need help choosing an implant

[EricDraven]

I've always been a grower. from about 3 inches flaccid, to 8 inches erect, pre ED. I was also girthy, at 6.75 circumference.

I've had ED for around 8 years and haven't had a real erection in all that time. Whenever the doctor did the stretch test, it was 3.5 inches. When I am standing, there is no stretch in my penis. I believe it's because i have a large pubic fat pad that hangs down and puts weight on the penis. However, Whenever I lay down on my back, I can get a stretch from between 5 inches and 6 inches. When I use the VED, I can get to 6 inches.

The PA told me that the implant would be 3.5 inches. I told her that it is between 5 and 6 inches when stretched on my back. She said that doesn't matter, only the standing measurement. I also found out that the surgeon prefers the coloplast titan, but they also offer the AMS 700.

My questions. Which implant would be the most beneficial? I had a large girth before, but don't know if i will still have it after ED. I've read that the AMS actually grows. Which would be better?

Also, which stretch test should the doctor go by, standing or lying down?

[Lost Sheep]

I've always been a grower. from about 3 inches flaccid, to 8 inches erect, pre ED. I was also girthy, at 6.75 circumference.

I've had ED for around 8 years and haven't had a real erection in all that time. Whenever the doctor did the stretch test, it was 3.5 inches. When I am standing, there is no stretch in my penis. I believe it's because i have a large pubic fat pad that hangs down and puts weight on the penis. However, Whenever I lay down on my back, I can get a stretch from between 5 inches and 6 inches. When I use the VED, I can get to 6 inches.

The PA told me that the implant would be 3.5 inches. I told her that it is between 5 and 6 inches when stretched on my back. She said that doesn't matter, only the standing measurement. I also found out that the surgeon prefers the coloplast titan, but they also offer the AMS 700.

My questions. Which implant would be the most beneficial? I had a large girth before, but don't know if i will still have it after ED. I've read that the AMS actually grows. Which would be better?

Also, which stretch test should the doctor go by, standing or lying down?

I would ask that question (laying horizontal or standing) and also ask him to describe how he measures while you are on the operating table. Then relate to him what his PA told you. I suspect the PA is not well-informed and perhaps seeking to diminish your expectations.

From what I know of the girth of the Coloplast vs the AMS devices, and at an erect girth of 6.5 inches, I would go for the Coloplast. The AMS devices are made of a polyester cloth (like sailcloth, which does not stretch) as the structural material. The Coloplast is a plastic that starts out at a larger diameter and expands to meet the diameter of the tunica. Discuss this with your surgeon. If he is not communicative, that is one thing. If he is unable to explain these things to you, consider another surgeon.

As far as being a grower, those days are likely over, especially if you get a Coloplast Titan. The way it can shorten in length upon deflation is by wrinkling up like an accordion (described to be by Dr Eid).

Larger diameter erection calls for Coloplast

If you want to stay a grower, get the AMS LGX, but do not expect to have 6.5" girth.

Lots of my opinion above. But there it is.

[Gt1956]

If the PA doesn't do the sugery? I'd presume that she doesn't understand the whole process. Just my opinion. You need to talk to the actual surgeon if you're not prepared to go into this blind.
Btw, in the YouTube videos that I've seen. When measuring, the tool is pushed in fairly forcefully.

[SW0110]

I have a lot of posts here on my search for an implant surgeon. Everyone of them had me laying down and injecting me for an election first.

Just a thought. You saw a PA.

You need to see a urologist surgeon who does implants. Preferably on a regular basis.

One of the urologists I saw talked to me for a couple minutes then handed me off to a pa. I hunted him down after putting my clothes back on and told him hell would freeze over before I let anyone in his practice touch my dick. If he can't meet with me and answer my questions there are tons more urologists out there.

My urologist who did my removal and replacement after my hernia surgery spent an hour trying to convince me to let him do it.

The implant surgeon I used for my initial implant spent a least an hour with me off and on over 2 visits to answer my questions before I let him schedule it.

Find a doc who answers your questions to your satisfaction. Standing measurement. Never saw that on here in almost 5 years of following.

[Gt1956]

I got a standing stretch test. I personally think the stretch test is bogus. They use a tool during surgery to measure you. I don't see any relationship between the stretch test & the surgery measuring. Stretching doesn't measure your hidden penis. Only the surgery tool does that.

[2435tjklAS]

I found this video earlier about the AMS and its expansion capabilities: https://www.youtube.com/watch?v=Z24GRfTGPTA

Keep in mind the video is an advertisement from the company that makes them, but it sounds very convincing to me.

[EricDraven]

I should have mentioned I’m a veteran and don’t have other options. I’ve been emailing and asking questions, and I have a pre surgery consultation in 3 weeks. Surgery is scheduled for May 5th. I kind of don’t know what questions to ask.

So does the titan just get hard, but not expand? And I’m guessing the ams is smaller but grows when inflated?

[Lost Sheep]

I should have mentioned I’m a veteran and don’t have other options. I’ve been emailing and asking questions, and I have a pre surgery consultation in 3 weeks. Surgery is scheduled for May 5th. I kind of don’t know what questions to ask.

So does the titan just get hard, but not expand? And I’m guessing the ams is smaller but grows when inflated?

They both get hard and they both expand. It is just that the Coloplast starts out a bit larger diameter and is made of initially stiffer material. This makes it a bit more difficult to live with most of the time, but has a marginal advantage when inflated for sex.

The Coloplast and the AMS CX shrink upon deflation, mostly by winkling the implant, like an accordion. They grow upon inflation. Do not expect growth over your fully nflated length. It sometimes happens, but it is in very small increments over months or years. The AMS LGX shrinks more naturally because of the weave of the material is is made of. So its flaccid state is more natural-looking and feeling. The erect states of all three are comparable.

There are a couple of threads listing questions to ask. If you search the forum (upper right corner if you are using a computer) you will find them. If not, I will search.

I got my implant through the VA. With my primary care physician's support I had no problem getting autorized and when I was not happy with the local community care surgeons available, the VA even sent me to Seattle (Wasnington VA) for surgery there. Fortunately a VERY expert surgeon was assigned to the local Air Force Base hospital and I am very happy of that.

Here is one:
viewtopic.php?f=6&t=6221&

[Gt1956]

A test was done on Titans & LGX implants. The 18cm LGX expanded to 21cm. The Titan expanded to 18.4cm. In my opinion, if you're a very good grower with little to no peyronie's then the LGX seems like the best option. Again, my opinion. The Titan is more suitable for a guy that is a shower. Mainly because his flacid matches the deflated implant length.
The claimed Titan larger diameter is offset if the LGX will expand by its claimed percentage. The expansion is dependent upon the patients anatomy & his willingness to cycle regularly for perhaps as much as a year.
I watched a 45 minute conference on YouTube last night. Three implant surgeons were on the panel plus the attendees were all implant surgeons. Jones, Loh Doyle (spelling??) & Brant. Not top names but I think all are are at least very competent. I very highly suggest that members watch it. Search for Boston Scientific. Open their library & it was in the top 10 videos if they are sorted by new.

[newbie443]

[quote="EricDraven"My questions. Which implant would be the most beneficial? I had a large girth before, but don't know if i will still have it after ED. I've read that the AMS actually grows. Which would be better?

Also, which stretch test should the doctor go by, standing or lying down?[/quote]

I did nothing for my ED for a little longer than you did. But really close enough. First you need to start VED therapy. This will help your doctor to be able to fit a larger device. But be careful as too much vacuum or vacuum applied too fast can cause damage and cost you size instead off helping. And if you do not have time to do VED therapy you can do manual stretching. Simply grab your penis near your Glans and pull straight out to the front then back and up to your belly button then back and down to the floor the back and then to the right side and ten to the left and repeat. There is a lot of good reading in the documents worth reading thread in the general section of this forum. A couple that deal with VED therapy before surgery from that thread are: https://file.scirp.org/pdf/ASM_2013012514045982.pdf and https://augustams.com/how-to-use-a-peni ... -exercise/ And this is an online copy of the AMS user guide DVD that was in my packet from my surgery. https://www.youtube.com/watch?v=qwp0YfSLxIU It has that stretching exercise in it as part of trouble shooting after surgery. But my experience was that the stretching worked as well or better than VED therapy. But I have found no documents on stretching pre op so do use VED exercise and you can decide about the stretching. And read the documents about preventing size loss during and after surgery.

I am not sure about your choices for doctors with this for you. If you are locked in for the doctor you have then it is different than if you are searching for a doctor for this. But from what I have experienced is there is a lot of difference in docotrs that do this and the way they approach this. Some are cutting edge and have a lot of interest and others have little interest other than to give you a working device. If you trust a doctor for this then I would trust the doctor to choose the device that is best for you. I would think that the doctor would in most cases do a bet better job if they are implanting what they think is best rather than using a device they think is not best for you. But again your choice. As I had size loss like you have I was leaning for the LGX to help with regaining size loss after surgery but also was considering a Titan. And I told my doctor this and left the choice to him. Here is a comparison document of the LGX and the Titan. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654325/ Table 1 in that document shows the expansion of the LGX in length and girth. It also shows that the Titan does expand a bit. And it shows that the 18cm Titan has the greatest girth. Where the 21cm LGX and 22cm Titan are very close. But some doctors do not like the 21cm LGX as that is the largest size for the LGX and with the softer cylinders has poor results for erection angle and maybe some other reason I do not understand. However my 21cm LGX is harder inflated than my natural erection ever was.

So my answer to your question would be that I think that the Titan would be better for maximum girth post op and the LGX would be better for helping to regain lost length. And the stretch test before surgery means nothing. Some doctors will do injections pre op or at the time of surgery. Some doctors will do an MRI or sonogram prior to surgery. Others do none of these. And I have read that if general anesthesia is used that some medication is used in surgery to relax the tissue to give a more accurate measurement for the cylinders. If a spinal block is used then that is not needed as your tissue is relaxed. The only thing that determines what size cylinders are used is the measurement when you are opened up during surgery. So this is why VED therapy or stretching the tissue prior to surgery helps your doctor fit a larger cylinder.

If you would like to talk just send me a private message and I will get you my phone number and we can arrange a time.

Best of luck to you going forward with this.