Chapter 2, Excision/Grafting Journey

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TDix

Thanks Tony, yeah that's what I thought too.  I was wrapped pretty good for 48 hours after surgery.  Removed first wrap after 24 hours, and the final one after another day.  Doctor said it's normal, and is happy I'm having nocturnal erections.  As painful as they are it is a really positive sign  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

No more pain meds for me.  Dr Yafi doesn't like his patients on them for more than a week.  Going to try Advil and Tylenol going forward and see if they help
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Think I finally turned the corner on at least my daily pain.  Pain at night with nocturnal erections is still there, but today I feel I finally came out of the day long pain.  Still swollen but nowhere near as bad as this time last week
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Pfract

Nice! How does it look like after you wake up with the night time erections?  

TDix

Dr asked me the same thing "it's straight though"...I told him the pain is too intense to even really focus on that right now.  Still swollen, and without pain meds it's a rough go at night.  I guess 9 days post op I shouldn't expect to be pain free and unswollen.  Going to keep relating how things are day to day until pain goes down more as well as swelling.  I will say I am a lot less swollen than I was a week ago but still have a long way to go
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Each day seems to get a little better.  I think I've gotten used to the pain, as it's pretty sore every morning due to nocturnal erections.  I was able to see how I am last night, and I am straight, but still swollen, so I look shorter than normal.  Stretching and possible traction after my follow up visit should help.  Glans is numb as is expected.  Returning to work in a few days even though I feel I need more time, but I have been using comp days I have accrued over the years for my time off.  Just waiting for the day the pain subsides and I can work on molding myself back to semi normal
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Well just as I say I'm used to the pain, today I am not enjoying it!  Is it normal to still feel this way 11 days after?  I know I'm still in the early phase of this, but man, every day having pain is not fun.  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

I feel the participation here is lacking.  I feel like a circus animal.  "Hey mom, look at the freak".  I appreciate the few that comment on my posts, however if no one else wants to contribute what am I doing??  Yeah providing my experience, but if only 3-5 people respond what does that do for me?  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TonySa

My pain decreased pretty much after 2 weeks.
Sorry you're not getting much response, but Even future readers will benefit from reading your experience here.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

swiss

This is really important. Thank you for posting this. I am considering exision and grafting in the future. How much would it have run you without insurance?

swiss

TDix

So far all I paid was my deductible of $300..hopefully my insurance came to their senses, because I was told $3700 by the dr office, down from $16k after Dr Yafi intervened.  That was just the facility fee however as I was covered for everything but the facility
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

swiss

I am going to definitely consider this in the next few months to correct my deformity/ hinge. Mine is near the base so stretching the scar has proven difficult though there has been some progress the last year.  

TDix

Swiss, pm me your location.  If you are in my area I highly recommend Dr Yafi  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Dr Wachs just called to see how I'm doing.  Wants to see me on Thursday.  I don't think I can equate how nice it is to get a random call from a urologist that genuinely wants to make sure I'm doing OK.  Like I've said, dr Yafi is the specialist, and is a very busy doctor, but Dr Wachs is way more personable and caring.  I feel lucky to have both involved in my care.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Juice

TDix, you're an inspiration! I'm scheduled for my surgery May 10th with Dr David Peters of Stonybrook Hospital, he seems very confident that I will 1. Straight 2. No length loss.  I am anxious and scared SH&tless at the same time..  please keep posting your results I would love to know what I can really expect!!!  
Thank you
Juice  
55 yrs old. Diagnosed Peyronies Disease Dec 2017 battling with it a bit longer.  Failed xiaflex, Gainswave, PRP..   underwent Excision and grafting May 10th 2019 with Dr David Peters. StonyBrook NY..

TDix

2 week mark.  Still painful erections at night, mainly at the base.  Notice that when I am getting them however I am not expanding.  I get hard, but do not "grow".  Concerned I called the office, who calmed me by saying this is normal.  I am still very early in the healing process.  Have two dr visits in the next few days so I will post how those go.  This is not a race but a marathon it seems!
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Glad I can help Juice.  Many days I feel like walking away from the forum because I feel I'm talking about some very personal stuff to a few people on a worldwide stage, but when I get posts like yours it makes me want to stay and help guys like you out there.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TonySa

I agree Tdix-it's a marathon.  I expect you'll have lost no size due to grafting/excision rather than just plication.  Stay positive and keep us posted! 🌝
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

TDix

I am getting the operation notes mailed to me.  Be interesting to see what they did
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Frank55

TDix - how did you originally hear of Dr. Yafi? Was that an insurance referral or some other way?

Thanks for your excellent account of this experience, by the way. I'm one of the users who does more reading than posting.  ;)
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step

TDix

I was referred to him by my urologist dr Wachs after my complications from Xiaflex
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Saw Dr Wachs today.  Said everything looks really good and professionally done.  Said my swelling is normal, and all my concerns are normal.  Said I already look straight even through the swelling.  My suture line is healing really well, and said they did a really good job compared to some other's he's seen.  Prescribed me some more pain meds to handle the nocturnal erection pain, and said to hang in there for the next month or so till the swelling goes down enough to have a true erection.  Right now there is so much swelling the blood cannot fully engorge everything and the back pressure is what causes my pain.  Found out they used a tutoplast graft on me as well
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Visited with Dr Yafi today.  All things look good.  The pain at the base is the result of a hematoma, but other than that I am healing very nicely.  Dr said I was 50 degrees prior to surgery and am now under 5 degrees.  Won't be able to truly see until my hematoma and swelling go away
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Every day that goes by things get better.  Hematoma is getting smaller and less painful, and swelling is slowly going down.  Waiting game now to see what I truly look like post surgery.  Dr Yafi will see me again on May 9th after he returns from Europe
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Pfract

So... How are your erections coming along? Did he prescribed you cialis or Viagra to help at this point?  

TDix

Erections are strong but still swollen, so not really expanding much.  Dr Yafi is holding off on Cialis right now since I get quite a few at night.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Finally able to start modeling...straight as an arrow!
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Doing daily modeling now.  Hematoma pretty much gone and pain has decreased substantially.  Working towards getting me back to semi normal!
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Frank55

Excellent news TDix. Please continue to keep us posted.
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step

TonySa

What instructions did Dr Yafi give for modeling post surgery?
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

TDix

I see him on May 9th.  I am just doing light stretching at the moment twice a day
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Got my explanation of benefits yesterday from Anthem.  Procedure ran $48k😳, and was denied due to being at UCI.  Dr Yafi had quoted $3900 so I am crossing my fingers.  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Swelling continues to go away.  Almost getting back to looking normal.  Soreness at graft site and still numb at glans but improving slowly everyday  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Guess I can say I have a $50k penis now😂.  Maybe I should insure it!
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

My stretched length is now back to where it was pre surgery.  Continuing manual light stretching daily.  Overall i'm Still .5 inch shorter than I was pre peyronie's but I'm happy to be back to my length before surgery, and I'm straight now too
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TonySa

PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

TDix

Thanks Tony.  I was worried since I had a swollen nub a full inch shorter for 4 weeks, but things have calmed down and pretty much returned to normal.  Nice not to feel a bunch of plaque like before
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Again, and I know I say it a lot, I want to thank this community and forum, especially those that comment.  Internet searches are few and far between for not only peyronie's but the procedure I went through and you guys are the gold standard for information.  I hope I contribute a little something to anyone considering what I've done.  Like I've said before I am open to answering any questions and am more than willing to help anyone who wants some answers  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

That being said, if you are a "guest" on this site I strongly suggest you join in.  Lurking does not help us as a whole.  Like I've said this forum's discussions go more into detail than any internet urology site.  If you need help and want answers join in.  It's anonymous and you join a dedicated group of guys looking to fix their condition  
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Showed my wife my progress last night.  She said "it's crazy how much that things been through in a year!"  It's true!  Shots, bruising, swelling, pain, hematomas, vein rupture/fracture, surgery....been a rough year for my lil guy
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

One day until I see Dr Yafi again.  Things are progressing good, just concerned about the solidness of the base of my penis.  I understand that it's only been 6 weeks, but I'm still interested to hear what's going on with my body.  Might still be remnants of a hematoma.  Lots of questions!  Hope I can get some answers
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Frank55

Let us know what you find out TDix. Always interesting to find out the Doctor's appraisal of your progress and issues.
Single and 58 yrs. old - first peyronies symptoms Fall 2015
Had grafting surgery by Franklin Kuehhas in June 2016 - complete failure
Borderline ED possible but not taking drugs, shots or using VED
Now evaluating options for next step

TDix

Dr Yafi said everything is normal and looking good.  Had a Brazilian dr with him this time, and cleared me for sex as well as prescribed me Cialis.  Said the swelling at the base is a lot better than it was a few weeks ago and should slowly go away.  Numbness may take up to 6 months to go away.  Length is slowly returning and I should get more back the more things continue to calm down
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TDix

Operation notes if anyone's interested
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

TonySa

Very interesting to read, thanks for sharing the notes!  The self adhering graft is very interesting.  My sutures took over 6. months to go away so I was wondering why not use the self adhesive more often.  But, I also had an implant had to cycle early during the healing process, so it may not have held.
PxD 2 yrs 9/16.  Failed all treatment. 9/11/18: excision, grafting & implant Dr Karpman MtnView Ca, AMS CX 18cm + 3-1cm RTEs.
Pump failed.  2/11/20 Dr Karpman installed Titan 22cm +1cm RTE.

Bubba dawg

Glad to hear everything is going well Tdix
5 Rounds of Xiaflex. Good results.

I am known to give out false information and post nonsense with little to no evidence to back up my claims.
I have ignored several warnings. Further reports to the moderators or Administrators and I will be banned.

TDix

Had a few sessions with the wife.  Not able to complete, and actually lose my erection due to the numbness.  Waiting for my cialis prescription to see if it helps me.
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE

Bubba dawg

Your erection problem could be mental more than physical. May take awhile to regain focus and confidence. Probably worried more about damaging the surgery. Cialis may help you get by until then. This is probably why many leave the forum when they get better. You just want to forget Peyrones
5 Rounds of Xiaflex. Good results.

I am known to give out false information and post nonsense with little to no evidence to back up my claims.
I have ignored several warnings. Further reports to the moderators or Administrators and I will be banned.

MarkDS

I've got a swollen ring around the base of my penis, following incision and grafting 10 days ago.  Other swelling has gone down significantly, but this area still remains painful
49 yrs old, Married
Peyronie's started 2016
Upward curve of 100 degrees  
Incision/grafting surgery in 6/2019.  Resulted in loss of length of around 1.5 inches, residual curve of over 40 degrees, some ED
12/2019 had failed skin anchoring procedure

TDix

I had the same and still have a little remnant of it.  Dr said it was a hematoma from the surgery
47 yrs old, 3 yrs diagnosed
Xiaflex w/original uro resulted in a fracture
Excision/grafting by Dr Faysal Yafi 3/26/19
Implanted by Dr Yafi 8/11/20, Titan 20cm + 1cm RTE