A Vacuum Erection Device/VED/penis pump should be used before and after surgery by essentially everyone.

[FreddyFree]

I used one before surgery. Useless.

No way I would use one after. Everyone concerned about the longevity of the implant, then put it under stress with a device unproven to work. What science are you following? Oh, it worked for me science?

Yet you’re free to do what you want.

[NYGuy1952]

Use a VED before surgery. Here's why:

When pre-operative VED is used, SPL could increase by a
mean of 0.80
0.38 cm. In addition, the surgeon is provided
with better opportunity to restore longer penile length that replicates
an appearance more consistent with the patient’s natural
erection. Ease of corporal dilation allows for an appropriate size
cylinder to be inserted, and thus helps to maximize patient satisfaction
post-operatively. There were no negative intraoperative
complications associated with the use of pre-operative VED, and
therefore, if patients have access to it, VEDs can safely be recommended.
Future studies among larger samples will help assess
the long-term outcomes and outline the role of VED as a valuable
intervention prior to PP implantation.

Canguven, O., Talib, R. A., Campbell, J., De Young, L., El Ansari, W., & Al-Ansari, A. (2017). Is the daily use of vacuum erection device for a month before penile prosthesis implantation beneficial? A randomized controlled trial. Andrology, 5(1), 103–106. https://doi.org/10.1111/andr.12258

Use a VED after surgery too. Here's why:

Penile shortening after inflatable penile prosthesis placement for erectile dysfunction is a common postoperative patient complaint and can reduce overall satisfaction with the procedure. In this prospective study we report our results regarding penile dimensions and patient satisfaction outcomes after 1 year of follow-up from AMSTMLGX700® penile prosthesis implant with 6 months of vacuum erectile device therapy. Seventy-four selected patients with medically refractory erectile dysfunction underwent AMSTM LGX 700® IPP placement. Postoperatively, patients were assigned vacuum device therapy for 5 min twice daily. Follow-up continued for 1 year after surgery. Dimensional and functional results were assessed. Baseline median preoperative stretched penile length and girth were 14 cm (range 10-17) and 9 cm (range 7-12), respectively. At the end of the study penile median dimensional outcomes were 17 cm (range 13-23) for length and 11 cm (range 10-13) for girth while a median number of 24 pumps (range 18–29) to fully inflate the device was seen. Baseline median International Index of Erectile Function (IIEF-5) score was 9 (range 5-11), at 6 months 20 (range 18-26) and at 1 year was 25 (range 20-27) (p<0.0001). Median Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) score at the end of the follow-up was 74 (range 66–78). Our postoperative rehabilitation program is feasible and should be recommended after prothesis surgery in order to increase overall satisfaction with the procedure. Penile postoperative dimensional outcomes were statistically significant improved and complications were negligible.

Antonini, G., De Berardinis, E., Busetto, G. M., Del Giudice, F., Chung, B. I., Conti, S. L., Ferro, M., Musi, G., Fragas, R., De Cobelli, O., Sperduti, I., Gross, M. S., & Perito, P. E. (2020). Postoperative vacuum therapy following AMSTM LGX 700® inflatable penile prosthesis placement: Penile dimension outcomes and overall satisfaction. International Journal of Impotence Research, 32(1), 133–139. https://doi.org/10.1038/s41443-019-0125-z

It is interesting reading these forums how many of you cite how one doctor said to do this and one doctor said to do that. Honestly, that's not the only way we learn things anymore. The research is consistent that a VED should be used to allow your penis to return to its original size. Your current sizes after years of erectile dysfunction and aging are not relevant to this situation, because this study refers to average sized penises pre-implant.

It's my opinion you should believe the research and by science, not by what Doctor John L. told you. My doctor told me a VED wouldn't do me any good. What I realized after two months is that it won't do me any bad either. It's helped since then.

If your doctor tells you specific reasons your penis cannot safely use a VED, consider not using one. What my admittedly uneducated (but fairly well researched) brain can safely argue is that your penis is gonna be able to survive a VED - for one, the research says it will, and for two, over the past tens of thousands of years, dicks have been through much worse than damn penis pumps. Your dick will thank you if you do.

OK. All that being said. I need to make clear that this information is MY opinion only and is based on MY experiences only. I have enjoyed "cock pumping" with VED for many years. Geronimo probably would approve. I used VelSeal cylinders from Pump Toys and highly recommend them. Not cheap but top of the line. Brake bleed pump with vacuum gauge. I was pumping moderately aggressive for 3 months before my original April 4th implant date. Ins co was pain in the ass so I had to reschedule to June 20th. Kept on VED sessions twice a day up until 1 week before June 20. Had IPP done and am convinced that the pre-implant VED made tremendous difference in surgery outcome. I believe came out at my old size. Went through normal early recovery. Things continued to heal and now everything is fine. I am 6 X 6 right now at initial pump up.
Have used VED on 80% inflated penis at 5-7 Hg for 10 to 15 minutes with vacuum break every 5 minutes. I can get 6.5 inches length with packing of 2 inch cylinder most of the way up in tube at vacuum. Full inflation after goes to almost 6.5 bone pressed length with 6+girth. Titan implant does make girth. VED on fully inflated implant does not work as well, at least not now. I will keep VED post implant protocol.
Again, this is what I have experienced and can't say what others will experience. Good luck to all the Brothers here.

[aussiePeyronies]

Use a VED before surgery. Here's why:

When pre-operative VED is used, SPL could increase by a
mean of 0.80
0.38 cm. In addition, the surgeon is provided
with better opportunity to restore longer penile length that replicates
an appearance more consistent with the patient’s natural
erection. Ease of corporal dilation allows for an appropriate size
cylinder to be inserted, and thus helps to maximize patient satisfaction
post-operatively. There were no negative intraoperative
complications associated with the use of pre-operative VED, and
therefore, if patients have access to it, VEDs can safely be recommended.
Future studies among larger samples will help assess
the long-term outcomes and outline the role of VED as a valuable
intervention prior to PP implantation.

Canguven, O., Talib, R. A., Campbell, J., De Young, L., El Ansari, W., & Al-Ansari, A. (2017). Is the daily use of vacuum erection device for a month before penile prosthesis implantation beneficial? A randomized controlled trial. Andrology, 5(1), 103–106. https://doi.org/10.1111/andr.12258

Use a VED after surgery too. Here's why:

Penile shortening after inflatable penile prosthesis placement for erectile dysfunction is a common postoperative patient complaint and can reduce overall satisfaction with the procedure. In this prospective study we report our results regarding penile dimensions and patient satisfaction outcomes after 1 year of follow-up from AMSTMLGX700® penile prosthesis implant with 6 months of vacuum erectile device therapy. Seventy-four selected patients with medically refractory erectile dysfunction underwent AMSTM LGX 700® IPP placement. Postoperatively, patients were assigned vacuum device therapy for 5 min twice daily. Follow-up continued for 1 year after surgery. Dimensional and functional results were assessed. Baseline median preoperative stretched penile length and girth were 14 cm (range 10-17) and 9 cm (range 7-12), respectively. At the end of the study penile median dimensional outcomes were 17 cm (range 13-23) for length and 11 cm (range 10-13) for girth while a median number of 24 pumps (range 18–29) to fully inflate the device was seen. Baseline median International Index of Erectile Function (IIEF-5) score was 9 (range 5-11), at 6 months 20 (range 18-26) and at 1 year was 25 (range 20-27) (p<0.0001). Median Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS) score at the end of the follow-up was 74 (range 66–78). Our postoperative rehabilitation program is feasible and should be recommended after prothesis surgery in order to increase overall satisfaction with the procedure. Penile postoperative dimensional outcomes were statistically significant improved and complications were negligible.

Antonini, G., De Berardinis, E., Busetto, G. M., Del Giudice, F., Chung, B. I., Conti, S. L., Ferro, M., Musi, G., Fragas, R., De Cobelli, O., Sperduti, I., Gross, M. S., & Perito, P. E. (2020). Postoperative vacuum therapy following AMSTM LGX 700® inflatable penile prosthesis placement: Penile dimension outcomes and overall satisfaction. International Journal of Impotence Research, 32(1), 133–139. https://doi.org/10.1038/s41443-019-0125-z

It is interesting reading these forums how many of you cite how one doctor said to do this and one doctor said to do that. Honestly, that's not the only way we learn things anymore. The research is consistent that a VED should be used to allow your penis to return to its original size. Your current sizes after years of erectile dysfunction and aging are not relevant to this situation, because this study refers to average sized penises pre-implant.

It's my opinion you should believe the research and by science, not by what Doctor John L. told you. My doctor told me a VED wouldn't do me any good. What I realized after two months is that it won't do me any bad either. It's helped since then.

If your doctor tells you specific reasons your penis cannot safely use a VED, consider not using one. What my admittedly uneducated (but fairly well researched) brain can safely argue is that your penis is gonna be able to survive a VED - for one, the research says it will, and for two, over the past tens of thousands of years, dicks have been through much worse than damn penis pumps. Your dick will thank you if you do.

OK. All that being said. I need to make clear that this information is MY opinion only and is based on MY experiences only. I have enjoyed "cock pumping" with VED for many years. Geronimo probably would approve. I used VelSeal cylinders from Pump Toys and highly recommend them. Not cheap but top of the line. Brake bleed pump with vacuum gauge. I was pumping moderately aggressive for 3 months before my original April 4th implant date. Ins co was pain in the ass so I had to reschedule to June 20th. Kept on VED sessions twice a day up until 1 week before June 20. Had IPP done and am convinced that the pre-implant VED made tremendous difference in surgery outcome. I believe came out at my old size. Went through normal early recovery. Things continued to heal and now everything is fine. I am 6 X 6 right now at initial pump up.
Have used VED on 80% inflated penis at 5-7 Hg for 10 to 15 minutes with vacuum break every 5 minutes. I can get 6.5 inches length with packing of 2 inch cylinder most of the way up in tube at vacuum. Full inflation after goes to almost 6.5 bone pressed length with 6+girth. Titan implant does make girth. VED on fully inflated implant does not work as well, at least not now. I will keep VED post implant protocol.
Again, this is what I have experienced and can't say what others will experience. Good luck to all the Brothers here.

Thanks for sharing, please keep us updated. I have been using VED for 2 months (not yet implanted) and I can definitely say it's helped regain some girth and improved EQ (I also have PD). Definitely think it can help regain some girth/length for some people which may help get to your old size after implant. Everyone is different though.

[crazyjoe]

So you guys only pump it up to 5-7hg? I go 10-15 to get the full effect -- and no damage so far except occasional edema ,which resolves in a day or 2. I am puzzled by this difference from you guys. Can someone help me understand? Many thanks

[Gt1956]

So you guys only pump it up to 5-7hg? I go 10-15 to get the full effect -- and no damage so far except occasional edema ,which resolves in a day or 2. I am puzzled by this difference from you guys. Can someone help me understand? Many thanks

I'd be curious at how accurate your gage is. The gages that I've see sure look pretty cheap. At 5hg I've gotten edema. Even had a 1/4" blood blister on my head. I can't imagine what 15hg would do to me.
I'd suggest buying a new gage for safey's sake. At least you'd either know or confirm how much vacuum you're really getting.

[Injustright]

Since I can’t access the Perito et al artcle in full, does it indicate whether the implant should be inflated fully, partially, or not at all when the VED is applied?

[wolfpacker]

Since I can’t access the Perito et al artcle in full, does it indicate whether the implant should be inflated fully, partially, or not at all when the VED is applied?

A tip for accessing scientific articles: if you go to sci-hub.se and past in the link to the scientific articles you're trying to access, it will automatically open a pdf for you

[OregonStrong]

Since I can’t access the Perito et al artcle in full, does it indicate whether the implant should be inflated fully, partially, or not at all when the VED is applied?

I've been a dedicated VED user after implant. I pump my implant up to the max and use it. I can get several more pumps in also using the VED, if I take it off every 5 minutes and give a few more pumps into my implant expanding my corpora even more. The VED is not going to break the cylinders. I mean look how many PSI of pressure they have to apply to it to buckle it in testing, a low pressure VED is not going to do a damn thing to it, but it will help expand/engorge your corpora with blood allowing more room for your implant to expand into.

[Craigohbig]

I wanted VED to work for me, but it caused me stinging pain regardless of how lightly I used it. Maybe I was doing it wrong, and I am willing to give it a another go if one of the top docs recommends that I do so.

I first used a VED two months after my procedure. I don't think I'd call it "stinging pain," but I would say it was extremely uncomfortable, more so than I expected. I had to contact someone to make sure I wasn't gonna break my dick. Cause it felt like a VED was gonna break my dick. But it didn't. Because they don't. Your dick will be all right.

Did Eid elaborate on why he doesn't recommend VED? I've seen accounts of people hurting themselves with VED but if it's not done aggressively, is it still a danger?

Of course you've seen accounts of people hurting themselves with a VED. Because the people who didn't hurt themselves don't report anything. Also, their accounts are not medical proof of any real injuries that happened; they are men complaining online about their dicks hurting. I would not recommend basing your decision to use a VED on the outliers you read online, many of which aren't legitimate injuries, and are concerning easily available and I believe FDA approved devices.

Have you read anything about Ved use after a revision? My failure was just 3 weeks before I got the revision…he installed the same size implant (filled the reservoir with more juice this time) but I seem to have lost some length. This loss is an assumption as of now because I’m not sure whether or not I was starting from scratch after the second surgery

[2435tjklAS]

I wanted VED to work for me, but it caused me stinging pain regardless of how lightly I used it. Maybe I was doing it wrong, and I am willing to give it a another go if one of the top docs recommends that I do so.

I first used a VED two months after my procedure. I don't think I'd call it "stinging pain," but I would say it was extremely uncomfortable, more so than I expected. I had to contact someone to make sure I wasn't gonna break my dick. Cause it felt like a VED was gonna break my dick. But it didn't. Because they don't. Your dick will be all right.

Did Eid elaborate on why he doesn't recommend VED? I've seen accounts of people hurting themselves with VED but if it's not done aggressively, is it still a danger?

Of course you've seen accounts of people hurting themselves with a VED. Because the people who didn't hurt themselves don't report anything. Also, their accounts are not medical proof of any real injuries that happened; they are men complaining online about their dicks hurting. I would not recommend basing your decision to use a VED on the outliers you read online, many of which aren't legitimate injuries, and are concerning easily available and I believe FDA approved devices.

Have you read anything about Ved use after a revision? My failure was just 3 weeks before I got the revision…he installed the same size implant (filled the reservoir with more juice this time) but I seem to have lost some length. This loss is an assumption as of now because I’m not sure whether or not I was starting from scratch after the second surgery

I did some quick research looking into "Penile implants" AND "revision" and "vacuum erection device" OR "VED." I don't know if this is especially relevant, but this study is about revision surgeries and the use of VEDs:

The patient underwent vacuum erection device therapy twice daily for 10 minutes per session for approximately 1 year as well as 8 hours of penile traction therapy daily for 8 months. A revision implant surgery was subsequently attempted...

A revision surgery enabled the placement of a prosthesis that was 20% longer in length (15 cm to 18 cm), and erect penile length increased by 4.4 cm. The patient reported that the new prosthesis enabled satisfactory maintenance of partner penetration.

Moskovic, Daniel J., Alexander W. Pastuszak, Larry I. Lipshultz, and Mohit Khera. “Revision of Penile Prosthesis Surgery after Use of Penile Traction Therapy to Increase Erect Penile Length: Case Report and Review of the Literature.” The Journal of Sexual Medicine 8, no. 2 (February 2011): 607–11. https://doi.org/10.1111/j.1743-6109.2010.02121.x.

I don't know anything about this but it would be my assumption you basically do need to start from scratch again. I guess you wouldn't expect post-surgery that you size stays that same as it was. Took like a year of exercises to regain your size, it won't stay that way after getting cut into again. So you need to strengthen it up again like you did before, ideally with VED also since it is proven to help.