Those times, she felt awkward and didn’t know what to do. I fought between the two options of either go at it again. Blow job, try to get hard again, and another attempt at intercourse and at orgasming. Or just give up, roll over and sleep. The problem with trying again was that another failure would just make me feel even more fucking pathetic. And she knew it. Which is why she preferred to not keep trying. I could of course easily mis-interpret that as she didn’t want to, and on it went…

So what happened after the implant then?

Well, the obvious change is that now my dick could stay hard forever.
But as I have said many times, that does not necessarily and automatically solve all the mental issues. Neither for the implanted man or his partner.
In our case, we had a long journey ahead of us. A journey that started about three weeks after my implant by Eid in New York – the first night I saw her after returning to our home in SE Asia, and after her returning from Christmas holidays back in Scandinavia where we are from.

The first time we had sex, I remember the weird feeling of my dick just not going down. I remember I touched it several times, just to make sure it was actually still hard. I just constantly kept thinking it would for some reason go soft. But it didn’t.

So what was the challenges, the issues needing adaptation?

Reprogramming our brains to change our sexual behaviour and dealing with the obvious difference – the pumping and lack of getting hard by arousal (rarely happened to me anyway) or by physical touch from my wife.
It has been six years now, and depending on where I place the bar, I can say that maybe we are not 100% at the end station yet. Are you ever? Isn’t everything a process? But for sure, these six years have taken us a very, very long way from where we started.

For a long time after the surgery, we maintained much of our previous sexual habits. Lack of spontaneous sex, fast and hard sex with few positional changes, etc. This behaviour was just so rooted in our brains that we just kept going like this. But of course, we enjoyed it a lot more.
I would still say that it took a long time before we really adapted to my bionic superpowers.
It wasn’t until at least year, or maybe even at least a couple of years, when we started to be more playful in bed. Until we just learned how to enjoy every minute and not bothering about the end. Just knowing there would be a happy ending no matter what…
Today, my wife basically comes every time we have sex. I would say it happens less than 1/10 she does not come. 1/20 perhaps. Most of the time she will orgasm first, from a combination of vaginal sex and clitoris stimulation. Which is achieved either with my dick and pubis bone or with my dick and my hand.
If she for some reason struggles to come, I just keep going. She might still get a tiny bit stressed about not coming as easily as normally, but we have learned to enjoy those occasions as well. Normally we both prefer a rather raw and aggressive type of sex. Not the 60 minutes grinding style. So those occasions when she struggles to come actually gives us a change from that style. Either we just take our time to make her come first, and then of course the pace must come down. I can’t fuck like a frantic maniac for 45 minutes… Or we do it the way we normally do, only she doesn’t come first, and then after I orgasm we just slow down again, and keep going for as long as it takes for her to come. Since this happens very seldom, it sort of becomes a nice difference to our normal style. This also helps us from getting stressed about it. If she (or me) doesn’t come as quickly as we normally do – we just relax and keep going at a slower pace for as long as we need.
The result is that it basically never happens that we don’t both come. Can’t say how often, but it can’t be more often than a few times per year.

My approach to the implant technical stuff – inflating, deflating etc – is just right for us. I would never let her inflate, and she would never want that either. Everyone is different, there is no right or wrong of course, but I just think it is really weird and I would never let my sexual partner do that. I wouldn’t feel ok with that.
What I normally do, if I know or at least strongly suspect or plan for sex to happen, is that I just inflate to roughly half when I go to bed. A level of inflation suitable for oral. When it is time to penetrate I just inflate more. From there I will need about 15-20 more pumps, which will probably take me about 30 seconds. I used to not like doing that in front of her, and in the early days I most often just inflated fully before I went to bed. Or while in bed and she was in the bathroom. Nowadays I have no issue with topping it up before I go in.

Something we both enjoy is to start with my oral hardness, and after she has given me oral, I do the same for her. Then I penetrate her with my oral hardness, fuck her softly for some time, go back to oral, inflate a bit more, back inside, etc. Then just gradually increase the hardness of my dick together with the intensity of the thrusting and breaking off with oral in between every hardness increase. She loves it and finally just can’t wait for me to inflate to the max and just fuck her really hard. It’s a good way to find the right hardness as well, and a quite good way to use the implant to its advantage by making use of its ability to serve with different levels of hardness for different types of sex.
If we do it spontaneously, not in bed at night, I just inflate while we get undressed, while giving her oral, or just in front of her while she waits for me to finish. With our busy lives, kids, large house, work, etc – that doesn’t happen as often as we’d perhaps like, but none of us have any issues with the 60 seconds we need to “wait” for my dick to get hard.

I keep saying that an implant is great if you let it be. I know that it is easier to deal with the inflation issues with a steady partner who knows about it than when dating. And yes, believe me, I know. With some deductive ability and adding one and one together, you can judge for yourself what my knowledge of dating and having casual sex with an implant is here on FT…

Anyway, for those struggling with the embarrassment of an implant when dating and having casual sex, the only logical conclusion is this:
You got an implant because your dick sucked. You couldn’t have sex. You hated that, and it destroyed your sex life. Failures and/or passed opportunities. You hated when your dick went down, and you might have noticed some of the women on the (supposedly) receiving end didn’t have much sympathy for you when it happened.
So now you have an implant. Now you have a dick which in terms of erection capabilities is second to no dick on the planet. But you still don’t experience that great sex life because you have issues with how/when to pump, how to avoid her feeling your pump in your scrotum, what to do if she surprises you and wants you to fuck her there and then on the sofa before you had a chance to inflate.
Well, I understand that.

But the fact is, if that’s how you will go about your implant, then it wasn’t much of an improvement to your crap natural ED dick.

Just embrace it. Take the bad with the good. You have a dick which will let you do whatever the F you want once it is inflated. Don’t let anxiety over how to get there stop you.
I really think that spending too much time and energy on finding strategies to avoid embarrassment will just take away too much of the upside.

The simple way of course is just to inflate in the WC before sex. Nothing strange to take a piss or a shower or whatever in the bathroom before sex. That’s it.
And if she feels your pump in your scrotum, just tell her you had an accident some time ago, but all is fine, it feels good, don’t worry, just keep going.
I think the woman who will stop, demand an explanation, and a complete description of what is inside your scrotum is such a rare exception that you don’t need to consider it. In that moment, when you’re already at it, she will just keep going and not ask any further questions.
She might ask you afterwards, but it’s quite easy to just get out of that as well if you really don’t want to tell her. As I said, I had an accident a few years ago, I needed some surgical intervention, but all is fine and I really don’t want to talk about it, hope that’s ok for you.
Done. How many one-night-stands would keep pushing for more answers?

When do you break the news to someone you’ve been dating for a while? After all, you will eventually run into problems with your “sorry babe, just hold it right there, I need to go and take a piss”. But when that day comes, and you need to explain what’s going on, I don’t think it’s a major problem unless you make it one.
You just have to face it, what is better? Hiding around in the bushes, being embarrassed and weak – or being strong, confident and upfront as in “Yes, that’s some story. I was skiing in Austria and crashed really bad. Don’t know how, but either my stick or my ski poked me really bad in my crotch. It hurt like hell, my dick was all blue for a week. Noticed afterwards that my previously so great dick didn’t work the way it should anymore. Got hard but didn’t stay hard. Doc said one of my veins in my dick was broken. I refuse to use the injections, vacuum pumps and such shit. Found this great surgeon who fixed my dick. It’s now bionic, and I just love what I can do with it. In some way, I don’t even miss my old dick. This is like an upgrade.”
And from then on, what’s to hide anymore? And I am pretty confident not many women whom you’ve already started a relationship with would back out because of that.

This is of course easier said than done for some people. Confidence is a personal trait, and some of us have more of it than others.
But reasoning with the logic part of your brain, you will know that being proactive and sitting in the driver’s seat will be a better way to deal with your implant than hiding under a blanket in the back seat.

Back to myself.
Except for turning my shitty sex life into a great one, how has the implant impacted me?
Has it changed me as a person?
Not that much. For me it was rather the icing on the cake, not the foundation needed to stabilize my soon-to-collapse wobbling house.
Everybody I meet would describe me as confident, tough, successful. So the implant didn’t make me that, I was that already. But for sure, it has given me an inner strength in those situations where I lacked it before. Knowing that I never need to fear or worry about any situation where sex might be the end station. I will always be able. Well not only able, I have the tool to be something special.
And in my marriage, I just feel like a complete man, like the man I was supposed to be. As strong and able under the sheets as in other aspects of my life. The implant has made me whole.

Will try to put one more part together in this “series” of my six-years’ update. With some reflections, thoughts and things I have learned through the years.

Till then, take care.

Thank you very much for the details

[merrix]

As asked in another thread and on PM:

Since there has been questions related to this, I'll try to explain how it works for me:

In clothes
There is no way I can bend my dick to fit it into clothes when I am 80-90% pumped. At that stage, my dick is way too hard to fit in any clothes.
All of these X% statements must of course be taken with a grain, or even a cup, of salt.
It is impossible to say how many percentage has been pumped. Simply because the amount of saline transferred with each pump will be less at the end than in the beginning. Hence, counting pumps will not result in an accurate percentage.
For a man who can do 40 pumps till he is full, half inflation level will most likely not happen by the twentieth pump, since the first 20 pumps will on average transfer a lot more saline than the last 20.
50% is probably reached at perhaps 15 pumps. 80% will most likely not be at 32 pumps, but maybe already at 25. We don't know.
In my case, I don't do full wall-to-wall pumps any longer. I find it quicker to reach full inflation with smaller, quicker pumps.
Of course, when starting already with half or 3/4 pumps, the difference between the first and the last pump will be less.
I do around 60-70 pumps (not full pumps) to reach the point where my strength limits me from squeezing one little drip of saline into the cylinders.
The last pump of those 70 will only transfer a fraction of the saline the first few pumps did, even though they were still not full pumps.
How many can I do and still bend it into a pair of jeans?
Not sure, never tried to push that limit, but I often do 10-15 pumps and bend it sideways in tight jeans when I want to show off.
And that's not places respectable by any means, more like the Mandrake kind of places.
30 pumps, which is probably around 50-60% inflation, would maybe be possible, but it would look bad and definitely not be comfortable. Probably painful.
And at 80%, or let's say 50 pumps, it would be 100% impossible to get it into jeans. Definitely impossible.
At that level, I cannot make my implant touch any part of my body. Not up, not sideways. Not even close.

For sex
In the beginning, I did not inflate fully for sex. Just thought it didn't feel right. A bit uncomfortable, artificial, less sensitivity, a bit more difficult to orgasm. Wife even said she thought my dick felt a bit uncomfortable. Too hard, and actually thinner. I am sure the "thinner" issue was actually that my glans didn't fill up really well when inflating fully, and that's why she noticed it felt thinner. Because the glans circumference is actually larger than the shaft, so if the glans doesn't engorge, I am sure a woman will feel it as if the dick is thinner than when the glans is super engorged.
In the beginning, full was perhaps 35 pumps, and I used around 25 for sex.

But nowadays, things work differently - for both of us.
To inflate to my maximum hardness, I will do around 60-70 pumps. Not full wall-to-wall, as described above. If I do full W2W, I would say I can do ~40 and then ~10 gradually smaller pumps till I just can't squeeze any more saline into my dick.
And to get to this stage - my maximum hardness - I need to use all the force I can generate with two hands and grunt like in the gym. With one hand only, I could probably only get to 50-60% of the two-hand hardness.
That would still be a 3 o'clock erection usable for sex. But not close to as hard as the two-hand erection.
Anyway, for sex I use (on the two-handed scale from 0 to 60-70) anywhere from 50-70 for sex. In percentage that means 90-100%. My dick will be very hard and it will be impossible to bend at the base. Just a few degrees. Cannot touch my belly, and does barely move at all sideways.
My glans does fill up very nicely no matter how hard I inflate. Don't know why/how that changed from the first 6-12 months, but it did. But that is the key to such hard inflation. If - for some reason - my glans does not feel fully engorged. It happens. After all I do have ED, and my glans is not a perfect machine. So, most of the time, my glans will be super hard and fully engorged. But sometimes, it will be less engorged. And at those occasions, the 100% super two-hand hardness is a bit uncomfortable.

I also got the question of there is a sweet spot hardness for sex and if some positions are uncomfortable when 100% full (well, 100% full based on the force I am capable of generating).

No, there is no sweet spot. Basically, maximum hard is best. Just feels great to be unnaturally hard. Wife same opinion. Not better for her if I hold back. As said above, sometimes full hardness does feel a bit uncomfortable. Very rarely, and most likely when I have an off-day on glans hardness. Alcohol or whatever reason behind it.
Positions… I would say maximum hardness doesn’t really impact that. Sure, if I did go over creative then perhaps there would be positions not suitable for maximum hardness. But we don’t go overly creative. We’re two adults having sex in a bed most of the time. Or in a sofa, or in a shower. But it’s not we’re hanging upside down in swing bent 180 degrees in our spines while doing a split. It’s different versions of me on top, her on top, spooning, standing up from behind, doggy style, or just standing up and me holding her with no wall support. But when staying within those boundaries – which are where we what to be anyway – the hardness is never a problem.

Of course, that hardness makes it impossible for me to hide my erection before getting started. If I inflated that hard in the WC before sex, I couldn’t keep it in my jeans. Not even in my underwear. My dick would point straight out/up and the waistband would leave a gap to my abs.
To keep it in jeans, I’d need to be at what I call the the foreplay level, or the blowjob level. That is roughly half or perhaps 3/5 of full inflation. Definitely usable for intercourse, but not the preferred hardness for neither of us.

Hope that clarified those questions.

[Echegollen]

How many can I do and still bend it into a pair of jeans?
Not sure, never tried to push that limit, but I often do 10-15 pumps and bend it sideways in tight jeans when I want to show off.
And that's not places respectable by any means, more like the Mandrake kind of places.

I know for sure I'll do the same thing whenever I get my implant.

I'm wondering when we'll have the chance to read a new juicy story from the legend Mandrake...

[merrix]

Might as well answer here, since there is nothing personal in the question:

Hi Merrix,

Am brand new on the board, and might post this on the main forum.

Saw one of your posts and have a question. Hope you do not mind. I noticed your'e from Asia. I live in Tokyo. Tokyo is a complete disaster for ED / implant information. There is only one doctor who does implants in all of Japan, and I will visit that single person on Monday. Does he even speak English .... I do not yet know. Japan is over 30 years behind the US in this field. Beyond frustrating.

My question is, since you live Asia too, I wonder why you did not go to India, Thailand, or Korea or other places. The reason why I am considering these is if something goes wrong, the trip to a nearby country is just faster than going back to the US. I've had surgery in Thailand before and was extremely impressed with the results. Clean hospital.

Also, I am considering going to the US for implant surgery. My question here is more logistical. I know this might sound silly, but if youre in the US for say 20 days for the operation, isn't that an additional $100/day for hotel and another $100 for a car (that I would hardly ever drive), not to mention costs for R/T tickets?

Also how long would you have to stay in the US. My greatest worry is I get the operation, where ever, and return to Japan a few days later get an infection. Then I would have to fly back.

I just found this forum recently, and reading it thorough. Like many I assume, scared with others playing with my Willy. Anyway, thanks,


Hi

First of all, I am not from Asia. I live in Asia, but I am as Scandinavian as it gets.
Why did I not go to India, Thailand, Korea?
Well, I had only one aim. Find the doctor on this planet I thought would provide me with the highest probability of a great outcome, and maybe more important, the doc who would provide the lowest probability of a disastrous outcome.
I didn't give a shit if that doctor was in Australia, South Africa, Canada, Switzerland or Kongo. I was prepared to travel to let him do my surgery.
For practical reasons, it is easy to review doctors mentioned on this site. And since this is mostly an american site, most doctors mentioned are americans.
It is quite difficult, for me at least, to find reliable available information on doctors in e.g. China - which I am sure have some guys doing high volume.
And from the part of the world where I can do my research, the American top surgeons where the ones standing out.
Plus - I just have to say, that I have been travelling quite a lot in India for business.
I have friends who have travelling there even more than me, even a friend who lived there on an expat contract with his family for a few years.
Hence I have some reliable stories of Indian health care system from those friends.
One of them was hospitalized in one of the top hospitals in New Delhi for a month.
Total fucking disaster.
I would never, ever under any circumstances ever have any surgery done in India unless it was a matter of life and death and no time to get out.
Thailand. Why? I will never find anyone there with better reputation on penile implants than the top guys in the US.
So it was quite simple in the end.

Regarding the travelling if shit happens.
Well, that's a matter of how you want to look at this.
Either you travel around the world to the best and then you will know that you will have an extremely low probability of having to go back there for some problems.
Plus - you will most likely have very good results.
Or - you do it nearby, have a higher risk of poor results and a higher risk of having to take that "short" trip for a revision.

I choose the proactive way. Find the best, minimize risks, and if shit happens - ok, long trip.
Instead of the defensive way. Settle for average results at best, increase the risk of needing revision. But minimize distance to that revision surgery.

Your choice.

I am surprised though that Japan don't have any good surgeons in this field. After all, you have a population of 125 Million and is as developed as any country on this planet.


But anyway, yes the tickets were expensive. I chose business because I wanted the comfort of a flat bed on the way back.
I stayed in New York for three weeks.
Eid recommended 5-7 days if I remember correctly, but for different reasons I chose to stay three weeks.
21 nights at a decent hotel in Manhattan is not cheap.
But I am lucky to be able to take that cost without really affecting my finances, so I just chose to do it that way.
I totally understand though that people don't break the bank to travel around the world for this surgery when they can find decent options nearby.

Only you can choose, but this was how I reasoned.

Good luck.

[Gt1956]

Merrix, nice post. A few comments from me.
As for who sounds like an American living in Japan. You're in a tough spot. May I suggest checking in Okinawa. Lots more American presence there so perhaps a better chance of a passable urologist being there. Downside is he might only see military personnel.
On the ease of researching implant surgeons. I think the USA is unique worldwide in the aspect that doctors can & do advertise their services. Also, there is at least some venues to research those claims. To those that are searching a surgeon in Europe on a different thread. They are there. Just a bit harder to find.
Merrix, your logic to use Eid in NYC makes more sense if people will take a minute to think. You have more time & travel expenses at risk due to your location. Why risk all that by cheaping out on the surgeon?

[Fourtytwo00]

It's not so easy quitting your job for weeks or more and saying nothing to your company, boss or whatever if you live in Europe or Asia. Atm I can't figure out how to do it.

[Gt1956]

It's not so easy quitting your job for weeks or more and saying nothing to your company, boss or whatever if you live in Europe or Asia. Atm I can't figure out how to do it

Those types of problems exist everywhere if you want to maintain some semblance of privacy. Can you try timing it with your countries holiday time? Depends on what amount of time is tradional for your country. Any chance that you could ask for a little more holiday time for this year only?