Implant + TEP procedure Journal - 34yr old Australian

[aussiePeyronies]

Hey guys,

I have uploaded some pics, I will explain below. Let me start with, I am putting these here so I can assess the differences in June 2024. Only then, I will assess if it is better to just live with these issues or opt for a revision from Dr Hakky.

First 2 pics - Deflated flaccid Angle and bulge

As you can see, in pic 1, my flaccid sticks out for an inch and then goes down (I have pushed it down as much as I can in the pic). So, it sticks out at about 3pm for one inch and then goes down (when standing) to about 4pm. I can wear it to the left, however, this causes the dog ear to stick out pronouncedly. It also does not move to the right. As you can see in pic 2, when wearing clothes the dog ear sticks out. This looks like an erection, and has caused issues whereby I have to go to the gym wearing long shirts and be constantly self-conscious. When wearing a suit, I always wear a long waistcoat/vest with it, and have to constantly worry about looking like I hav an erection in a professional environment. In the pic I am wearing compression underwear, I have tried two pairs of compression underwear and although it pushes the penis down, the part at the base, and the dog ear, still stick out looking like an erection. I have had issues going to the gym, wearing professional clothes for work etc, watching what I wear when I am around my niece n nephew etc. I have also tried just loose silk boxers, and this causes the dog ear and the shaft to point out. This has affected my quality of life.

Retracted Graft

It is difficult to tell but if you look closely on pic 3, you can see that the right side is thin and slants, it does not inflate fully/properly. In the final pic (I have posted this in another post below as FT only allows 3 pics per post) you can see how my inflated shaft was post surgery, before I had any of these issues - it was nice and round. The surgeon advised that he thinks this is due to the graft retracting/contracting. I have searched the internet and ask doctors, couldn't find much info on retracted grafts at all. I can say that that area is painful and that I get less engorged than I would post-surgery.

If this issue resolved, I think I would be happy.

The surgeon also isn't 100% sure as he did not write which side he put the graft in his surgical notes. There is a slight possibility that it could be scar tissue or a kink, although, I think the surgeon would probably know best.

If anyone has any info on retracted grafts, I would appreciate it. Atm, I am just cycling and using the VED, but have not seen any improvement. The surgeon used a TachoSil graft. I will be starting the Perito exercises soon too. I only feel the stretch on the left side when cycling.

Pain

I still have general pain, a lot of pain after ejaculation (even after the prostatitis issue settled) and pain/tenderness by the frenulum. Really not sure what is causing all this, almost 1 year post-surgery. All I can do at this point is have faith, wait till June 24, then see if it's time to accept everything or opt for a revision.

I have been told to just have sex and enjoy the implant, and so far I have had sex once. However, having sex while anticipating pain is a difficult thing to do. I'm sure you guys with peyronies pain can relate. After ejaculating, I just feel like laying down and will be sore in the tips, shaft, frenulum and perinium area.

Dont let my post put you off implants, I have been going through a tough time and its just hard staying positive. I do anticipate that eventually, the pain, and pain after ejaculation will subside, and I will be able to have an active sex life gain.

On the 22nd Jan, I will be having a video consult with Dr Hakky and will send him my MRI results to review.

I will say, when choosing your surgeon, choose wisely. After doing some research, I found that Dr Perito, who is very well known and high volume has been sued due to having to two men ending up having to amputate their penis! (Coincidentally, I believe my surgeon trained under Dr Perito)You can find the article here: https://www.dailymail.co.uk/news/articl ... tions.html

My heart really goes out to those two people.

Thanks for all the support.
J

[aussiePeyronies]

Fourth pic which I was referring to, before the retracted graft issues.

[aussiePeyronies]

Update:

Almost 1 year post surgery.

I am actually starting to like my implant. I just measured, and I hit 6.5 inches BP (without engorgement). This was my pre-op length. With engorgement, I am probably an extra 1cm in length. So, I would be about 1cm above my pre-op with engorgement.

My girth is a little less, due to the retracted graft. But, I may consider fillers to resolve this.

I gotta say, it feels good knowing you can have sex when, and however long you want. I can see how people grow to really love their implant. I can pump to 80% and it just mimics a normal natural erection, it's round, reliable and just looks like a normal erection. At 90%, its a bit harder more girth but ovalish and flat. I remember when I was in my 20s and being with attractive girls, sometimes having threesomes (pre-peyronies), and I would have performance anxiety and not be able to keep it up. Sometimes, I would ejaculate too early. Imagine that experience with the implant, your penis would just be rock hard the whole time, what an experience that would be!

I was out the other day, and I got some attention from a blonde girl. I felt so great knowing that, if I wanted, I could probably start dating again and have an intimate sex life. With peyronies these are things that would make me depressed. I am generally pretty good looking, have a great physique and good background, when I'd get attention from girls (back with peyronies) I would have to cancel on them and just not pursue them, I didn't have any direction in where I wanted to go in my romantic life as I just didn't know what would happen with my peyronies. Now, I can have an active sex life and date as much as I want, and plan for a future .

The retracted graft issue is still there, I thought it was improving, but I am not entirely sure, I will do some measurements and pics soon. It's disheartening, going through the trauma of TEP + circumcision, to be left with less girth. Had this risk been known, I may not have opted to be circumcised. All we can do is accept it, and write our journey in our journals so no one else has to go through this experience. I can get fillers, but fillers are not without risks either. If anyone has any info on retracted grafting, I would appreciate it.

The pain after ejaculation is still there, but not as bad. I anticipate that, it will improve as time goes on.

Most of my length gains came in the last 6 weeks where I changed my cycling routine. Instead of doing perito exercises and VED (these were causing some pain and discomfort) for 30m each day, I just started cycling for 2 x 1hr sessions. I basically pump to max, then wait 20m then pump again (I can get about another 12-15 pumps in), then wait 20m then pump again (about 10-12 pumps in), that last 20m block is pretty excruciating pain!! I have to edge to get through it.

I am thinking when the pain while cycling subsides, I may try VED and perito exercises again, and after 3 months of VED and Perito exercists, I will probably accept whatever dimensions I have and opt to get fillers to compensate for the loss of girth.

Advice

Do you guys think, that, due to the pain while cycling, there are still gains to be made? I guess its impossible to tell, some people make gains past a year, and some don't. I also have a bend to the left, how normal is this?

The more I pump (high levels of inflation), the more pronounced the bend to the left is. Could be due to the retracted graft on the right side, I Really don't know. I usually pull the penis up and then pump so that it inflates straight.

As I am seeing growth, I am a bit worried on one thing. I initially had a 110ml reservoir, the surgeon, on my second surgery stated that he took out about 25ml as the reservoir was indenting the bladder. What risk is there that, as the device grows, I may run out of fluid?

Final thoughts

I must say, this has been a crazy journey. My sex life has improved but my personal life has taken a hit. The dog ear protruding out still sticks out and looks like an erection. This has taken a toll on my personal life. But, it could improve as the cylinders soften. The right side angle hasn't dropped as much as the left either.

I am going to put this message here for others. I've spent about 20k on my surgery (2 surgeries) including airfares and accommodation. If I choose to get fillers to compensate for the lack of girth, that would cost another 10k. That's 30k AUD, another 10k and I could have just gone to Dr Hakky for my surgery, and I believe, I wouldn't have many of these issues. My surgeon, wasn't much help once I started having issues, and he LIED in his post-operative letter stating that I was unhappy/obsessive due to the length and girth, and he stated he believed my anxiety was contributing to my symptoms. However, you can read this whole journal on this website (you can't delete posts on this website - referring to the peyronies website), and see that I have never had issues or complained about length/girth. Rather, prolonged pain, deformity, retracted graft etc. He was also complaining that he spent 45m talking to me after my 2nd surgery and I still had to email him for confirmation of some things once I was back in my state (is this not ridiculous?), we pay our surgeons 12k out of pocket, have to have a 2nd surgery due to issues and prolonged pain and they are complaining that they had to go beyond their 45m post-surgery consult and send emails?

See the difference in patient care, the surgeon who did my surgery downplayed the risks of sub-coronal TEP, yet he told another patient (user:morphball) that he had performed sub-coronal TEP and had to amputate the patients glans due to a complication (tissue necrosis I think), YET he still continues to perform the procedure.. Why? Money perhaps? In contrast, Dr Hakky stopped performing sub-coronal incisions due to the complications and risks associated with it, this tells me, he does what is in the best interests of the patient. As you know about my retracted graft issue on the right side, this is still a GUESS from the surgeon as he did not write which side he put the graft in his surgical notes - I think this is very poor form from a medical professional performing major surgery. I will also add that, Dr Hakky wanted an MRI as soon as I had my video consult with him, he said my surgeon should not have performed the second surgery and taken the risk. It makes sense, the surgeon probabaly should have requested an MRI and further diagnosed the issues before opting for a second surgery. Choose a good surgeon guys, you only get one penis, and this procedure is irreversible, don't take any risks. I really do not want anyone else to have to go through what I went through.

I will post some pics up in a few weeks.

J

[satyrum]

Glad you're better now. Really happy for you. I think your journal is one of the most important implant journals in the history of this site. No different than frequently referenced ones (e.g. Merrix, Tangerine etc.)

I'm not from the States. The highest volume surgeon in my home country offered me TEP with subcoronal incision. I was hesitant, to say the least. Long story short, I decided to go with Hakky. Flew from the other side of the planet to be implanted with a 26cm Titan. He used scratch technique, no TEP (which is an outdated technique according to him). He also told me that subcoronal incision can be extremely dangerous when it comes to a XL penis (especially +7"). It simply shouldn't be performed on a guy like me.

I'm not saying your journal is the only reason I changed my decision, but it played a crucial part in terms of forcing me to research TEP as humanely as possible. Journals like yours are why FT is an incredibly important website. Thanks again. Wish you a great year full of great sex.

[aussiePeyronies]

Glad you're better now. Really happy for you. I think your journal is one of the most important implant journals in the history of this site. No different than frequently referenced ones (e.g. Merrix, Tangerine etc.)

I'm not from the States. The highest volume surgeon in my home country offered me TEP with subcoronal incision. I was hesitant, to say the least. Long story short, I decided to go with Hakky. Flew from the other side of the planet to be implanted with a 26cm Titan. He used scratch technique, no TEP (which is an outdated technique according to him). He also told me that subcoronal incision can be extremely dangerous when it comes to a XL penis (especially +7"). It simply shouldn't be performed on a guy like me.

I'm not saying your journal is the only reason I changed my decision, but it played a crucial part in terms of forcing me to research TEP as humanely as possible. Journals like yours are why FT is an incredibly important website. Thanks again. Wish you a great year full of great sex.

Glad it all worked out for you. I have a video consult with Dr Hakky to go over a few things soon. If I could go back, I would’ve just saved up and seen him to begin with.

Very happy that you have overcome everything and have a good result with your implant.

J

[aussiePeyronies]

Hey guys,

Bout to hit 1 year from my revision surgery (partial revision) and 17 months from my initial surgery.

I do have some good news, here are my dimensions (see pics):

L: Just over 6.5 inches (BPEL)
G: Just about 6inches (5.8 or 5.9? We use cms in Australia, hopefully I have measured correctly).

Just before surgery, I was 6.5 inches length and I never measured girth, however, I have included a pic from before surgery, in the third pic, you can see, the penis was quite narrowed out, especially at the base. I can confidently say, this looks like some significant girth gain. I was 5.3 inches girth and 5.75 inches length 8 weeks post-surgery (see beginning of this journal).

I am pretty happy with these dimensions. Thing is, almost 1.5 years post surgery, I am still getting pain when cycling, and the device seems to still be growing, albeit, very slowly. My completely layman and unprofessional guess, is that there was a lot of scar tissue and narrowing in my penis which is still stretching and/or due to the retracted graft on one side; growth is slower as one side is not stretching/inflating as much as it normally would be. It seems that, if the tissue can grow, and you keep cycling regularly; it will grow.

I have been cycling 1 hour twice a day. Most of my progress came within the last few months when I started this regime. I am thinking of switching to 30m VED and 30m Perito exercises soon. Simply because, 2 hours of cycling per day can really take up a lot of your time, and I am not sure how much more it will grow. Dr Hakky also recommended 30m VED.

These pics are about 85-90% inflation which is just comfortable for sex, it is not too hard or rigid but just mimics are hard natural erection, maybe slightly harder. 80% would probably mimic more of a natural erection, but not as hard, and slightly less girth. I can get the girth to 6 inches on the dot if I pump it up more (95-100%), however, the device would be too rigid and hard for sex, and this level of inflation also results in less blood flow, and some loss of sensitivity. I did measure the girth in the middle when at a comfortable level of inflation for sex, and it is 5.75 inches and at the base is about 5.5 inches. The length is slightly over 6.5 inches, it looks shorter than pre-surgery, and I think that is just because of the thickness. I think a thicker penis just looks shorter. Please view my pre-surgery pics in this journal and you will see what I mean. I think the glans also seems bigger, may just be the pics but it looks that way. Pre-peyronies, I think I would have been around 7.2 or 7.5 inches length. Girth, I never really measured pre-peyronies, but I was told it was above average from women.

I will say that, I think 6 inches girth is really good. I was reading that at above 6 inches girth, some people can leave the penis in the vagina and make a woman orgasm just from slow thrusting. It reaches spots that aren't usually reached. Just what I have read.

I can also use VED pre-sex, and this results in probably 1cm extra in girth and 1cm extra in length. Can maintain this for a few hours after (without a cock ring). This is a good solution for guys that have lost a lot of girth to peyronies; pump up with the VED before sex. I might do this and post a pic just to show it's a viable solution for some.

These are the positives, and I am pretty happy with it tbh. However, there are some issues I have been dealing with which I will explain below.

Flaccid:

The device does stick out at about 4pm, and twists to the left when flaccid. As there is a strong kink/dog ear protruding out of the right, I can't wear anything other than thick jeans in public. If I wore shorts or trackies, it would look like I have an erection. This is an issue as I had a corporate job which required me to wear a suit. This has resulted in some huge lifestyle changes for me. Dr Hakky advised that this does happen, and it is dependent on the penis; each case is different. There is a surgery which may fix it, but it is not without risks. He advised it is a possibility to switch to AMS which would get rid of the dog ear. It just depends how much it is affecting my life. I am about to start a new job which requires me to wear a suit, and I am seriously considering what to do. My job requires me to go to court regularly, and it just would not be a good look if something was protruding out of my pants constantly. It's also a bit of a mental burden, having to worry about looking like you may have an erection.
When getting penile implant surgery, I didn’t think I would be avoiding my niece and nephews beach parties because I can’t wear shorts, or avoiding social gatherings when I can’t wear jeans or stressing about a new corporate job because I could look like I have an erection in a suit.

A user on FT suggested a stretching pump device from Ebay. It seems to stretch the penis from the base. It is supposed to help, it worked for him. I just ordered and will try it out.

Dr Hakky advised some patients have this issue, it just depends on the penis, some stick out, and some don't. He has performed surgery to fix this issue in some patients, and in some, he has switched to AMS.
Please don’t message me advising that there is nothing wrong with a bulge, as I agree with you. It’s not a bulge that is the issue, it’s the device/dog ear protruding out which looks like an erection through clothing (not a bulge).

Frenulum pain:

I do still get some pain by the frenulum. Dr Hakky advised that this was a common issue with the sub-coronal T.E.P with circumcision. He advised that he could perform a frenectomy (I think that's what it was called), or put grafting in the glans. He has come across this issue before and it is one of the reasons why he stopped performing sub-coronal incision; they just had too many complications.

Tubing:

There is some prominent tubing by the base of the penis when inflated, this can be felt when a woman is deep throating or you are deep thrusting. It also feels like some tubing is tangled or twisted in my scrotum – this can be painful and uncomfortable.

Peeing:

Unfortunately, after peeing, I get a mini stream dribble down after about 5m. Dr Hakky advised that this can be due to the large kink/dog ear, the urethra becomes bent. Can also spray in different directions when peeing. When I had peyronies, I would have 2-3 drops post peeing; this was manageable. I have spoken to some people on FT who had this issue after penile implant surgery, they just started sitting down to pee or using liners in their underwear. Bit easier to accept when you’re 60+ and have a less active lifestyle.

I have considered doing kegel exercises, however, they are not recommended if you have tight pelvic floor muscles (I will explain below).

Prostatitis:

This issue is still here, I do have flare ups, they are painful, but can be managed with pain killers. Dr Hakky advised that this does happen, he had a patient that developed prostatitis post-surgery recently. He advised the medication regimen he usually prescribes, but unfortunately, he could not prescribe me anything as I am in another country.


Ability to discreetly pump:

The squeak is still there, it’s a reasonably loud honk. I also must hold my penis straight when pumping otherwise it will pump bent to the left (no idea why?). I read a guy on FT who started holding his dick straight and pumping to avoid the device inflating to the left, and it worked. The fact that I have a loud honk, and have to hold my dick straight to pump it, makes discreet pumping almost impractical. However, it is possible to pump it up in the bathroom, tuck it up, and then go to engage in sex.

I can imagine, the guys who have no squeak, and the device pumps straight, would have no issues discreetly pumping.

Pain after ejaculation:

I still get pain after ejaculation, if I take a lot of NSAIDS pre-sex, the pain can be minimal. This could be prostatitis related, I am really not sure. It was a non-issue with peyronies. Sex is a bit difficult to enjoy when you anticipate pain. Also, having multiple rounds can be painful and cause a lot of discomfort.

Retracted Graft Issue:

The retracted graft issue is still there, albeit, with blood flow, it’s only noticeable if I were to press on one side or hold it. I can press and feel that one side is softer than the other (as it does not inflate as much), and also slightly thinner.
I would be very happy if this issue resolved, as it would result in slightly extra girth, as well as a rounder penis.

Bend to the left:

See the discreet pumping paragraph above. If I don’t hold my penis straight out and just pump, it will inflate completely bent to the left. Not sure why this happens, it’s not a major issue as I can just hold it straight with one hand and pump with the other, but can cause issues if one wanted to discreetly pump.

Orgasm:

I have been having strange, weak orgasms, and I think this is due to a tight pelvic floor. When I orgasm my penis/perinium area seems to kegel. My guess, this could be due to nerve damage from surgery. I was doing some pelvic floor exercises (thanks to Dr Hakky’s advice), and it did seem to help. There were some times where I had a normal relaxed and intense orgasm. I had to stop the pelvic floor exercises as on top of 2 hours cycling a day, I just did not have the time.

I will start the pelvic floor exercises again. Rolling was a good one.

Final thoughts:

I am happy with the device, I have my sex life back. The burden of peyronies is gone. You all know that feeling when you’re out in public, you get attention from women, or you meet a girl and you develop a connection, but you have that burden of peyronies in the back of your mind. That feeling is now gone.

I have been struggling with a lack of a social life, if I can't wear thick jeans somewhere, I won't go. I worry at the gym, if my long top isn't covering my crotch, it could look like I have an erection. These are some issues that can really affect your quality of life.
If I didn't have the issues described, I would probably be on top of the world. After talking to Dr Hakky, he told me two things, that a sub-coronal incision, and leaving the devise inflated after surgery (mine was left inflated for 5 weeks as my Dr went on holiday), are both notorious for causing issues. Some of these issues I have, could be a result of these two things.

My advice for anyone considering this surgery is to really find a trustworthy doctor, if you can't afford one, consider whether it’s in your best interests to wait, save up, and do the surgery overseas. Especially, if you have a complex case. I have had 2 surgeries already, and may have to have a third to fix the frenulum pain and flaccid issue. Had I just chosen to go to Dr Hakky initially, it may have saved me 2 surgeries plus a circumcision. Having multiple surgeries can really cause issues including scar tissue build up, risk of infection, losing bloodflow, nerve damage etc.

There is a story from Jordan Peterson's book and it tells of how his daughter Mikhaila had rheumatoid arthritis in her ankle, she had constant pain and discomfort. The first physician they went to wanted to amputate her ankle. The second physician they went to was able to snap a bone back in place, and this resulted in her pain being diminished and her being able to walk properly again. This just emphasises the importance of choosing the right physician.

Unfortunately, Penile implants are not well understood, even by doctors who do the surgery. Doctors in Australia were not able to tell me what was wrong and tried to blame the issues I had on anxiety etc. It wasn't until I had 2 appointments with Dr Hakky that he advised these issues do happen, and they are common with sub-coronal incisions and leaving the device inflated for long periods post-surgery. The point I am trying to make is, as bad as this sounds, if you don't have one of the top surgeons in the world (find a world class surgeon as Merrix says),I really don't think you should trust your doctor. After having issues with my penile implant, I went to the top doctors in Australia, they all rushed me out of their office, said it was in my mind etc (kind of like when you first get peyronies and that urologist gives you cialis and rushes you out of his office. I also did my MRI here, I emailed it to Dr Hakky and he was disappointed, he said that the doctors here were looking for all the wrong things.

I really don't advocate anyone undertake the Tunica Expansion Surgery. I just don't think it's worth the risks. Dr Hakky also is against it, says its outdated and dangerous. He has his own auxetic technique and I think it's the scratching technique as well that he believes is a bit better and safer than TEP. I trust him, he just seems very ethical and knowledgeable. Only doctor who could tell me everything that was going on and reassured me that these things happen.

Finally, I would just like to say, don’t take my post as being negative. I am actually quite happy with the implant. It has resulted in quite a few lifestyle changes, but that burden of peyronies which can leave a man depressed and suicidal is now gone. Sex is possible, and arguably, better sex, as I have a rock hard erection on demand, complicated acrobatic positions are even possible (lol), performance anxiety is a non-issue.

I just have some questions for anyone out there who has had to switch from titan to AMS. This may be my only way to get a flaccid that is able to be easily tucked in without a dog ear so I can wear suits and resume my corporate job:

1. Did you lose much girth going from titan to AMS? I am quite happy with my almost 6inch girth atm.

2. Did your penis become less round and more oval with AMS? I have heard this can happen.

3. Did you have a dog ear? If so, how prominent was it? Please consider, if I did not have a dog ear, I could easily just tuck my penis to the left and wear a suit and resume my job. It’s the dog ear that protrudes out and looks like an erection.

4. My next revision will probably be the 24cm Titan, I heard the equivalent is 21cm AMS +3 cm RTE’s, has the RTE’s been an issue?

The community we have here has been more helpful than ever, thank you to everyone who supported me.

[aussiePeyronies]

Here's my current comparison pic. Left is peyronies top view (the underside was very scarred which you can find a pic of earlier in this thread).

Right side of the pic is current, size is as follows:

Length: 6.75Inch BPEL
Girth: Top: 6inches Middle: 5.75 inches bottom: 5.5 inches.

My size with peyronies was 6.5 inch length BPEL and I estimate about 4.5 inch girth.

J

[aussiePeyronies]

Update

6 Weeks Perito exercises, my length is at 7 Inches BPEL, this is getting closer to my pre-peyronies length.

My goal is to get as close to pre-peyronies as possible. Not only in length/girth, but in quality of life.

J