Tissues thinning over time

[Parmenides]

After fifteen years without seeing the doctor, I had the feeling that he did not give much importance to this aspect and made me activate the prosthesis to see my penis. He gave more importance to the placement of the pump, which he will correct, or the angulation of the penis, which he will improve by acting on the suspensory ligament. But as I told him, in the last five years, the feeling is not the same. I don't know if I would say that the tissue has thinned or that that extra erection (so to speak), noticing the flow of blood and growth of the glans when the prosthesis is activated and you get excited, is not the same as in the first years but has been progressively reduced and I have especially noticed in the last five years that more than a sensation it is something objective. Whatever the reason, it is true that in the final part of the penis the prosthesis is more noticeable.

[duke_cicero]

I got my first implant in 2021, almost 4 years ago, and the tissues in my shaft and glans seem to have thinned out drastically in that time. I feel way more implant material and much less penis tissue in the shaft than in the first year, and in the glans when flacid I touch and feel almost only the hard implant tips. Really don't feel much glans tissue when flacid. Has anyone else experienced this atrophy over several years?

I'm so sorry to hear about this. But I also wonder if what you're experiencing is actual tissue atrophy. If it is, I wonder if it has something to do with the penile expansion / jelqing exercises you did before you got the implant. Have you visited your surgeon for a follow-up and discussion on this? I also wonder if it's possible that you're simply noticing the implant more because you're naturally more aware of it over time, or that your anxiety about implant malfunction, etc., is making the implant feel subjectively more prominent.

[LastHope]

....For example, look at obese people who gain or lose weight, the surrounding skin and tissue will accommodate or in the case of losing weight quickly will remain and have to be surgically removed, there is not a problem with the tissue stretching.....

Perhaps the biological adaptation and reaction of tissues in contact with a foreign material like implants is totally different compared to the body's own evolved stretch and pressure mechanisms.

The formation of a fibrous surgical capsule around the cylinders seems to be one such biological adaptation, representing a passive rejection by our tissues against the foreign implanted material. It prevents the implant from interacting with the surrounding tissues. I'm tempted to speculate that this process doesn't stop on a microscopic level.

[duke_cicero]

Wanted to add that while it may not apply specifically to OP's situation, my surgeon (Laurence Levine) told me that the risk of erosion is virtually the same between IPP and MPP implants, and that surgical technique and proper fit is the main thing that determines the risk of erosion for specific patients.

[fucked0ne]

Wanted to add that while it may not apply specifically to OP's situation, my surgeon (Laurence Levine) told me that the risk of erosion is virtually the same between IPP and MPP implants, and that surgical technique and proper fit is the main thing that determines the risk of erosion for specific patients.

Duke,

Did he explain this in greater detail? This doesn't make sense to me. How can something stationary like a fixed MPP or breast implant cause erosion? I can see this with the IPP and its ability to expand with repeated use.

If there's an association with age, could something else be causing the thinning of tissues, like collagen depletion or weakening vascular integrity? In the case of wolfpacker, I don't know the underlying condition acquired by jelquing that causes ED. Fibrosis? Vascular damage?

[fucked0ne]

I got my first implant in 2021, almost 4 years ago, and the tissues in my shaft and glans seem to have thinned out drastically in that time. I feel way more implant material and much less penis tissue in the shaft than in the first year, and in the glans when flacid I touch and feel almost only the hard implant tips. Really don't feel much glans tissue when flacid. Has anyone else experienced this atrophy over several years?

wolfpacker,

What about when engorged? I would think that that's what's most important anyway.

While it wouldn't help with the glans (would it?), what about dermal filler?

[duke_cicero]

Wanted to add that while it may not apply specifically to OP's situation, my surgeon (Laurence Levine) told me that the risk of erosion is virtually the same between IPP and MPP implants, and that surgical technique and proper fit is the main thing that determines the risk of erosion for specific patients.

Duke,

Did he explain this in greater detail? This doesn't make sense to me. How can something stationary like a fixed MPP or breast implant cause erosion? I can see this with the IPP and its ability to expand with repeated use.

If there's an association with age, could something else be causing the thinning of tissues, like collagen depletion or weakening vascular integrity? In the case of wolfpacker, I don't know the underlying condition acquired by jelquing that causes ED. Fibrosis? Vascular damage?

He didn't go into much more explanation. Levine has done more than 5,000 implants throughout his career so I'm inclined to just believe him. I think the secret here is that nothing is "stationary." Your tissues are always moving. But in general the erosion issue with implants generally (knee replacements, breast implants, penile implants, etc.) is very low. My understanding is that poor implantation, uncontrolled diabetes, or infection is the main reason for implant tissue issues down the line.

[LastHope]

Some erosion stats from the literature. I would like to see a study that stratifies these rates by high, medium and low volume surgeons.

"The rate of erosion with IPP and MPP has also been studied. The AUA ED Guidelines reviewed the rate of erosion for MPP and IPP in 7 and 20 studies, respectively. The rate of erosion for IPP was on average 2.5% (range 0–6.5%) and for a MPP was on average 4.1% (range 0–17.5%). With chronic compression on the corpora cavernosum and the urethra, it is not surprising that the MPP is more likely to have an erosion. Slightly downsizing the malleable cylinders during implantation can help mitigate the risk of erosion."

Reference:
Khera, M., Mulcahy, J., Wen, L. et al.

Is there still a place for malleable penile implants in the United States? Wilson’s Workshop #18.

International Journal of Impotence Research 35, 82–89 (2023).

[fucked0ne]

Some erosion stats from the literature. I want to see a study that stratifies these rates by high, medium and low volume surgeons.

"The rate of erosion with IPP and MPP has also been studied. The AUA ED Guidelines reviewed the rate of erosion for MPP and IPP in 7 and 20 studies, respectively. The rate of erosion for IPP was on average 2.5% (range 0–6.5%) and for a MPP was on average 4.1% (range 0–17.5%). With chronic compression on the corpora cavernosum and the urethra, it is not surprising that the MPP is more likely to have an erosion. Slightly downsizing the malleable cylinders during implantation can help mitigate the risk of erosion."

Reference:
Khera, M., Mulcahy, J., Wen, L. et al.

Is there still a place for malleable penile implants in the United States? Wilson’s Workshop #18.

International Journal of Impotence Research 35, 82–89 (2023).

Interesting. Having a malleable, do you have any concerns about the higher erosion risk?

[duke_cicero]

Some erosion stats from the literature. I want to see a study that stratifies these rates by high, medium and low volume surgeons.

"The rate of erosion with IPP and MPP has also been studied. The AUA ED Guidelines reviewed the rate of erosion for MPP and IPP in 7 and 20 studies, respectively. The rate of erosion for IPP was on average 2.5% (range 0–6.5%) and for a MPP was on average 4.1% (range 0–17.5%). With chronic compression on the corpora cavernosum and the urethra, it is not surprising that the MPP is more likely to have an erosion. Slightly downsizing the malleable cylinders during implantation can help mitigate the risk of erosion."

Reference:
Khera, M., Mulcahy, J., Wen, L. et al.

Is there still a place for malleable penile implants in the United States? Wilson’s Workshop #18.

International Journal of Impotence Research 35, 82–89 (2023).

Interesting. Having a malleable, do you have any concerns about the higher erosion risk?

I personally do not. There's a greater chance of me dying while crossing a busy street in Chicago.