Implanted Oct 11th 2024 - Dr Karaman + Rigicon AX

[Discovernew]

Hi Everyone,

i got a lot of value from this forum so decided to post my experience to give back info to those looking wether to do the implant or not.

You can check in the titles inside this post if any particular section is useful to you and go straight to it.

Background

I had ED since 2010, pills worked great for several years, and recently stopped being reliable, to the point that i found myself avoiding sex to not embarass myself. I tried all sort of alternative treatments with basically zero results. Shockwave, prp, stem cells, botox, you name it. (The only benefit of botox is that it made my flaccid penis bigger, but didn't affect ED).

Been researching the implant for more than a year, i was reading this forum for months even before i registered in it.

Doctor Choice

I had consultations with many of the top implanters around the world, as my concern was to find the right doctor for me and didn't care about the location.

Over the past year and a half, had consultations with many doctors, among others: Karaman (Turkey), Rosello (Spain), Koenraad van Renterghem (Belgium), Clavell (USA), Dr Khaled Altopajee (Dubai), and probably a few others that i am not remembering right now. I had even a consultation with a Dr from Russia but i remember he mentioned he would need to do 2 incisions in my case because of a history of inguinal hernia, so i discarded that option.

I must say i liked all of them during the calls, but my criteria was to speak with minimum 3 patients of each doctor before making a decision (every doctor can sound great on a call but i want to see what the patients actual results are).

Dr Van Renterghem gave me only 1 reference of a patient to speak with, who was happy with the result, but i couldnt find others, and also i was leaning towards the rigicon AX implant, and the patient he gave me was from Colopolast.
Dr Altopajee from Dubai told me none of his patients were willing to talk (despite that i liked him during the consultation and he seemed very charming also).

Since I was leaning towards doing the rigicon AX implant which expands in length, and this is not available in USA, I discarded Clavell despite liking him very much. Clavell himself told me there was some kind of Rigicon trial going on in USA but he was not selected to participate in it, or something like that. As a reference: What i liked about Clavell was that he does not use a catheter (which i must say now, 9 days after surgery it still burns when i pee and i hated that catheter SO much), and also Clavell has plenty of positive references in this forum.

Rigicon AX is available in Europe and Turkey. So in the end it came down to Rosello and Karaman.

Dr Rosello in Spain, i must say gave me some of the very best consultations, he was always available for me to ask questions even through whatsapp after the oficial consultation was done. His bedside manner is absolutely excellent and i always felt he cared, he ocasionally even sent me messages to see how i am doing (even without me texting him, when i hadn't decided to do the surgery yet). I spoke with 4 or 5 patients from Rosello. First he gave me a patient to speak with , but then the patients themselves were referring me to other patients, the ones i spoke with were super happy and spoke wonders of him not only as a surgeon but on a human level. I also visited Rosello in person and we did a full ecodoppler of my penis with a quite detailed report. He insisted this study is useful, so that the Dr will have a "roadmap" of my penis and know what to expect during surgery. (Turns out this study will become relevant a bit later in this story).

I was actually very close to doing it with Rosello, but then it came to a financial reality. Rosello's price (standard price in Europe in general) is Eur 22.500. In Turkey the same surgery costs $8500 (approx EUR 7800). So almost 3 times cheaper.

I did a calculation that even if i would do it in Turkey, and it goes wrong, on the second time i would have a world wide warranty from rigicon and even doing it 2 times (second time in europe) would be cheaper than doing it directly in Europe from the first time.

Which now brings me to Karaman: I spoke with at least 4 or 5 patients from Karaman. Most from this forum, but also i was introduced in peroson when i visited the hospital the first time. All of them were very happy with the results, and almost all of them have gained size (either length or girth several months after surgery). There were some minor exceptions: One of the patients from this forum, Mr Beard, had some kind of failure of his pump 1 year after surgery, which seemed to repair itself after a few weeks, but as of this writing he told me the problems with his pump came back and he can only pump 80%. This sounds like a manufacturer problem and not related to the doctor though. Another patient from Bulgaria (also from this forum), told me he needs 150 pumps to inflate. When i asked Dr Karaman, he told me this is most likely the patient not pressing the pump fully in order to avoid pain, and just doing "mini pumps". Since this patient didn't have a followup in turkey i am not sure about it. Except for these 2 details, everyone seemed super happy.

So in the end, I actually decided to go with Karaman.

The process and pricing

I arrived a few days earlier in Istanbul to get familiar with everything. I found my own acommodation and transport as i am a very frequent traveler and i am totally comfortable with that (though less experienced travelers might want to get the whole package with hotel and transports).

I have been told that if you get quoted through a rigicon sales rep, you get a cheaper price than if you go through the hospital. I know members from this forum got $7k pricing (as of last year). I paid $8500 through the hospital (without any hotels or transport, it would be $9500 if you want the whole package i was told). I was told initially that the difference of going through the hospital is that you have a dedicated translator who is there to assist you every step of the way (please note, nobody in the hospital speak english except the doctor himself, which can be a bit challenging at times).

Turns out, my assistant for the surgery (Nasimi, who has been mentioned in this forum many times), told me he is about to quit the hospital in about 1 month. And i could notice this in his demeanor. Literally the night before my surgery, i was asking him questions about the schedule and what we will do when i arrive to the hospital prior to surgery. He told me that i ask too many questions and he cannot work with a patient who is "questioning" so much. So literally hours before my surgery, he said he will not work with me and will transfer me to another assistant. I freaked out a bit and texted the doctor that we can reschedule the surgery if he wants, as i dont want to do anything rushed or in less than ideal conditions. Dr Karaman told me that we will work with another assistant and we will proceed with the surgery.

The same day of the surgery i was introduced to Muhammed, who does not speak a word of english. Despite him having great attitude. We communicated through the telegram app which has a translator built in. I must say Muhammed did a great job and always responded super fast and straight to the point (for example he got me all my lab test results and my surgery report almost immediately when i asked for it). The only limitation was the lack of english but aside from that, he was great and very responsive.

My takeaway on pricing: If you can save $1500 by getting quoted through rigicon, go for it. You will get the same Dr, same hospital, and pretty much same services overall. But again, $1500 is relatively tiny amount compared to what this surgery would cost in USA/Europe so in my case it didnt make a difference overall. But if you are struggling to pay for the surgery, this can make a difference in your case.


Dr Himself


Dr Karaman is very patient, answered all my questions, he is a straight shooter with the questions i asked him. He also visited me on my hospital room multiple times during my stay at the hospital to check how i am.

Also i must note on one of the days i was texting him to ask questions about my surgery, he told me he had 4 surgeries the same day. So the fact that he still has time to answer my questions and followup with everyone is really impressive. (note these 4 surgeries are not implants, he is a general urologist so he can do anything related to urology, kidney, bladder, etc). I was even discharged from the hospital on a sunday when the hospital itself is closed, and he came to visit me in the hospital even on a sunday. I can really tell he works a lot so i can say i admire him for still being able to check on patients and answer all questions, especially when we consider the price point about 3 times lower than europe (this cannot be ignored).

Also i noticed how incredibly punctual Dr Karaman is. He told me my surgery will be 11:30, and i remember already 11:25 i was in the rolling bed being taken to the surgery room. Also i remember on Sunday, when i was supposed to be discharged i asked "Do you know at what time i will be discharged"? , he said. "Approximately 1pm". And at 12:59pm literally he was walking into my room to discharge me. I tried arriving earlier to my next followup appointment on purpose and he was already there waiting for me.


The hospital

The hospital looks super modern and clean. I was very happy that i got a room with a great view. Considering i would sleep 2 days in that room post op and presumably be in pain. Having a nice view was a very nice perk (i am always a sucker for nice views and having natural light in my room).

In general i felt the whole attention and demeanor from everyone in the hospital was super nice, including nurses (despite the lack of english unfortunately).


Pre Surgery


I arrived the day of surgery (without sleeping the previous night because of nervousness), Muhammed met me in the reception of the hospital. I showed him how to use the free translate function inside telegram app so we can communicate with each other, and after that everything went smoothly.

I had already done all my blood tests and pre-checks a couple days ago in the hospital so there was nothing to do except to pay.

The hospital insists to pay in cash instead of credit card for some reason. But somehow i managed to pay a part in cash and another in credit card (as i did not have enough cash with me).

I was escorted to check in to my room, which was very pleasant. This could easily rival any 5 star hotel room in my opinion because of the views and cleanliness. (except there is a medical bed inside instead of a normal one). The medical bed has some buttons where you can adjust if you want to go up,down, recline. It feels like a business class seat in an airplane.

I took some time go get comfortable in the room, i brought some extra bottles of water as i knew i would be there a couple days at least, bought some lube and some baby socks (suggestions from this forum).

I was taken into the surgery room in the rolling bed. A male nurse injected something into my arm in the elevator on the way there. I asked, what are you injecting me? he jokingly said "It is a shot of tequila, so you will relax". I remember laughing out loud for some reason at that silly joke.


Post surgery


I woke up, i remember having that super uncomfortable feeling around my penis area. And that damn catheter (that i still hate SO much until this day).

I was told i would keep the catheter until the next morning (around 20hs). During that first day, i presume because of the catheter, i was not allowed to move literally anywhere from bed. I cannot go to the bathroom (since the catheter supposedly takes care of it), and i am not allowed to literally move from bed.

I cannot change the air conditioner if i am hot to turn on or off without calling a nurse and explaining what i need (who doesnt speak english), i cannot literally grab the bottle of water that is next to my bed because i cannot reach out to it, change my socks, grab my tshirt if i am cold, or touch anything which is not in my bed itself. That night i did not sleep as i simply couldnt find the position to sleep.

I was brought food but the idea of eating in those circumstances was totally crazy to me, so i can say i did not eat anything until the second day. (also what would happen if i need to go number 2 in those conditions?).

First day was a bit of a nightmare. And i think it is just because of the catheter.

Second day the catheter was removed. The removal lasts 5 seconds, but i do remember i said i need to go to the bathroom and i couldnt wait to get out of that damn bed for the first time. The Dr who removed it said something like "well you wont have anything in your bladder now anyway because of the catheter", as soon as he said that, i got out of bed and i started uncontrollably peeing all over the room on my way to the bathroom. It was a big mess with all the floor covered in piss all the way to the bathroom.

Later someone had to come and clean the room.

Since that moment i was very happy i could stand up and move around, and everything in the room because MUCH better just relaxing and enjoying the views.

Only issue is that because of the catheter, peeing afterwards burns and is painful in general (to this day, 9 days later, it still hurts when i pee).

All in all, i can say the worst part of the surgery, for me personally, was the catheter. All the rest was great or within what i would expect.


Very early post op results


As soon as the bandages were removed on my penis, i asked Dr Karaman if everything went well with my surgery. He mentioned i have a bit of a hypermobile glans (despite doing my research for over a year prior to surgery, i did not even know what hypermobile glans means).

I noticed the implant does not reach my glans, and the glans itself is wobbly. At the moment i am supposed to be 50-60% inflated so i do not have a final conclusion about it.

The placement of the pump was done behind my testicles, which is what i personally asked the Dr to do and i am glad he did, because it seems very hidden (time will tell if it is easy to reach for inflation/deflation).

Regarding the floppy glans (i made a separate topic about it). I decided to get a second opinion from Dr Rosello, who previously had done an ecodoppler study months ago on my penis. I asked him "If i do have a hypermobile glans issue, wouldn't have something showed up in the ecodoppler i did with you?".

We actually went through my study report in the consultation. The report clearly states that my corpus cavernosa reaches 1.3cm into the glans, however it also states that i have fibrosis near the tip of my penis. What this means is that, likely because of so many years of ED, the tissue near the tip has hardened, which would require the surgeon to do a bit more of an aggressive dilation near the tip to be able to reach the end of the corpus cavernosa as it's supposed to be. I know he did not make this information up, because i have the report that was sent to me before my surgery and it is written in plain language, so i know he is telling the truth. Dr Rosello suspects the dilation was not done all the way to the end for this reason, resulting in the implant not reaching my glans fully. He also insisted on how important is to do this study before the surgery, so the Dr has a roadmap and knows what to expect during surgery.

That being said, because of my implant being the AX that expands in length, he told me there is a 75% chance that the issue will resolve itself over time with cycling.

I am hoping this is just a small hiccup and everything will be excellent a few months from now. From now it is too early to tell as i am just 9 days out of surgery.


I really hope all the above is useful to someone who is going through what i was going through a year ago trying to put all the info together.


Cheers.

[Andy100]

Thank you for this review!!! It’s super clear and with a lot of details

I hope everything will be allright with your floppy glan.

One question:
How much did you pay in cash at the hospital?

Andy

[Discovernew]

Thank you for this review!!! It’s super clear and with a lot of details

I hope everything will be allright with your floppy glan.

One question:
How much did you pay in cash at the hospital?

Andy

Approximately 20% was credit card. But that was simpy because of the limit of cash I had with me. I would say discuss with them and ask if you can pay with credit card.

[ravh2419]

That's a great journal.

Is the main advantage of the Rigicon AX that you shouldn't lose size after the surgery?

Also, 9 days after the surgery what are you able to do?

Do you feel able to go for a run? Could you work? Are you able to get on a plane?

Thanks

[Discovernew]

That's a great journal.

Is the main advantage of the Rigicon AX that you shouldn't lose size after the surgery?

Also, 9 days after the surgery what are you able to do?

Do you feel able to go for a run? Could you work? Are you able to get on a plane?

Thanks

I am hoping and praying not to lose size. I just had the idea that an implant that expands in length could adapt better to my penis over time. Only time will tell if it works out or not as i am obviously not an expert.

No way i could run now. Yesterday i masturbated for the first time (9th day). It seemed normal at first, but after i came i had so much pain i could barely get out of bed to go to the bathroom. Today i feel better. But in general just getting out of my room feels like an adventure each time.

[Discovernew]

Hi Everyone! I decided to make this into a Journal.

Yesterday was my 9th day. I decided to try masturbation for the first time. The main reason is that because of my floppy glans, i was wondering if stroking my glans against the cylinder would help the cylinder tips reach deeper into the glans. (Floppy glans is my number once concern at this point).

I masturbated succesfully, everything seemed normal and my glans was completely as usual, as the cylinder does not penetrate the glans, i do not even have any scarring or anything different than before there. Exactly the same sensation.

I came a lot. Probably because 9 days without cumming must have been the longest i've been in my life.

After cumming however. The whole area under my balls became sore, uncomfortable and painful. It felt painful to even get out of bed to go to the bathroom.

So after that i spent the rest of the evening in bed without moving.

The bad news is that the floppy glans remained exactly the same.

----

Today is the 10th day. I sent a message to Dr Karaman, and asked him if he doesn't mind that i try deflating and inflating a little bit. I want to be sure i can deflate before flying out of Istanbul. As i heard some stories, for example Mr Beard in this forum who had to fly back to Istanbul just to learn how to deflate. So i want to be sure i can do everything before i fly away.

Dr Karaman said it is ok, as long as i keep myself inflated afterwards and i sleep inflated.

I took a long shower to clean myself, and then i took a long hot bath in the bathtube. First i disinfected the bathtub with sanitizer just in case.

Because the incision is on the front of my scrotum and the pump is on the back (per my request to the Dr), i could feel the pump without touching the incision.

After some time in the hot water, the whole area around my balls felt relaxed and "floaty", which made it easier to locate the parts of the pump.

I managed to deflate succesfully. But i did notice something that i did not expect. Both the top of the implant, and the bottom of the implant, are hard parts that do not deflate. So i could easily feel the hard part at the base of my penis and at the top of my penis (which does not even reach the glans).

I because of this, i realized that if i am with a girl and she ever touches my penis flaccid she would realize immediately it is not natural. It's something i never thought about before but probably worth noting.

I do not know if the base of the implant is supposed to be palpable from the outside too? or if the RTE plays a role in this. In any case, this is not my main concern right now as i am assuming most girls i would ever have sex with, would only interact with my penis when erect.

After succesfully deflating, i started inflating again.

I managed to do 20 "mini pumps". The pump itself was super hard, and slippery. I needed both hands and almost all my strength to pump, and i am someone who lifts weights several times per week. I cannot imagine how someone elderly would be able to pump this.

I did not experience any pain, but also i am sure i did not pump anywhere near to the max.

The limiting factor was not pain of any kind, but just how hard and slippery the pump was.

By the time i came out of the bathtub my penis looks exactly the same as before going in. So if i remember correctly the Dr's words, i should still be at 50-60%.

I am hoping if i do this at least once per day (considering i am very early on my 10th day), i might get one or two mini pumps extra per day, we'll see.

Also since i was inmersed in hot water, i was hoping this might losen up my glans and i would be able to push into the cylinder. I tried doing this for a while but it did absolutely nothing.

My glans is just as floppy as day 1.

So, i still have a hope that over the months the floppiness would go away, but i am still very worried about it. Thinking of needing a revision of this would be terrible as the whole process of surgeries in general is horrible and incredibly long and slow downtime.

Still hopeful to get a positive outcome over time.

Of course, any tips from experienced implanted users of the forum would be welcome.

[Discovernew]

New update: Just tried masturbating again, but this time with 100mg Sildenafil (Viagra). Glans engorged, and penis measured 1cm longer just because of the engorgement (i did not get engorgement without it), and i am still about 1.5-2cm shorter than before surgery even with Viagra. Unfortunately glans still floppy though maybe a tiny bit better than before. It is vey clear to me that the tips of the cilinders do not reach where they should be.

I only pray and hope that with repeated cycling over the months the cylinders will push forward into the glans. I am not worried about the length as most people say they get it back, but i am only worried about the floppiness.


Edit, Oct 22. Having nightmares almost every night since i got the implant. I think it's probably because my body is in pain and it translates into the dreams themselves. Last night i dreamed i was in an airplane crash and i was injured trying to find the emergency exit of the airplane. And the night before that i dreamed i was in a post apocalyptic world trying to run away from the zombies.

[atul21]

New update: Just tried masturbating again, but this time with 100mg Sildenafil (Viagra). Glans engorged, and penis measured 1cm longer just because of the engorgement (i did not get engorgement without it), and i am still about 1.5-2cm shorter than before surgery even with Viagra. Unfortunately glans still floppy though maybe a tiny bit better than before. It is vey clear to me that the tips of the cilinders do not reach where they should be.

I only pray and hope that with repeated cycling over the months the cylinders will push forward into the glans. I am not worried about the length as most people say they get it back, but i am only worried about the floppiness.


Edit, Oct 22. Having nightmares almost every night since i got the implant. I think it's probably because my body is in pain and it translates into the dreams themselves. Last night i dreamed i was in an airplane crash and i was injured trying to find the emergency exit of the airplane. And the night before that i dreamed i was in a post apocalyptic world trying to run away from the zombies.

Good luck my friend! You are still early in your journey. Glans engorging can happen by eating cialis/viagra. If you had it before implant, you will have it afterwards also.
Having nightmares is also normal. I had many and have even written about them in my journal. The correct position of the tip of the cylinder is about 3/4th into the glans/penis head. For me the left cylinder is further down but my surgeon said I will be fine as I am young and can handle the slight oversizing.
My advice would be to give it another 2 weeks before getting excited to use it even for masturbation.

[Discovernew]

New update: Just tried masturbating again, but this time with 100mg Sildenafil (Viagra). Glans engorged, and penis measured 1cm longer just because of the engorgement (i did not get engorgement without it), and i am still about 1.5-2cm shorter than before surgery even with Viagra. Unfortunately glans still floppy though maybe a tiny bit better than before. It is vey clear to me that the tips of the cilinders do not reach where they should be.

I only pray and hope that with repeated cycling over the months the cylinders will push forward into the glans. I am not worried about the length as most people say they get it back, but i am only worried about the floppiness.


Edit, Oct 22. Having nightmares almost every night since i got the implant. I think it's probably because my body is in pain and it translates into the dreams themselves. Last night i dreamed i was in an airplane crash and i was injured trying to find the emergency exit of the airplane. And the night before that i dreamed i was in a post apocalyptic world trying to run away from the zombies.

Good luck my friend! You are still early in your journey. Glans engorging can happen by eating cialis/viagra. If you had it before implant, you will have it afterwards also.
Having nightmares is also normal. I had many and have even written about them in my journal. The correct position of the tip of the cylinder is about 3/4th into the glans/penis head. For me the left cylinder is further down but my surgeon said I will be fine as I am young and can handle the slight oversizing.
My advice would be to give it another 2 weeks before getting excited to use it even for masturbation.

Thanks for the supportive message! My implant is far from the glans. I would say at least 2cm to the mid glans or about 4cm away from the tip of the penis. Still hoping it will be fixed with cycling.

[Andy100]

hi discover new,

just like you know I'm considering karaman too.

would you advise me to book through the hospital or directly with rigicon (it's cheaper) ?

Would the post-operative treatment in case of problems be the same?