Postby Cnidium » Sun Jul 17, 2022 5:27 pm
Update after visiting Dr. Hakky:
Hakky believes that the likely cause of the curvature if a recurrence of p\eyronie's scarring, with a smaller possibility of it being a kink in the cylinder. Given that is occurring in the same exact spot as my peyronie's before my implant surgery, the probability is in favor of scarring coming back.
Major lesson from Hakky: He believes that implantees should continue to cycle daily, even after the initial ~4 months post opp. He thinks this will absolutely prevent an scarring from coming back in the Tunica, or at least the scarring from coming back in a way that causes constriction of the cylinders. This is very different from Eid's advice, which, back in 2017, was that one could forgo daily cycling after the first 4 months post-opp of daily cycling. In fact, in 2020, I called him when I saw the curvature first coming back and he said that there is no way that is going to happen with the titan. Well, it did in fact come back, and I have to agree with Hakky on this one. This doesn't mean that there is a 100% that daily cycling would have prevented this, but my gut thinks so. Hakky recommended pumping it up 30 mins per day if possible, or at least just pumping it up to full even if its just for a minute. I am going take his advice moving forward.
Next steps and VED: Hakky recommended that I try VED for 10 mins per day while fully inflated each day for 8 weeks. He presented a ton of research (which has also been posted on FT), showing the benefits of VED, and in his experience it is a great things for implantees. He thinks there is a good chance that the VED will stretch out the constricted tunica scarring that is causing my curvature. If it doesn't, the a revision can easily be done. I will also be getting a 2nd opinion from Dr. Clavell (originally was going to see Dr. Cardone). I am switching to Clavell for the 2nd opinion because Hakky has consulted with him before, and because Clavell has a ton of patients on this forum reporting good results. Lastly, Hakky wants me to get an MRI done so he can see exactly what is going on in there. He has an affiliated clinic that he sends his patients to, and I am going to schedule that tomorrow.
The revision: Hakky said that, if his guess is correct that the curvature is caused by scarring, then he would likely use auxetic cuts on the scarred area to expand it. This seems to be in-line with the most recent research floating around FT. The MRI results will let him know exactly what needs to be done. If its the cylinder kinked, then a replacement will be done instead.
Minimizing infection: Hakky also uses the no-touch technique developed by Eid. He also has installed this giant medical-grade air decontaminator in the surgery room, among other things. As expected, I believe Hakky will minimize the chance of infection as well as anyone.
Conclusion: I think the biggest take away is that for guys like me, who had peyronie's before getting an implant, you need to cycle and possibly VED regularly to make sure everything stays in check. I'm not blaming Eid for not giving me this information, as I recognize that I may just be an odd case. After my surgery in 2017, I was really hoping that I would not need to play with my dick on a daily basis. Don't give me wrong, I love sex, but I never masturbate and, being that I am young, I would rather apply my time towards more productive endeavors that cycling my implant daily. However, the reality is that, given my situation, daily cycling/VED appears to be the most logical thing to do, regardless if I want to do it or not. In fact, I want to do what makes the most sense, so I am absolutely going to follow Hakky's advice here.
I was very impressed with Hakky, especially with how involved he is with developing research, working with Coloplast, and the fact that he knows many of the FT members here personally. If for some reason I couldnt get a second opinion from Clavell, I would still be more than happy to move forward with a revision with Hakky.
Lets see how VED goes over the next 8 weeks and the results of the MRI. At the end of 8 weeks, I will either need a revision or I wont. Either way, the solution will be found.
Let me know if you have any questions.
Titan OTR. Dr. Hakky - successful surgery and very happy with outcome.
My advice: choose a world-class surgeon and make yourself the healthiest you can.