Dr Hakky

The final frontier. Deciding when, if and how.
LastHope
Posts: 968
Joined: Sun Feb 18, 2024 1:26 am

Re: Dr Hakky

Postby LastHope » Sat Dec 21, 2024 9:58 am

sambalamba wrote:
JohnHC wrote:
I'm not sure, just too ready to finally get this behind me I didn't think to ask about the keto diet, everything else I pretty much already knew. He was shocked that my last Dr left the Catheter in overnight and didn't use a drain to help keep the swelling down in my scrotum.


Dr. Hakky is excellent as are quite a few other surgeons. I have had the good fortune of meeting Clavell/Hakky/Eid multiple times. Based on my conversation and own research I found all 3 to be excellent. They have their differences in surgical techniques/pre and post operative protocols. All have great personalities and comes across as very caring about their patient.

Dr. Eid is like a professor and will get into great details about what and why he does his procedure in a certain unique way. He also will provide honest review of other surgeons protocols. Clavell and Hakky also has a lot of respect for him.

My concern in picking Eid is his advanced age. I wonder whether his skills and dedication are as sharp as before.

I loved Hakky's personality. He makes you feel like you're talking to a friend. The reason he is third on my list among the three is because he does a horizontal penoscortal cut as opposed to vertical. This is cosmetically a big no no for me. Also watching his surgery videos I think his surgeries are not as neat as Eid and Clavell.

Clavell is a little less forthcoming with information at first. He gives you a basic set of information which is appropriate for most patients. He expects the patient to initiate more questions if they have any. But he'll also open up more after a few conversations. He is young, passionate and comes across as extremely competent also.

Currently I'm trying to decide between Clavell and Eid. If Eid was younger no question I would absolutely pick his as I think his techniques and explanations are the most logical to me (except maybe dipping into a hot tub on the 3rd day). I'm trying to settle in my mind whether my assessment of his superior techniques outweigh the risk of his advanced age.

Also lastly both Eid and Hakky are on Coloplast center of excellence list but not on AMS center of excellence list. Their bias towards the Titan are very obvious although they also do AMS. Clavell is on both and I believe he has the most objective opinion between AMS and Titan.

Just wanted to share where I stand with surgeon choice. Feedback welcome.


Great research and summary, sambalamba! Thank you for sharing your experience with all three.

Isn't Dr. Hakky mostly into InfraPubic? This sounded like his default incision of choice. Curious if he only agrees to do penoscrotal by special request.

Have you considered Dr. Perito and Dr. Kramer as well?
Born early 80s. Congenital ED. Pills worked great for a while. Jan 2025 - Coloplast Genesis. 22cm (1cm RTE)-13mm.

fucked0ne
Posts: 294
Joined: Wed Nov 22, 2023 7:47 pm

Re: Dr Hakky

Postby fucked0ne » Sat Dec 21, 2024 11:26 am

LastHope wrote:
duke_cicero wrote:Interesting that he recommends a keto diet. Did he say why?


I presume a keto diet for 4 weeks after surgery could curb glucose spikes. Glucose feed pathogens with the energy they need to multiply. Another infection prevention strategy?


This was my immediate thought when I read that--yes, probably to reduce likelihood of infection. While controversial, since infection risk never really goes away with an implant, everyone with one should probably consider modifying their diet to reduce sugar/carbs.
Last edited by fucked0ne on Sat Dec 21, 2024 11:31 am, edited 1 time in total.
40. Implanted July 5, 2024, by Dr. Andrew Kramer, Urology Associates of Cape Cod. AMS LGX, 21cm cylinders + 2cm RTEs. Idiopathic "hard flaccid" ED following bacterial infection. Tried pulse waves, Cialis, TRT, even spinal injections. Nada.

fucked0ne
Posts: 294
Joined: Wed Nov 22, 2023 7:47 pm

Re: Dr Hakky

Postby fucked0ne » Sat Dec 21, 2024 11:29 am

LastHope wrote:
sambalamba wrote:
JohnHC wrote:
I'm not sure, just too ready to finally get this behind me I didn't think to ask about the keto diet, everything else I pretty much already knew. He was shocked that my last Dr left the Catheter in overnight and didn't use a drain to help keep the swelling down in my scrotum.


Dr. Hakky is excellent as are quite a few other surgeons. I have had the good fortune of meeting Clavell/Hakky/Eid multiple times. Based on my conversation and own research I found all 3 to be excellent. They have their differences in surgical techniques/pre and post operative protocols. All have great personalities and comes across as very caring about their patient.

Dr. Eid is like a professor and will get into great details about what and why he does his procedure in a certain unique way. He also will provide honest review of other surgeons protocols. Clavell and Hakky also has a lot of respect for him.

My concern in picking Eid is his advanced age. I wonder whether his skills and dedication are as sharp as before.

I loved Hakky's personality. He makes you feel like you're talking to a friend. The reason he is third on my list among the three is because he does a horizontal penoscortal cut as opposed to vertical. This is cosmetically a big no no for me. Also watching his surgery videos I think his surgeries are not as neat as Eid and Clavell.

Clavell is a little less forthcoming with information at first. He gives you a basic set of information which is appropriate for most patients. He expects the patient to initiate more questions if they have any. But he'll also open up more after a few conversations. He is young, passionate and comes across as extremely competent also.

Currently I'm trying to decide between Clavell and Eid. If Eid was younger no question I would absolutely pick his as I think his techniques and explanations are the most logical to me (except maybe dipping into a hot tub on the 3rd day). I'm trying to settle in my mind whether my assessment of his superior techniques outweigh the risk of his advanced age.

Also lastly both Eid and Hakky are on Coloplast center of excellence list but not on AMS center of excellence list. Their bias towards the Titan are very obvious although they also do AMS. Clavell is on both and I believe he has the most objective opinion between AMS and Titan.

Just wanted to share where I stand with surgeon choice. Feedback welcome.


Great research and summary, sambalamba! Thank you for sharing your experience with all three.

Isn't Dr. Hakky mostly into InfraPubic? This sounded like his default incision of choice. Curious if he only agrees to do penoscrotal by special request.

Have you considered Dr. Perito and Dr. Kramer as well?


As he told me, if you're getting a revision and your first surgery was penoscrotal, he enters the same way. I think if you wanted penoscrotal on an initial surgery, I don't see why he would be opposed. After all, it is your body and your implant.
40. Implanted July 5, 2024, by Dr. Andrew Kramer, Urology Associates of Cape Cod. AMS LGX, 21cm cylinders + 2cm RTEs. Idiopathic "hard flaccid" ED following bacterial infection. Tried pulse waves, Cialis, TRT, even spinal injections. Nada.

sambalamba
Posts: 109
Joined: Tue Jul 02, 2024 9:31 am

Re: Dr Hakky

Postby sambalamba » Sat Dec 21, 2024 1:34 pm

LastHope wrote:
Great research and summary, sambalamba! Thank you for sharing your experience with all three.

Isn't Dr. Hakky mostly into InfraPubic? This sounded like his default incision of choice. Curious if he only agrees to do penoscrotal by special request.

Have you considered Dr. Perito and Dr. Kramer as well?


He does infrapubic, penoscrotal, sub-coronal. He'll let you decide what you want after telling you the pros and cons of each. He told me that since I'm thin he would recommend the penoscrotal approach. He advised that in the infrapubic approach the tubing will be palpable for me.

With regard to Perito, I don't want infrapubic and I don't see any more need to consult any more docs. I don't think I'll find more competent surgeons that the ones I have looked at. In fact I would have been happy with Clavell since I'm just 3.5 hrs drive away from him. I consulted the other two for thoroughness. I think I have already gotten answers to most of my questions and don't need any further input. Time to narrow down choices and make a final decision and try to get to the next chapter.
55 years. Using bimix 0.4 units. Works well but inconsistent and very inconvenient. Seriously considering an implant.

LastHope
Posts: 968
Joined: Sun Feb 18, 2024 1:26 am

Re: Dr Hakky

Postby LastHope » Sat Dec 21, 2024 2:45 pm

sambalamba wrote:
LastHope wrote:
Great research and summary, sambalamba! Thank you for sharing your experience with all three.

Isn't Dr. Hakky mostly into InfraPubic? This sounded like his default incision of choice. Curious if he only agrees to do penoscrotal by special request.

Have you considered Dr. Perito and Dr. Kramer as well?


He does infrapubic, penoscrotal, sub-coronal. He'll let you decide what you want after telling you the pros and cons of each. He told me that since I'm thin he would recommend the penoscrotal approach. He advised that in the infrapubic approach the tubing will be palpable for me.

With regard to Perito, I don't want infrapubic and I don't see any more need to consult any more docs. I don't think I'll find more competent surgeons that the ones I have looked at. In fact I would have been happy with Clavell since I'm just 3.5 hrs drive away from him. I consulted the other two for thoroughness. I think I have already gotten answers to most of my questions and don't need any further input. Time to narrow down choices and make a final decision and try to get to the next chapter.


That makes sense. Seeing the three best surgeons is thorough of you. For some reason, I thought you were on a spree to consult all the top players in the country and get their inputs. My lazy self would get decision fatigue fast, and I'd just settle with the nearest best one!
Born early 80s. Congenital ED. Pills worked great for a while. Jan 2025 - Coloplast Genesis. 22cm (1cm RTE)-13mm.

LastHope
Posts: 968
Joined: Sun Feb 18, 2024 1:26 am

Re: Dr Hakky

Postby LastHope » Sat Dec 21, 2024 2:52 pm

fucked0ne wrote:As he told me, if you're getting a revision and your first surgery was penoscrotal, he enters the same way. I think if you wanted penoscrotal on an initial surgery, I don't see why he would be opposed. After all, it is your body and your implant.


Thanks, F1! Do you see any harm (other than scarring) in getting different incision types between the 1st vs. 2nd, or is it usually the norm to enter the same way as the first one?
Born early 80s. Congenital ED. Pills worked great for a while. Jan 2025 - Coloplast Genesis. 22cm (1cm RTE)-13mm.

fucked0ne
Posts: 294
Joined: Wed Nov 22, 2023 7:47 pm

Re: Dr Hakky

Postby fucked0ne » Sat Dec 21, 2024 5:51 pm

LastHope wrote:
fucked0ne wrote:As he told me, if you're getting a revision and your first surgery was penoscrotal, he enters the same way. I think if you wanted penoscrotal on an initial surgery, I don't see why he would be opposed. After all, it is your body and your implant.


Thanks, F1! Do you see any harm (other than scarring) in getting different incision types between the 1st vs. 2nd, or is it usually the norm to enter the same way as the first one?


That's a great question! Like I said above, Hakky simply told me that he would go in the same way, perhaps to not create additional scarring. I don't logically see how using another approach could generate harm though.
40. Implanted July 5, 2024, by Dr. Andrew Kramer, Urology Associates of Cape Cod. AMS LGX, 21cm cylinders + 2cm RTEs. Idiopathic "hard flaccid" ED following bacterial infection. Tried pulse waves, Cialis, TRT, even spinal injections. Nada.

sambalamba
Posts: 109
Joined: Tue Jul 02, 2024 9:31 am

Re: Dr Hakky

Postby sambalamba » Sat Dec 21, 2024 9:05 pm

LastHope wrote:
That makes sense. Seeing the three best surgeons is thorough of you. For some reason, I thought you were on a spree to consult all the top players in the country and get their inputs. My lazy self would get decision fatigue fast, and I'd just settle with the nearest best one!


Seeing three was exhausting enough man. If I kept on seeing more docs I would probably have a nervous breakdown and end up at a mental institution. :D.
55 years. Using bimix 0.4 units. Works well but inconsistent and very inconvenient. Seriously considering an implant.

LastHope
Posts: 968
Joined: Sun Feb 18, 2024 1:26 am

Re: Dr Hakky

Postby LastHope » Sun Dec 22, 2024 6:02 am

sambalamba wrote:Seeing three was exhausting enough man. If I kept on seeing more docs I would probably have a nervous breakdown and end up at a mental institution. :D.


That's funny. If this implant saga leads me to a mental institution, I think I'll be grilling the psychiatrist like: "So, doc, are you a high-volume, center-of-excellence shrink, or are we just winging it here? :lol:
Born early 80s. Congenital ED. Pills worked great for a while. Jan 2025 - Coloplast Genesis. 22cm (1cm RTE)-13mm.

JohnHC
Posts: 246
Joined: Mon Apr 24, 2023 9:35 am

Re: Dr Hakky

Postby JohnHC » Sun Dec 22, 2024 9:27 am

Ok sorry I didn't cut and paste but here are some answers from my visit with Dr Hakky. Yes he treats you like a very good friend - like you're buddies who grew up together. He does implant both - he only does 4 a week and could do more, but feels that 4 a week is best for him.
He will go into detail on the pros and cons of both implants, he told me the issue of having to downsize the LGX vs the CX, he told me about the dog ears and possible pump squeak with coloplast. He told me that the AMS does look and feel more natural in it's flaccid state.
He appears to be liking the AMS more now than he used to, he does have the Tenacio pumps for the AMS and highly recommends getting it.
Now both my previous surgeries were penoscrotal - he at first recommended infrapubic since "it's been opened up twice now in less than a year - need to give the boys a rest and lessen infection risk" but after thinking he has scheduled the surgery as penoscrotal but possibly switching to infrapubic.
I had asked why my last Dr did a horizontal incision instead of vertical and he told me the blood supply comes from the sides and wraps around the scrotum, sorta like fingers. When you do a vertical cut, you're cutting through all those blood supply vessels whereas a horizontal cut doesn't wreck the blood supply as much so he does a horizontal incision as well.
But in the end he listened to my concerns, he listened to what I wanted, told me the pros and cons at every step, and will do what's needed to get the best results for you.
I like the fact that he isn't dead set on doing it his way, that he listens to you, and explains everything to you in a easy way to understand - even bringing in real implant displays and showing you how to use the implant ( which I didn't need but he brought the AMS one in to show me the Tenacio pump and show how it looks and would feel and how it operates ) that's something my last Dr didn't do.
I brought in the surgical notes from both my surgeries and he was questioning why my last Dr did this or that, he knew I didn't have the answers, he was just thinking out loud and did not like the fact that my last Dr didn't use a drain to help keep swelling down and the fact that he left the catheter in overnight instead of removing it at the end of surgery - he said leaving it in is just asking for a infection.. if you need more I'll try to answer as best I can. But my consult with him started at 9am and I left around 11am ( roughly 2 hours ) much longer than I ever expected and very thorough.
AMS 700 CX 21 cm X 12 mm with 1.5 cm RTE, MS pump, Conceal Reservoir. Implanted on 4-12-2023 revision on 6-22-23 next revision by Dr Hakky Feb 18th 2025 same but with Tenacio pump


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