Implanted at 38 and concerned about size & revision

[moetheman]

I have now managed to obtain a report on my implant size. I was fitted with a 18cm Titan Zero Degree with 3cm RTEs on both sides. So that's a total of 21cm. The RTEs are not ideal but it's the overall length that's important. My measurements were 10cm down and 11cm up on both sides. I'm not sure what length I should expect based on the implant size and my measurements? Almost half of the implant is inside me

[merrix]

Great!

I am one who has spread the word that RTEs are not good. This comes from what Dr. Eid has told me. He doesn't believe in RTEs and that they should be avoided if possible, for reasons I have thoroughly explained before.

On the other hand, I think it is proven that it is possible to get great results with RTEs as well.
This forum is full of people who have RTEs and are very happy with their results.
I think the majority of guys here have RTEs and it just proves that one can have great results with them as well.
Besides, the avoid-RTE therory is Eid's. Kramer for example seems to be of the opinion that they can be used to a reasonable length without any negative impact.

So I think you should relax about the RTE issue. That's a minor (or perhaps no) issue.
What is important is that your surgeon did a good job with the installation and that you get a good recovery.

Good Luck with your Titan!

[alibaba]

39% of my implant is inside with no tip extenders. Seems to be the new "trend". 8cm/13cm. I think I would have done better if 1/2 of that amount was an extender. Eid says it depends on type of implant that needs extenders. He emailed me that it is very difficult to make an AMS LGX work without any which is the type implant I have. Coloplast seems to be fine w/o as it keeps it from wobbling and the tubing does not tend to kink when inside the corpora with the cylinders like the AMS. 16 days to go to see what can be done about this thing. Hopefully you can get some extra length cycling. Coloplast is not supposed to extend in length but a couple people said pumping it up did push it into the glans and resolve their issue. I am convinced that the old doctors who said infrapubic does not allow a patient to be properly measured to full length and the study that said the same are correct. Milam says no, you can measure better infrapubic but from an engineering standpoint I do not agree unless they use a curved tool to measure which they do not. Probably explains why the corporal incision is not buried deep as they advertise. You go deep, you cannot measure with a straight tool working in a deep hole ( pubic incision which is deeper than scrotal). We are an experiment. Once they figure out what works 100% whatever we have will be obsolete as marketing will need a new product. I've talked to 4 doctors and all have a different opinion of the best implant and approach. Best of luck to you.

[moetheman]

Great!
...So I think you should relax about the RTE issue. That's a minor (or perhaps no) issue.
What is important is that your surgeon did a good job with the installation and that you get a good recovery...

I also agree that RTE is more of a secondary issue (if you can even call it an issue, it's more of a nice to have than a deal breaker). Primarily what's important is the total length (Implant + RTE) inserted.

I've been on a fact finding mission and now that I have the current implant size details, it should help with the second opinion in exactly three weeks time. I must admit that my heart sank when I first saw the 18cm cylinder but then I felt a bit better when I saw another 3cm of RTEs. In this case RTEs were quite welcome.

Planning ahead if I were to require a revision, I don't know whether I would need a new implant or whether further RTEs would suffice. On c-lab's thread he mentioned that Kramer thinks that up to 5cm of RTEs are okay. I have to consider the cost element too, as I'm paying completely out of pocket. It's probably too early to plan too far forward until I've had the second opinion. I must admit I would have expected more penile size based on the 21cm implanted in me but as mentioned in my earlier posts, it could be swelling and/or fat, or it could be that this is all the size I'll get with 21cm and there is no more room to put more in. Time will tell.

[alibaba]

I see how no tip extenders can be a good thing and that was my first question to Milam in October. He told me it makes no difference, then in January when I got to feel a tip extender I saw why as far as feel. My issues are 3 fold. Internal part pumps up since there is less resistance instead of pumping penis. Second, the tubes nearly all the way down inside the cavernosa with the cylinders since there are no extenders. The tubes kink so you have to constantly tug on things to get the kinks out to pump it up. If you had 3 hands, 1 to hold the pump and tug on it, 1 pump, and 1 to wiggle the penis so the kinks stay out of the hoses it would not be a problem but much like a circus. As it is, I have to constantly change what I am stretching and jiggling to have a soft and easy bulb to pump. 3rd, as Eid told me, the tubes are too short for the pump to sit correctly when so much tube has to go inside. This seems to be more of an issue with the LGX as I understand him.

[moetheman]

To me the difference between RTE and no RTE feels kind of academic. The main factor seems to be the skill of the surgeon and then possibly the implant type. At the end of the day I personally couldn't care less if there were RTEs or not, as long as I have a working penis with a decent erection, suitable for intercourse, with no major issues.

In my case, I guess that's what I feel I don't have so it's the only thing that matters to me right now. If and when the main issue (assuming it is an issue based on the upcoming appt for the second opinion) is resolved then I'll probably end up focussing on minor areas where things are sub-optimal and the process will probably repeat in an iterative manner, until the remaining issues are of no real significance and I can move on. I guess it's kind of like somebody trying to achieve the perfect body. No matter how hard one works on it, there is always something that can be imp'roved. Personally I don't want to end up feeling like that about the implant so I would like to move to acceptance as soon as I can but I don't think it's possible at this stage.

However I do want to move forward with life as soon as I can and make up for all the time I've spent dreading ED and almost devoting the last few years of my life to it. I'm just fed up of it really and willing to throw all resources at it to resolve it in the quickest time frame. Life is short and I don't want to look back thinking I wasted years living like a zombie, obsessed with my ED issues. I just found out that an ex-colleague passed away recently from cancer and he was the same age as me. Diseases are indiscriminate so better make the most of the time we've got.

Merrix talked about ED not affecting him and that he carried on with life and make everything else a success. I really do admire that. I guess one aspect that's different in our cases as Merrix had a particular baseline and things didn't deteriorate but he just got a taste of what good feels like so he wanted more of that. In my case I had no ED issues till my early thirties and life was good and I was very sexual. One day ED just came out of the blue and completely flipped my life and I have not been the same ever since. The implant has had it's ups (pun intended) and downs. I really felt weird about having it in the beginning but I'm more comfortable with the mechanical aspects (Robot dick as Merrix calls it) so I think it can be a really good instrument for curing ED (as much as possible in current day). I'm just hoping to reach the stage one day when at least the primary function of the implant works well for me and then I can just try to manage the remaining minor issues that come with it, which I'm more or less okay with even at this stage.

My only regret so far... I didn't go to a top class surgeon the first time and just went to the local guy. Given that I paid out of pocket anyway, the cost wouldn't have been much more (maybe another 25% max) even with travel to the US. Wish I had Merrix's journal available before my implant. This advice is especially true for the younger guys as you'll have decades with the implants and will need to be re-implanted. The first implant is very important to get right.

[alibaba]

I was fortunate to read merrix's journal ( 1 month before my implant) and one other, Pockie's. Both were very informative and both were kind and gracious to pm me answers to my questions. I am one that once a deal has been made, I respect it and follow through, though sometimes it was not the best, but honor is important to me. Your word has to be good. If someone with an AMS implant would have told me they have dog ear folds like the Titan, I would have gone straight to Eid and likely had the best possible outcome. cost and dogears on a Titan were the only reason I did not go to New York. Eid has been gracious always. As it was, advice had always been that an AMS feels exactly like an natural penis in the flaccid state. Poor people surely were hallucinating or selling implants. I've been very conscious of having to adjust my junk always and just did not want any more issues especially since I had finally found underwear that I did not have to adjust it all the time to keep from sitting on my balls or dick getting in a bind. Again, I've made an appointment with someone within driving distance as this years budget has been set and spent. I'll hear him out, if not satisfied, then a trip to Maryland or New York will have to be in the December budget even though it will cost a few thousand more.

[moetheman]

I had a video consultation with Dr Eid. The man is a true professional and I can now see the contrast between a great surgeon and a wannabe surgeon. I'm still getting my head around it all but the discussion with Eid was amazing, I'll probably post the full details at another time but the quick summary is that I do have soft glans and was fitted with an undersized implant. The tips only barely reach the start of the glans when they should be going in 3/4 of the way into the glans. In one way this is kind of good news as he will be able to insert at least a 22cm cylinder instead of the current 18cm (+3cm RTEs). He may even be able to fit a larger device. He thinks I may gain around 2cm, possibly more in length. At the same time he can place the pump in the posterior and conceal the tubing, which is what he recommends for a relatively young man like me. Currently the pump is in front of the testicles and I don't like this placement as it's difficult to conceal and the tubing sticks out in front reducing size. I think the pump and tubing fixes alone will free up a couple of centimetres of available length.

Eid thinks that with the current implant things will deteriorate over the next couple of months as the glans will start to droop (this has already started happening over the last couple of weeks), erection will point further downwards (already nearly at 3:45) and I'll have hinge issues because of RTEs.

I think at this point I'm pretty certain I only want to go for a revision with Eid. I'm not sure I would even use Kramer, though he is great too. I just feel Eid is the right guy for me. The only issue is financing, as I'm already out of pocket for the first implant and Eid isn't exactly cheap. You get what you pay for at the end of the day. Seriously considering a revision with Eid now and soon....

[moetheman]

A quick update from me. I've decided to go for a revision with Dr Eid. If everything goes to plan then I'm looking to have it done at the end of March. I still need to complete the paperwork and get the clearance but I'm pretty sure that I'll have it all sorted out very soon.

I'm nervous and excited. Can't believe I'm going through the whole thing again in a different country but reading Merrix's journal gaves me a lot of encouragement. Eid seems to be a good guy and has plenty of advocates. Fingers crossed that it finally gets sorted out in a month's time when I'll go under the knife again

[alibaba]

Read Pockie's thread also. It is a few months older than merrix but he also travel from another country to Eid and turned out well also. He gives a good breakdown of cost too.