moving from titan to ams cx

[sambalamba]

on Tuesday I will do my revision from titan to ams cx, according to your experience, even those who directly put a cx, without any revision, in your opinion, I should expect a loss of girth/length, I should expect a much lower stiffness, an angle better/worse, I should expect more ovality or more flattening than the titan, my titan was already very oval and flat what do you think based on your experience

Any specific reason behind your decision to switch from Titan to AMS?

[frank66665]

on Tuesday I will do my revision from titan to ams cx, according to your experience, even those who directly put a cx, without any revision, in your opinion, I should expect a loss of girth/length, I should expect a much lower stiffness, an angle better/worse, I should expect more ovality or more flattening than the titan, my titan was already very oval and flat what do you think based on your experience

Any specific reason behind your decision to switch from Titan to AMS?

yes, the left cylinder hurts when deflated up to the middle of the shaft all day, I have to move it often, also when I have sex after half an hour it starts to bother me to the point of not being able to reach orgasm, I don't reach orgasm masturbating or when they give me a blowjob because of the discomfort I feel, gradually the discomfort turns into pain, this thing has been happening to me since I had the implant, the doctor said it will pass it will pass, but it has never gone away

[sambalamba]

Sorry to hear about your situation. Since you're going in for surgery Tuesday, I guess you've already made up your mind. I'm seriously considering an implant right now. Have consulted with Dr. Clavell, Eid & Hakky. Majorly confused about which implant to pick right now. Dr. Eid/Hakky says Titan would be the best for my anatomy and Dr. Clavell said either would be fine. My reasons for leaning towards the Titan is captured in my post: https://www.franktalk.org/phpBB3/viewtopic.php?f=6&t=25067&hilit=titan+kink#p236395. After reading many posts on this forum it seems the eventual outcome about satisfaction is highly dependent on each individual although the medical journal links posted does point to some statistically significant data. I do take these studies with a grain of salt because the outcomes are heavily dependent on how the study was designed. Also a lot depends on the surgeon's skills in my opinion.

All the best to you and hope you end up with a much better outcome than your current situation. Keep us posted.

[Jage64]

I don't know that I've ever noticed a patient on FT with an AMS from Eid or Hakky. Do they even offer the option of AMS? If not, then that's why they recommend Coloplast. (plus, the Coloplast is less expensive to the surgeon)

I'm 100% satisfied with my AMS CX, my flaccid looks and feels normal, which is the state my penis is in 98% of my life. It can get too hard for my wife (she likes 80% inflation), so any additional hardness over the AMS maximum is of no value to me, which seems to be an often repeated "benefit" of the Coloplast. Basing a decision on bench testing seems to be a foolish metric to me when all the implant offerings provide more than enough rigidity for penetrative intercourse or they wouldn't sell a single device.

One reason I chose Dr. Clavell is because he does offer both implants, and they are not the same. The outcomes are not the same, the pros and cons are not the same, the reliability is not the same, etc.

Like you, I did extensive research even before talking to Dr. Clavell, which led to a very informed discussion and decision. Every penis and person is different.

[Rider1400]

I had the big idea I needed the titan after hundreds of hours of research… but now after 2-1/2 years whenever this thing wears out I’ll go with whatever Clavel suggests. I think where the difference in hardness shines is if you have pyronies disease and needing to overcome a bend. That would definitely go to the titan. Also if your xtra girthy it might be a benefit to go with titan otherwise both seems to study out much harder than is necessary for any kind of sex you desire.

[LastHope]

all the implant offerings provide more than enough rigidity for penetrative intercourse...

@Jage64,
This statement was for anal penetration or vaginal penetration?

[sambalamba]

I don't know that I've ever noticed a patient on FT with an AMS from Eid or Hakky. Do they even offer the option of AMS? If not, then that's why they recommend Coloplast. (plus, the Coloplast is less expensive to the surgeon)

I'm 100% satisfied with my AMS CX, my flaccid looks and feels normal, which is the state my penis is in 98% of my life. It can get too hard for my wife (she likes 80% inflation), so any additional hardness over the AMS maximum is of no value to me, which seems to be an often repeated "benefit" of the Coloplast. Basing a decision on bench testing seems to be a foolish metric to me when all the implant offerings provide more than enough rigidity for penetrative intercourse or they wouldn't sell a single device.

One reason I chose Dr. Clavell is because he does offer both implants, and they are not the same. The outcomes are not the same, the pros and cons are not the same, the reliability is not the same, etc.

Like you, I did extensive research even before talking to Dr. Clavell, which led to a very informed discussion and decision. Every penis and person is different.

Dr. Eid does have both but it seemed he definitely prefers the Titan. I didn't ask Hakky if he offers the AMS. He just told me Titan would be a very good option for me based on my anatomy. Dr. Clavell initially recommended the AMS CX but after looking at my erect state while doing the penile Doppler with injection, he also said either would be fine. After talking to all three docs I'm leaning towards the Titan but still quite confused about it.

My reasons for leaning towards the Titan are (not in order of importance):

1. My penis has a slight downwards bend and I would like to have a post implant straighter penis.
2. I would like to avoid rear tip extenders which I have heard can cause less stability especially since I probably won't have a very deep crura given I'm a thin person. Since the Titan comes in 2cm increments, it gives me a better chance to avoid extenders.
3. With the thinner diameter cylinders of the AMS (18mm vs 22mm), I have also been told by Dr. Eid that the penis can look a lot more oval with the AMS especially the when the urethra can get nestled in between the cylinders
4. The cylinders are a lot more durable than AMS. Dr. Hakky told me that the exterior of the AMS cylinder is a very thin silicon material and it can tear with the implant still working and tissue can grow into the underlying dacron fabric.. He just said that it makes things difficult for him during a revision. No idea whether this is a real concern.
5. The pump is quite a bit smaller and is easier to inflate.

My concerns with the Titan:

1. Whether the titan will be too big for my corpora width. My erect size from pubic bone to the tip of the engorged glans with bimix is 6 inches. My girth near the tip is 4.5 inches and girth near the base is 5 inches. The tip of my glans from one side to the other runs just a tad bit above 1 inch. I'm 4 inch flaccid length and 4 inch flaccid girth. Some of my anatomy pics are at: viewtopic.php?f=6&t=25067&p=236654&hilit=titan+kink#p236654
2. Dog ears for my size above.
3. More fragility of Titan tubing.

I have sent you a PM wanting to discuss this a bit further. My main concern with the AMS is related to the bold line items above. Thoughts?

[sambalamba]

@jage64,

I did see your post about the Titan single cylinder circumference of 7 cm vs. AMS CX single cylinder circumference of 6.5 cm. I even saw Dr. Clavell's video on this. But these numbers don't jive with the published cylinder diameter of 22mm and 18mm for the Titan and the AMS CX respectively. Again looks like trying to take too much of a mathematical approach only creates more questions than answers.

[Jage64]

Dr. Eid does have both but it seemed he definitely prefers the Titan. I didn't ask Hakky if he offers the AMS. He just told me Titan would be a very good option for me based on my anatomy. Dr. Clavell initially recommended the AMS CX but after looking at my erect state while doing the penile Doppler with injection, he also said either would be fine. After talking to all three docs I'm leaning towards the Titan but still quite confused about it.

My reasons for leaning towards the Titan are (not in order of importance):

1. My penis has a slight downwards bend and I would like to have a post implant straighter penis.
2. I would like to avoid rear tip extenders which I have heard can cause less stability especially since I probably won't have a very deep crura given I'm a thin person. Since the Titan comes in 2cm increments, it gives me a better chance to avoid extenders.
3. With the thinner diameter cylinders of the AMS (18mm vs 22mm), I have also been told by Dr. Eid that the penis can look a lot more oval with the AMS especially the when the urethra can get nestled in between the cylinders
4. The cylinders are a lot more durable than AMS. Dr Hakky told me that the exterior of the AMS cylinder is a very thin silicon material and it can tear with the implant still working and tissue can grow into the underlying dacron fabric.
5. The pump is quite a bit smaller and is easier to inflate.

My concerns with the Titan:

1. Whether the titan will be too big for my corpora width. My erect size from pubic bone to the tip of the engorged glans with bimix is 6 inches. My girth near the tip is 4.5 inches and girth near the base is 5 inches. The tip of my glans from one side to the other runs just a tad bit above 1 inch. I'm 4 inch flaccid length and 4 inch flaccid girth. Some of my anatomy pics are at: viewtopic.php?f=6&t=25067&p=236654&hilit=titan+kink#p236654
2. Dog ears for my size above.
3. More fragility of Titan tubing.

I have sent you a PM wanting to discuss this a bit further

If you are at the point that you truly can't decide between the two main devices, then I would defer to the surgeon you choose, especially if there is a cosmetic issue they feel one or the other would address better (bent shaft). Based on the rocket in my pocket, your penis will be arrow straight no matter which one you choose. Of the 3 surgeons you've mentioned, I don't think you can go wrong.

You are a young man, so I would consider that there is likely going to be revision or two at some point in your life, I also thought about that and am confident that Dr. Clavell will still be practicing when that time comes and will take good care of me. Dr. Hakky also seems to be a young man. Dr. Eid has already taking extended periods away from his practice due to health issues.

RTEs are not the boogeyman. Excessive and improper use of RTEs are bad, none of these 3 docs would use them inappropriately. RTEs are primarily used to 'fine tune' the implant to your body. The tubes coming out of the cylinders are fixed, they cannot be adjusted. So, when the cylinder is inserted into your crus and the tube exit doesn't line up well with your scrotum, the surgeon can install a RTE to move that exit point distally so that the tubes drop down in an optimal position. Also, some men have different measurements from side to side, using a RTE on one side or the other results in even tips inside the glans.

My AMS does not look oval. This is something you likely cannot control either way, some report the Titan looks like a 'surfboard'. IMO you're overthinking this one. Everybody is different, you won't know what you've got until probably a year post-surgery when everything settles down, trust me, you won't give a second thought to surfboards or ovals. Your penis works again and you'll get all giggly when you think about it. Remember, this is an implanted device to give you back your sex life, this is NOT a replacement OEM penis. Just as with breast implants, they're not perfect and they're not OEM, but when done by someone that knows what they're doing, they're damn good! (and breasts don't have to mechanically do anything, they just sit there looking great)

As for the cylinders in the AMS tearing, rupturing or tissue growing into it....how many times have you read about that happening on FT? Ever? Yet FT is the place where men often come to complain about their implant. AMS has a worldwide penile implant market share many times that of Coloplast, yet there are only 'reports' of this happening. I've not seen anything to suggest it is a problem worth worrying about. Same can be said of a plane crash, there are reports that planes crash and many people die a fiery death. I'm confident that if this was a real issue there wouldn't be a single surgeon installing AMS.

Having not ever had anything but an AMS pump, I have no basis of comparison. My scrotum is apparently large enough to house the AMS pump along with the twins. It is of no issue for me, and cannot be seen by looking at me in either an inflated or deflated state, with a tight scrotum or a loose scrotum, in heat or in cold. As for the pumping of it, Dr. Clavell oriented it perfectly for my dominant right hand, to the rear of my sack and rotated so that the deflate button (looking down at it) is facing about 10 o'clock, so my thumb rests right on it when I need it, the way my hand naturally falls. I really like the vibration when deflating, I know that fluid is moving back to the reservoir. It makes no noise, no squeaks, and at my age of now 60, there is absolutely no issues with hand strength, dexterity of difficulty pumping. That may be a valid concern for older men or men with other issues.

Flaccid. For me, this was a HUGE part of my decision, and I've posted about it too many times on FT. There has been a phrase here used quite a bit..."I didn't get my implant for the flaccid". Well, in my opinion that kind of thinking is a mistake. Your dick will be flaccid for 98% of the rest of your life. I have grandkids, they can climb on my lap without me giving my dick a second thought. I don't worry about looking like I have a boner at the nude resort, I don't have to strap myself up so I don't look like I have a gym erection, I have no crinkly noises or weird feeling, my dick is not 'stiff' in the flaccid state, I don't exit a swimming pool with my suit stuck to me wondering if I look like a pervert, my pump is silent with no squeaks, I don't have unsightly dog ears or the pain that can come with them (the answer to 'give it a few pumps' is unsatisfactory for all the reasons above). My CX is soft when flaccid, looks completely natural, is preferred by my wife at 80% inflation, is completely painless and comfortable. I'm sure there are Titan owners that could say the same.

Again, if your decision making between the two is that close, then choose the surgeon and let him decide.

I'll add that I followed more than a few FTers that had Clavell implants and noticed that they by and large seemed to have less pain, less discomfort and easier recoveries than other reports I read by other docs. I wanted that. Normally Dr. Clavell does not use a catheter, which can be a huge pain point. I had near zero pain and very little discomfort, only using alternating Advil and Tylenol every 3 hours for a few days post surgery. I also iced down there constantly. I had surgery on Wednesday, flew home 5 hours on Friday morning, and was back in my office chair on Monday morning working (with a boner). Again, near zero pain. I don't know if Dr. Clavell has a special pain management protocol that is different than other docs, but I can give you firsthand experience that my recovery was NOTHING like many men's terrible experiences I've read on FT.

Any questions I had I was encouraged to text Dr. Clavell directly, which I did and he responded quickly.

[Jage64]

all the implant offerings provide more than enough rigidity for penetrative intercourse...

@Jage64,
This statement was for anal penetration or vaginal penetration?

My testing indicates the they'll both work just fine for whatever your partner may allow.