Tryna Settle on Choices After Consultation

[Crazy_Horse]

I have not had an erection since late 2012. Consequently I no longer have a baseline to develop anything like a realistic post operative expectation for length and girth in 2024.

This morning I showed a doctor a photo of my penis in a vacuum erection tube. He says: "Yeah, that's supra-physiological. We can't duplicate that."

I showed him a study finding that trans-scrotal approach, although "tedious" for the surgeon, can add 1-2 centimeters length when combined with aggressive cycling post op.

"Yeah. I was trained to do trans-scrotal, but I only do the infra-pubic approach."

"Why?"

"Easier healing."

At which point I'm thinking: This guy would rather save 45 minutes of his time and give me a 5 inch penis than spend 45 minutes to give me a 6 inch penis."

I don't say that. But that's what I'm thinking.

I have not penetrated a woman in 12 years. I had a substantial penis then and i know the difference between giving a woman real joy, and pity sex. it would be nice to really take care of a lady once or twice before I die.

I understand the need to manage expectations, but this 35 year old surgeon's orientation is the management of expectations. His life is a halftime show. He is not considering the urgency that comes with being 65 years old, diabetic, three coronary stents, and probably not a lot of time left on the board. It's not enough to be within field goal range for me.

I'm in Tennessee. I'm open to comments. Be nice, if you can.

[Old Guy]

You need to find a surgeon that will go the extra step. That may involve numerous interviews and travel, which is not an option that you want to deal with it seems.
After dealing with 13 years of ED myself my length loss is nothing compared to the fact my penis is able to get erect. Basically, a floppy penis isn't good for anything except to expel urine no matter how long it is. A hard penis can do all the things you used to do before ED, no matter how long it is.
Best of luck on that decision. Hope you're able to bed a few ladies before long.

[Jage64]

I travelled 2000 miles and paid out of pocket for my implant. I could have driven 5 miles and paid a $20 copay for my local Kaiser urologist (I paid 1000x that and would pay it again). He was a nice guy, but when he held out my penis and told me "this will be the outcome", that's the last time we spoke.

This is not something you shop price or convenience on. If you have the means, then consult with the very best across the country, educate yourself, make wise choices and ask intelligent questions. You'll be very happy.

In the meantime, use that VED to keep blood flow to your tissues, when it's time to measure your dick in surgery, it is what it is. Your tunica albuginea tells the surgeon what size implant to install, he/she will hopefully cheat up just a little and you're off to the submarine races.

Good luck sir, there's more info here on FT than you'll be able to process. Take notes, ask questions, watch videos.

[DeadlineDave]

It's important to like your surgeon or at the very least have great confidence in them.

But, according to your transcript, he said the healing from pubic is easier than the healing from trans-scrotal. I'm not sure one is quicker than the other. I believe I heard Perito say in a video that he could do a trans-scrotal in 12 minutes.

I'm in the early stages of recovery and have read so much and listened to so many surgeon's videos. I think they generally size as agressively as they can and encourage daily cycling for many months to restore as much size as possible.

Besides being wary of what a doctor say is not possible, I'd measure what a doctor says is possible against all of the common knowledge on the boards and the videos.

[HikerMan]

I have not had an erection since late 2012. Consequently I no longer have a baseline to develop anything like a realistic post operative expectation for length and girth in 2024.

This morning I showed a doctor a photo of my penis in a vacuum erection tube. He says: "Yeah, that's supra-physiological. We can't duplicate that."

I showed him a study finding that trans-scrotal approach, although "tedious" for the surgeon, can add 1-2 centimeters length when combined with aggressive cycling post op.

"Yeah. I was trained to do trans-scrotal, but I only do the infra-pubic approach."

"Why?"

"Easier healing."

At which point I'm thinking: This guy would rather save 45 minutes of his time and give me a 5 inch penis than spend 45 minutes to give me a 6 inch penis."

I don't say that. But that's what I'm thinking.

I'm 65 years old now. I have not penetrated a woman in 12 years. I had a substantial penis then and i know the difference between giving a woman real joy, and pity sex. it would be nice to take care of a lady once or twice before I die.

I was a lawyer. I understand managing client expectations, but I'm not sure this 35 year old surgeon understands what it's like to be 65, diabetic, with three stents, and a sense of urgency that comes with all of that.

I'm in Tennessee. I'm open to comments. Be nice, if you can.

I think your trepidation is very warranted.

After my prostatectomy, I was handed off to a urologist who did implants and I wasn't impressed with this guy at all.
In fact, dealing with him and his blase' attitude and approach I high tailed it out of his office prontissimo.

I'm very glad I did.
I truly believe your surgeon is about 75% of this whole shooting match..
I actually found my surgeon here on this site.(Thanks, guys)

Make sure you choose your surgeon very carefully.
My Doctor has told me absolute horror stories of the revisions he has had to do because of sub-standard work.

I wish you well.

[Witheringhog]

I have not had an erection since late 2012. Consequently I no longer have a baseline to develop anything like a realistic post operative expectation for length and girth in 2024.

This morning I showed a doctor a photo of my penis in a vacuum erection tube. He says: "Yeah, that's supra-physiological. We can't duplicate that."

I showed him a study finding that trans-scrotal approach, although "tedious" for the surgeon, can add 1-2 centimeters length when combined with aggressive cycling post op.

"Yeah. I was trained to do trans-scrotal, but I only do the infra-pubic approach."

"Why?"

"Easier healing."

At which point I'm thinking: This guy would rather save 45 minutes of his time and give me a 5 inch penis than spend 45 minutes to give me a 6 inch penis."

I don't say that. But that's what I'm thinking.

I'm 65 years old now. I have not penetrated a woman in 12 years. I had a substantial penis then and i know the difference between giving a woman real joy, and pity sex. it would be nice to take care of a lady once or twice before I die.

I was a lawyer. I understand managing client expectations, but I'm not sure this 35 year old surgeon understands what it's like to be 65, diabetic, with three stents, and a sense of urgency that comes with all of that.

I'm in Tennessee. I'm open to comments. Be nice, if you can.

I would recommend one of the high volume docs people discuss on this site. I went with clavell and couldn’t be happier. I went with Clavell because he seemed passionate about the implant, even though he is younger he has the experience of a veteran. I wanted those passionate young hands working on my dick.

I agree with the other posters, do a few phone consultations with multiple surgeons, then go with your gut. You will be able to out last an entire whore house if you so chose after getting implanted. Your back will give out, your heart could stop, but your dick will remain rock hard. My favorite part about being implanted is the patience during sex, i can take my time and enjoy the entire experience. Before, i would think, if we dont start right now my dick will go soft, then if i didnt try and rush to finish I would most likely go soft and not finish. Best thing i ever did for myself was getting implanted.

[Crazy_Horse]

Based on the advice from you who answered my post, I just drove 150 miles over snow and ice to find a doctor I feel I can trust: Lee Andrew Evans, MD, Baptist Health, Paducah, Kentucky.

See https://www.baptisthealth.com/providers ... md-urology

Paducah is a small town, but Dr. Evans told me he's the number 10 penile implant surgeon in the country. I didn't realize anyone was keeping score, but I believe him. He told me that he did 115 implants last year. The procedure takes 30 minutes and I am convinced this guy is working for me.

Dr. Evans displayed the model choices, AMS and Titan, side by side. Nobody in Nashville showed me the two models and so I was able to get the look and feel of both options. Dr. Evans examined me and recommended the Titan Coloplast; which, the Titan looks like it might need a little more time to break in, but that's fine. I prefer the Titan Coloplast over the Boston Scientific models.

Dr. Evans also employs a trans-scrotal approach, which conforms to my preference.

Dr. Evans listened to my concern about preserving penile length, and he said: "I'll give you whatever I can. I won't short you." And he seems confident about the result. So I am too.

We're scheduled for the morning of Friday, January 26, 2024.

[Mark1974]

I love your sense of humor

Glad you found a doctor that would do peno-scrotal. My understanding is that you can get better pump placement from this approach.

If you have a Titan (which has a smaller pump) and better pump placement it will help towards having better aesthetics, which may help psychologically even if you have lost size.

Follow cycling instructions to try and get a good angle. Just focus on the things you can control

Dr. Jonathan Clavel spoke in one of his videos about how having less of a stomach or pubic fat pads can increase the amount of functional penetration even if you can't gain anymore size. I don't know what your shape is, but that is something else that maybe you have some control over.

[Crazy_Horse]

Well: I’m sitting here in a hotel in Paducah, Kentucky, 9 hours post op. Dr. Evans installed a Titan Coloplast with one cylinder slightly shorter than the other, and when he came to see me he remarked that I really did need to get this done due to scarring.

I am elated to have a conscientious doctor and I made a decision to look outside Nashville based on the advice in this thread. Thank you all.

[Rider1400]

Anxious to hear about your surgery and recovery. Start a new thread about your recovery so Al of us can follow a newbie! Good luck with recovery. The journey is just beginning! ICE,ICE, ICE!