Different implants for larger penis

[alibaba]

by Dr. Jean Francois Eid.
We avoid using the 21-cm AMS 700 LGX or CX cylinders for these large penises, especially if rear tip extenders are needed. These cylinders do not provide adequate rigidity when inflated especially in patients with long and wide penises.

The reason for this is that in general long penises tend to also have larger diameters that are not filled by the 21cm LGX cylinders (girth expansion limited to 18 mm). This may cause the cylinders to curve inside the corpora as they lengthen with inflation. For penises longer than 18cm, as previously mentioned, a Coloplast Titan 20 or 22cm cylinder, will provide the patient with a better erection.

The Dr. Eid and Dr. Ryback were the first to tell me ( after my implant by Milam) that AMS will not pump to an adequate girth.

[KMeister]

by Dr. Jean Francois Eid.
We avoid using the 21-cm AMS 700 LGX or CX cylinders for these large penises, especially if rear tip extenders are needed. These cylinders do not provide adequate rigidity when inflated especially in patients with long and wide penises.

The reason for this is that in general long penises tend to also have larger diameters that are not filled by the 21cm LGX cylinders (girth expansion limited to 18 mm). This may cause the cylinders to curve inside the corpora as they lengthen with inflation. For penises longer than 18cm, as previously mentioned, a Coloplast Titan 20 or 22cm cylinder, will provide the patient with a better erection.

The Dr. Eid and Dr. Ryback were the first to tell me ( after my implant by Milam) that AMS will not pump to an adequate girth.

I haven't found this to be the case. I have a AMS CX and according to my op report I have 21 cm cylinders on each side along with a 5 cm RTE on the left and a 4 cm RTE on the right. I had a Coloplast Titan before. Besides other issues with the Coloplast I just constantly felt uncomfortable with it when flaccid. The erection I have with the AMS CX is equal to that which I had with the Coloplast.

KMeister

[merrix]

I think I told you Alibaba!

KMeister, there is no way to know if this is true or Eid's Coloplast kickback speaking.
I personally think it is true as a principle simply because a larger diameter logically should fill a larger space than a thinner diameter.
I do also however think that there is no absolute truth. It is not so easy as to say that all men with big dicks will get a perfect result with a Titan and all men with big dicks will get a shitty result with an AMS.
I am sure there is a random variation caused by individual anatomy and doctor's performance. But on average I think this is right, although with a big overlap maybe.

[strongagain]

I wanted an AMS but my doc said he would give me a Titan because my size is above average. Titan would suit me better.

[alibaba]

Strongman, the Titan is what Eid and Ryback have told me I should have had. merrix, yes, you said it. I believed the hype that AMS would blow up like a balloon and work. I does not. Eid's comment that 18mm is the max on an LGX proves it and Dr. Ryback demonstrating both does again.The Titan starts out larger, nearly as large flaccid as the LGX was pumped, and is huge pumped compared side by side. My wife was all kinds of excited watching the difference.

[KMeister]

Strongman, the Titan is what Eid and Ryback have told me I should have had. merrix, yes, you said it. I believed the hype that AMS would blow up like a balloon and work. I does not. Eid's comment that 18mm is the max on an LGX proves it and Dr. Ryback demonstrating both does again.The Titan starts out larger, nearly as large flaccid as the LGX was pumped, and is huge pumped compared side by side. My wife was all kinds of excited watching the difference.

I can't testify to whether 18 cm is the max for the AMS LX. I have an AMS CX and as I already wrote, the cylinders are 21 cm, the RTE's are 4 cm on one side and 5 cm on the other, and I'm very satisfied with the results. Perhaps the results for you were due to your surgeon's poor skills.

Doctors have their preferences for many reasons including financial considerations. My uro is primarily a Coloplast man but after doing his homework he decided the AMS CX was the best for me. Perhaps Eid's surgery skills are limited to one company. Members here have mentioned that Eid doesn't use RTE's although many other uros use them very effectively. Also, other members have mentioned that Eid doesn't believe in pre-surgery vacuum pump therapy although a study on the matter definitively proved its efficacy and other prominent uros such as Dr. Karpman in California recommend the therapy. Perhaps Eid just isn't as good as my guy.

KMeister

[merrix]

Kemister - Do I smell a bit of sarcastic humor between the lines..?

Nobody will ever know who is the best doc out there. Just because a lot of guys here have done their implants with e.g. Eid and Kramer, and most have gotten good results, it doesn't prove they are the best.
Just in the same way that we cannot sit here, using our limited experience and say that Titan is better than AMS for big dicks. Or that they are equally good. It is all about probabilities.
It is likely that Eid and Kramer are among the best. It is (in my opinion) a decent probability that in more cases than not, a large cylinder diameter will better fill up a big dick than a thin cylinder.

Eid's disliking of RET has, according to him, nothing to do with skills. On the contrary. He claims it is easier for doctors to use RTEs than using the right size of cylinders. It is a tool used by inexperienced surgeons to make the insertion easier. To find the exact right size immediately requires either perfect measuring skills or the possibility to insert an implant and if not perfectly sized just scrap it and insert a new one. Something he did with me, but something I think low-volume surgeons cannot get away with because of their (lack of) relation with AMS/Coloplast. Plus, RTEs are, since they are solid, easier to insert deep in the crus than a flaccid cylinder. RTEs are simply making it easier for the doctor. Doing a perfect job without RTEs is a harder task than to insert the implant with RTEs.
Furthermore, he claims RTEs will not give a noticeable worse result in the early years, but after a few years they will make the erection wobblier and make it swivel. Simply because they never get deflated, so they will expand the crus 24 hours per day and expand the crus while the RTEs of course stay the same size. When the deflatable part of the implant goes all the way back in the crus, there is no constant tissue expansion and the crus will stay small enough to always be tight around the inflated cylinders.
And as with all other science, this is of course not a digital truth. It may not happen to some, it may happen big time to some, and to most it probably happens a little bit. Some of those will notice the problem, and others won't notice the problem because they don't know it is there and they don't know what the other outcome would have been. He also claims many of the patients he sees after a few years don't even notice the wobbling themselves. Simply because it comes sneaking up on them. A tiny little bit more wobbling week by week over several years. But Eid claims he sees it. And then we're back to my previous rant about expectations. If a patient isn't bothered by, or maybe even notices, the wobbling, is it then a problem? That's a philosophical question.
Again, Above reasoning is based on Eid's words, no guarantee they are right, but it makes logical sense to me.

Regarding that study, I am still surprised you are so narrow sighted. One study does in my opinion not proof anything. Do you think all published studies always are right? Don't you think there has ever been one published study which stated false results? I can tell you for sure they are not always right. It can simply lack quality, method can be wrong, chosen on faulty assumptions. Reliability or validity lacking. Or results can simply be skewed or even made up to show what researchers or funders want. Sorry, but it happens. And I think you know it with your background. I don't say it is the case with this study, but you cannot say it isn't the case either.
And why is there no other study then to prove this one wrong? Well, maybe VED-strategies pre-implant surgery is not the hottest area of research out there... And especially when one study (right or wrong) is done, maybe there is simply nobody who bothers to publish a second one.
Eid claims he has seen himself that it has no significant impact. Who knows, with the volume he is doing, he might have actually performed a higher quality research on the subject himself. Did he publish it? No. Does it mean it is less valid? No. It may be, it may not. We don't know.

And that is the whole point here. We don't know. We don't know shit. All we have to do when getting an implant is trying to take in whatever information is out there. Choose the sources we find reliable. And hope we got it right, and most of all, hope the surgeon got it right... And what most of us will do, since it is in the nature of humans, is to do all we can to justify our choices after surgery. Those of us who went with Kramer will say he's the best. Those of us who has a Titan will say they are the best. Those of us who has half our dick (well dick+crus) full of RTEs will say that they are not seeing any wobbling. Those of us who did VED therapy will say their dick grew half a meter from it.
That's just how it works. And it also contributes to the imperfection of FT as a source of reliable information. It is populated by individuals with extremely limited experience of patients (one - themselves) and surgeons (almost always only one) and implants (almost always only one). Top that up with the need to justify our choices, and we are where we are.

Good luck Alibaba with the revision.
For what it is worth - I think you are on the right way.

[alibaba]

The skill and technique of the surgeon is imensely variable. I have seen that clearly and now that I have started reading backward into the threads of past years, early 2014, 2013, and 2012 here, I find more people who had a variety of issues with their doctor or device than I had read in more recent posts. Hopefully it is a trend of improvement but I do not think it is given the number of issues reported in the past 5 months. it seem cyclical, people having issues, people getting their issues resolved. Not only are the devices, the fit, the technique and skill highly variable, so are our bodies, in design, size, condition, damage, age, scarring et ecetera. To a certain extent, you cannot expect someone 58 years old like I am to have quite as good an experience as someone younger like pockie in his 20's or merrix in his early 40's. Age, health and wear on our shlongs can have an effect too. Some of those shlongs have gone through a lot of years or war, some sat on a shelf aging like a grape till they were raisins. Some have been screwed with in so many ways to try to make them right it is a wonder when things actually do go correctly. When you start compounding possible variables together it is quite possible that without superior experience and skill, you will likely have a 50% chance or less of having a perfect outcome. I say "perfect" because I am certain many who consider their implant ideal for them would be considered less than ideal for others or by the best of professionals experienced with implantable penile prosthetics. For a person who has had ED failures for a decade and gets an implant that produces the first on demand erection they have had for an eternity, their less than the best possible result may seem to be an outright biblical event. It is not that they are accepting less, it is just they do not know they could have had better. Acceptance comes on many levels. I told Dr. Milam that the first time we met. I was willing to accept a little less than ideal because I know this is a highly variable situation and I felt his half of the coin was posturing to cover his ass in the event things were dissatisfying, but there is a limited level one is willing to give up before things are marked unacceptable rather than acceptable enough to live with. Mine clearly falls in the unacceptable level so many ways that the grade mark is fail.

[merrix]

Amen.
Well said.

[alibaba]

Thank you sir.d