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[Tortão Pra Direita]

I've read some implant journals and I found that the length post-implant is the pre-op stretched flaccid penis length and the girth post-implant is the same pre-op. Nice, but we're talking about people that had mainly erectile dysfunction but hadn't lost any (or much) size due to Peyronie's.
I read some posts made by SW01 and he claimed a Titan took care of his hourglass. On the other hand, a few urologists claim that an implant alone won't recover the length and girth that was lost due to Peyronie's disease.

My Peyronie case: I've not lost much length, but I have lost a decent amount of girth. I've hourglass and I really don't know if manual stretching and VED are gonna recover my previous girth. It's working really well for curvature, but I haven't seen a very good result regarding girth. If things don't improve in the next months (maybe till the end of the year) then I'm gonna be a candidate for an implant. At this moment, buckling is a serious concern for me.

So, this is my concern: reconstructive surgeries are very delicate, expensive, can lower the sensibility of the penis and cause erectile dysfunction (this is why, generally, doctors do these kinds of surgeries along with an implant surgery).
Do they are really needed or an implant alone can recover girth and length?

[Hawk]

Several statements in your post are not accurate. Almost every implant journal is by men who absolutely had Peyronies Disease.  I would have to check, but I think most men report they gained a little size after their implant.  I know my journal says that, and others do as well, so you need to do more reading.

That is to say that you will regain some size above and beyond what you had the day before surgery.  It is unlikely (but possible) that you will regain all of your lost size.  This is especially true if you lost a significant amount of size, and it has been years since you lost that size.

You have a few options.
1. Do nothing
2. Start mechanical traction and VED and move for an impact.
3. Have excision and grafting and hope it straightens you and restores some size without interfering with erections.  (If it does, you can get an implant later)

Also, for the record, Most doctors do NOT do reconstructive surgery along with an implant.  The majority of implants are done without grafting, and most grafting is done without implants.

[shrunken_dick]

@Tortao ; You are a Brazilian, so you should be able to find some of the patients of Dr. Egydio. He does a lot of reconstructive surgery, but we see no patients of him on English forums.

[Tortão Pra Direita]

Almost every implant journal is by men who absolutely had Peyronies Disease.

Not by men that had lost a decent amount of size. This is my focus. If I remember correctly, I've read just one implant journal that showed a gain of lost girth due to peyronie (SW01 journal). Maybe I've read more but have missed this part.

Also, for the record, Most doctors do NOT do reconstructive surgery along with an implant.  The majority of implants are done without grafting, and most grafting is done without implants.

I think I wasn't clear but when I talk about reconstructive surgeries, I talk about surgeries that restore girth and length. The classic sliding surgery, as far as I know, doesn't restore size. It just straightens the penis.
So I talk about surgeries like Modified Sliding Technique (MOST) and Multiple Slit Technique (MUST).

Finding a consensus is really important, in my opinion. If just an implant is necessary to restore length and girth, then people going for these surgeries are just giving away money to their surgeons and risking their penis! This is F^@$!ng important and we should be taking it seriously.
Take a look, for example, at this study done by Egydio and Kuehhas: https://pubmed.ncbi.nlm.nih.gov/25644141/
"143 patients underwent our modified 'sliding' technique for penile length and girth restoration and concomitant penile prosthesis implantation."

If a penile prosthesis is enough, then why risking your penis doing these techniques?

I mean, is just me or anybody else here recognizes how important this discussion is? This is why I want to find if an implant is enough to restore the girth and length lost by Peyronie and plaques.

[TDix]

Speaking solely from my experience my excision and grafting surgery got rid of scar tissue which led to getting length back.  It also got rid of an hourglassing that had formed from the scar tissue.  Unfortunately the graft site never regained proper rigidity, which is why I needed an implant.  I didn’t really pay attention to my girth however, so I apologize I can’t help there.

[Hawk]

Not by men that had lost a decent amount of size. This is my focus. If I remember correctly, I've read just one implant journal that showed a gain of lost girth due to peyronie (SW01 journal). Maybe I've read more but have missed this part.

It is not my intent to argue but you are completely wrong.  Did you read Merrix journal or my journal to name just two?  Apparently not.

[Tortão Pra Direita]

No, I didn't read both. I read some, but it's kind of difficult to read every single journal on this forum.
There's no template for journals, so if I want to find about length and girth I need to do a search using ctrl + f.

If it was something so obvious that an implant can recover all the lost size lost by peyronie, people wouldn't be doing these surgeries. So this discussion is very important. Something here is not right, I'm seeing a red flag.

You won't help men with Peyronie just saying "oh, go read some implant journals" on every discussion.
Maybe I and some will read, but the majority won't. There's much to read, and people prefer to delegate these things to doctors. This is why they fall prey. 

----
TDix
Thanks for your reply!
Surgeries involving graft have this risk, unfortunately.

[Bud luck]

Tortao, what about Hyaluronic acid to gain girth, I will ask the specialist that does it

[anon1986]

Wouldn’t a guy gain back length after cycling for some time? The implant going in basically “bores” through the scar tissue, thus getting you back to where you once were, no?

[Tortão Pra Direita]

But implants only correct erectile dysfunction

Hi, Jan.
No, implants also correct curvature. Even severe cases (like almost 180º).
Also, implants give a good rigidity, so if someone presents buckling, it can revert it.

Tortao, what about Hyaluronic acid to gain girth, I will ask the specialist that does it

I haven't read about HA, but I know that procedures that stuff things in the penis to increase girth are not recommended by the best urologists.

Wouldn’t a guy gain back length after cycling for some time? The implant going in basically “bores” through the scar tissue, thus getting you back to where you once were, no?

Yes, in most cases they will get back to the pre-op girth and pre-op flaccid stretched length.
But this doesn't mean they recover the size pre-peyronie, and this is my concern. Mainly girth.
Take Hawk as an example. According to his implant journal:
"My pre prostatectomy/pre Peyronies Disease length was 8 1/8" 8 1/4" (15 years ago)
My pre implant length the instant it came out of the VED was 6 1/2" BPEL"
https://www.peyroniesforum.net/index.php/topic,9938.50.html

After about 8 months, he states his length is 7". So he recovered a good amount of length, but not the length he had before peyronie.

Some guys seems to recover, some not. So this is why I created this thread. Reconstructive surgeries are expensive and risky. When are they necessary? I think there are cases where men don't need them (and an implant alone can recover size), but surgeons recommend cause they want money. So I think knowing when one needs is very important. 

[postrocker]

Hahah, it's also pretty obvious to me that this is Jan again.

[shrunken_dick]

Speaking solely from my experience my excision and grafting surgery got rid of scar tissue which led to getting length back.

It means your Neurovascular bundle was mobilized. If I may ask, does your glans engores?

[LuisFernandez]

Dr. Perrito, who's a world class urologist actually does recommend hyaluronic acid: https://www.youtube.com/watch?v=wrxHb9tR-lQ

Sounds interesting, i don't know much about it.

It might be interesting for men who lost girth and don't want to do grafting. Another good optional might be extra tunical grafting, but the incision looks gnarly. Maybe with a ventral incision.

[Hawk]

Dr. Perrito, who's a world class urologist actually does recommend ...

I would never recommend this surgeon.  Google his name in conjunction with both criminal and civil legal issues.

[LuisFernandez]

Even Dr. Kramer lost his position due to come civil litigation. Anyone can sue you for any reason these days.

Even with the specifics of Perrito. One was a man who was a prisoner to received an implant. While in prison he did not properly care for his wounds and developed an infection. Don't even think Perrito actually put in the original implant.

When he got the infection they took him to Perrito to try to salvage it. He was pretty far gone. He ended up losing his penis or something due to complications. I'd say that Perrito shouldn't have even operated on him but had the "integrity" to do so. I kind of doubt the results would have been different with any other surgeon.

The rest didn't seem relevant to his surgery skills, as is the case for Kramer's case. I simply wouldn't personally recommend them because Perrito does not seem to aggresively upsize like Dr. Eid does.

Just my 2 cents based on what i've read.

[Hawk]

Dr. Kramer has ZERO criminal charges, much less convictions, AND he has ZERO civil cases that have been won for malpractice.  His leaving the practice had ZERO to do with any civil case against him. It is absolutely false to make a comparison between a man who never had criminal charges and never lost a civil case with someone who had both.

Dr. Kramer's situation was solely a decision based on a political disagreement. It had nothing to do with his practice of medicine or any legal cases against him.

If you suggest that it is irrelevant to you if your doctor is knowingly and premeditatedly cheating, lying, and physically harming people for money, you and I have astoundingly different views. 

[Tortão Pra Direita]

Nobody caring much about this really important question, but I'm gonna leave an important answer from Dr. Eid.

I asked:

Hi, Dr. Eid.

Does an implant correct narrowing and loss of girth?
If so, when do reconstructive surgeries (modified sliding techniques like MOST and MUST) are recommended? These techniques claim to restore size, but an implant is needed and is put into the penis in the same surgery.

If an implant is enough to restore size, then I see no point in making these procedures before putting the implant.
Dr. Paulo Egydio, for example, says in his videos that an implant alone is not enough to restore size. I don't know if he says this cause he has some interest in selling his surgeries or if he is being legit.

Greetings from Brazil!

He replied:

Thank you for comment. This type of procedure, sliding techniques and others are fraught with complications including infection and penile necrosis with complete loss of penis. Indeed the physician which you referred to has been suspended from operating for 6 months. Often the best option for patients with severe Peyronie’s disease is to place a temporary malleable implant. This will model the penis making it straight and restore the anatomy. The malleable is then replaced with an inflatable implant 3 to 6 months later. Staging of the procedure mitigates the risk of infection and necrosis.!
https://www.youtube.com/watch?v=tdmgZsIRUms&lc=UgxVV2DukUfmQJCHyUB4AaABAg


He's right when he talks about infection risk and glans necrosis.
I've talked to Dr. Marco Tulio today, and he said to me every procedure has its infection rates, and the multiple sliding, of course, has more chances of infection than a simple implant procedure.
He said he never had a patient with glans necrosis, though.
The major question I face now is: does this implant procedure (without any sliding technique) is enough to restore size? I've lost a bunch of girth and have a bad narrowing. I'm gonna discuss this topic better when I make a consult in person with dr. Marco Tulio. I asked if I could just get an implant, he said yeah but he thinks it won't remodel my penis enough, but a better (and in-person) evaluation is needed.

Infections scare me, but not getting my size back scares me a lot too.

[Bud luck]

Great post Tortao. Good to know that Egydio was suspended for six months, I'm definitely will use Dr Eid

[gaussrifle]

Tortao, why are you not looking into Extra Tunical Grafting (ETG) developed recently in the last 5 years. It is not a traditional grafting procedure where incision into the Tunica is made or the NeuroVascular bundle is touched. This means there is very minimal chance of erections or sensation loss as evidenced through statistics.  If you have erection problems too, you can maybe get this done along with a penile implant. Patient satisfaction rate was very high and it resolved all narrowing and hourglass for more than 90% of patients. How old are you by the way ?

[Hawk]

Good post  Tortão Pra Direita.

You need to know that my experience and impressions of Dr. Eid are that he always under promises and over-delivers. He does promise, however, and does not typically tell people to have no expectations.  He tells them what they can expect, and they typically get more.  He estimated my post-surgical size as shorter than it ended up, AND he prepared me that he would probably have to make a second incision to locate the reservoir since I had prior abdominal surgery.  I did not need the second incision.  You can literally examine me with a magnifying glass and find no hint of an incision scar.

Here is an example of Dr. Eid straightening a greater than a 100-degree curve with just one surgery and a Titan and some relief incisions, and some hand remodeling.  Keep in mind this is moments after surgery.  This curve reduction will continue for at least several weeks.  https://www.peyroniesforum.net/index.php?topic=11204.new

[Tortão Pra Direita]

Tortao, why are you not looking into Extra Tunical Grafting (ETG) developed recently in the last 5 years.

I think today there's no technique that can restore my size without an implant, unfortunately.
When I talked to Marco Tulio, I asked about grafting. He doesn't like it for a couple of reasons. I've seen more doctors (on Youtube) talking bad about grafting.
However, I'm gonna research this exact method (ETG). Thank you for the words.
I'm 28 years old.

You need to know that my experience and impressions of Dr. Eid are that he always under promises and over-delivers.

Eid is a very knowledgeable and skilled doctor. If I could, I'd consult him. Unfortunately, I can't use my insurance in USA.

I'm ignorant regarding medical stuff in the USA, but I have known cases (not peyronie cases) where the patient had no insurance, stayed 1 or 2 days in the hospital because he/she had a small complication, and had to pay a loadshit of money. Because of this, I don't consider traveling out of Brazil for medical appointments.

[Hawk]

I'm ignorant regarding medical stuff in the USA, but I have known cases (not Peyronie cases) where the patient had no insurance, stayed 1 or 2 days in the hospital because he/she had a small complication, and had to pay a loadshit of money. Because of this, I don't consider traveling out of Brazil for medical appointments.

I was not suggesting you travel to the U.S.  I must not have been clear.  I showed the type of correction that can be done with Just a Titan, some incision, and hand molding.  I do not doubt that Dr. Eid warns patients of needing two surgeries but seldom uses more than one surgery.  My point is that you would likely get better results with just an implant than you might think.  Of course, you have to consider the options and the risk and make the decision.

[gaussrifle]

Tortao, no problem. Ask your doctor about it : https://pubmed.ncbi.nlm.nih.gov/29644164/

[shrunken_dick]

@tortao ; So the government of Brazil has suspended Dr. Egydio?

[LuisFernandez]

https://www.uol.com.br/vivabem/noticias/redacao/2021/01/22/acusado-de-enganar-sobre-correcao-peniana-cremesp-proibe-medico-de-atender.htm

Apparently accused by 6 patients. The main one being interviewed is complaining because he got a semi-rigid implant. Didn't even seem to have gotten the most complex surgery.

[shrunken_dick]

@Luis ; I can’t  read Portuguese. Can you tell me why was Dr. Egydio got suspended?

[postrocker]

According to this news piece, a patient accuses him of inserting an implant that makes him erect all the time and that contributed to end his marriage. Not an inflatable implant. Probably a communication issue between him and the doctor? We won't know.

Other anonimous patients (5 or 6) also made complaints.

And the Federal Council of Medicine of Brazil said he could not perform surgeries for 6 months because his procedure, created in 2011 and used since then, was not approved by Brazilian authorities as such. Mainly the part that the patient could gain length with penile reconstruction and Egydio technique.

His defense claims that the procedure is widely known in and out of Brazil and used by other doctors elsewhere (and it indeed is). Also, that he does 2 to 3 surgeries a week, for decades, so his rate of failure is less than 0,5%. Dr. Paulo is battling the Federal Council in courts now. Until that is settled, he cannot perform surgeries. Probably until June 2021.

[Tortão Pra Direita]

My point is that you would likely get better results with just an implant than you might think.  Of course, you have to consider the options and the risk and make the decision.

I'm thinking a lot about this lately. This decision is taking a toll on me.
I know a Titan can straighten any curvature (like that 180º curvature in the thread you linked), but is it possible to restore all the girth that was lost? My circumference was 13.5 cm. It is still at the base, but it starts to narrow and it's now 11 cm under the glans. A substantial loss.
Length is not much of concern (I THINK). I had 16 cm before Peyronie and I can reach this length using VED.

I'm gonna try to find some severe narrowing cases that were treated just with an implant. I really need to see them.

By the way, I also have a bit of torsion. Is it a problem or an implant can correct this too?

[Tortão Pra Direita]

Postrocker resumed very well what happened to Egydio.

We don't have the details, unfortunately.

I've heard Egydio had 5 patients with glans necrosis. If we take into account his numbers (more than 6000 surgeries, according to his site) then this number is low.
I'm just citing glans necrosis, the worst possible outcome. But probably there are less severe cases too, like temporary loss of sensibility. We also don't know the conditions of the patients that faced these problems. Maybe they were diabetics, obese, who knows. We lack details.

What we know is this kind of surgery (sliding techniques) has more risks than conventional implant surgery. This is why this thread was made, to debate this topic and if it is worth it to have a reconstruction.

[shrunken_dick]

In this video, Professor Ralph is doing the Sliding technique.

https://www.vjpu-issm.info/videos/peer-reviewed/1-penile-prosthesis-malleable-inflatable-penile-prosthesis-ipp/1-a-first-time-implant/1-a-e-lengthening-procedures

[Hawk]

I'm thinking a lot about this lately. This decision is taking a toll on me.
I know a Titan can straighten any curvature (like that 180º curvature in the thread you linked), but is it possible to restore all the girth that was lost? My circumference was 13.5 cm. It is still at the base, but it starts to narrow, and it's now 11 cm under the glans—a substantial loss.

One point to remember, just because only 5 men are publically and legally voicing a complaint does not mean they are the only ones dissatisfied.  Men have poor outcomes from the surgery every day and never make a public outcry about it.  That does not prove he is not a good doctor.  It only raises the question that we don't know the satisfaction rate, especially on this forum because he has no patient base on the forum.

The Titan has more girth capacity than you had at your best.  The question is can it push the scar tissue to that capacity.  unfortunately, there is no way any of us can know that answer for you.  It would take the input of a skilled, well-respected surgeon who you trust to evaluate.  I had a dent in the base of my penis that looked like someone pressed a spoon down into hot butter.  It was on the underside.  Immediately after surgery, it was gone, and my overall girth was slightly bigger even without arousal of the spongiosium.  My girth did not keep expanding like my length did, however.  That might be because I was back to my pre-Peyronies girth.  As far as my dent goes, that might have been helped by some surgical incisions that were made to correct a small angle I had even after the implant was placed.  I cannot be sure.

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