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Welcome to Dr. Landon Trost - Directly answering member questions in the "Medical Professionals" section below the Treatment boards. https://www.peyroniesforum.net/index.php/topic,16512.0.html

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Author Topic: Diminishing returns  (Read 116 times)

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westerntown

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Diminishing returns
« on: November 23, 2021, 03:55:20 PM »

Hey guys

I spoke to Trost recently about many things via free consult. One thing we spoke about was the diminishing returns of a penile prosthesis.

Trost alikened the situation to that of Michael Jacksons nose, essentially saying the first revision could be fine but that the more revision surgeries you do, the more complex the surgeries begin to become.

He draws the comparison to the many nose jobs MJ went through, and notes that the tissue can only be ameliorated so many times before it begins to give up. He said it leads to all kinds of issues including length and girth loss amongst other things.

Obviously, this is not a major problem for those in their 60s or 70s, however being 20 years young, I am scared. i am perfectly fine with the idea of an implant, however I dont know how I will feel about it 10-15 years down the line when my revisions would supposedly become so complex.

How do my young implanters on the forum feel about this?

Thank you guys so much for existing and sharing your thoughts
Logged
20 yrs old
Sex injury late 2020, hourglass while semi-erect ever since.  Also caused Erectile Dysfunction
Mild pain August 2020
September 2020 erect ultrasound showed mild corporal fibrosis but no plaques. Still only hourglassing while semi. Pntx,cilis, vt

Hawk

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Should Young Men with a NON-functional Penis wait or proceed to implant?
« Reply #1 on: November 23, 2021, 09:25:24 PM »

I have immense respect for Dr. Trost, both for his medical knowledge of male sexual health and for his personal values as a service-oriented human being. He knows few, if any, equals in this regard.

I also have immense respect for Dr. Eid, both as a great surgeon and an incredible person. One is the leading implant surgeon in the world, and one does not perform any implant surgery.  There is no doubt unavoidable inherent specialty bias with both of these men because ... they are human.

While I can believe that Dr. Trost suggested like; Michael Jackson, there are a limited number of surgeries you can have before you run out of options.  I have to doubt that Dr. Trost meant to suggest a man's penis would begin to deteriorate and be misshapen like Michael Jackson's nose.  Every surgery on a nose operates on the tissue forming the nose more like excision and grafting.  That tissue is altered and reshaped.  Tissue is removed and added. Structural cartilage is removed and transplanted. Nothing like that happens with an implant.  No tissue is ever removed.  In the first surgery, the cavernosa tissue (like a web or sponge) is pushed aside in the chambers to make room for the cylinders.  Subsequent surgeries remove cylinders from the chambers, and new ones slide into the capsule.  The reservoir and scrotal pump are replaced.  Often the old reservoir is deflated and left in place.  I have known men with three surgeries (2 revisions).  Their penis looked perfect, and they gained some modest size over the first implant.

None of this suggests that men can have 9 or 10 implants using today's materials and methods but even a 6th implant would be at least 40 years down the road.  That assumes you average less than 7 years per implant.  It also assumes you live 40 years and that implants and procedures do not improve. The internet is a vast place.  I challenge anyone to produce a photo of a penis that has an inflatable implant currently installed that is atrophied or misshapen because it was one implant too many.  Being that anything CAN happen, there might be one or two on the planet.  However, I am willing to bet that it is like the case of a misshapen guy with one implant.  The surgeon faltered, or there was a severe infection.

NOW FOR THE REAL ARGUMENT - we have been here before but I will lay it out again because no one ever has a comeback.

Even if the false analogy to Michael Jackson's nose was accurate, this is NOT a medical decision for young men with a non-functional penis as much as it is a philosophical decision. 

Young guys with a functional penis should NOT be getting implants.  No one should even have to discuss this.

However, if a young man does not have a functional penis and avoids an early implant because he wants to save his penis, one has to ask the obvious question - What is he saving his penis for???
A penis is a usable body part, not an heirloom.  Is the goal to die with a perfect penis or to live with one?  Is the goal to have a functional penis at 80 or at 30?  Is the goal to get killed in an auto accident at 30 or from a tragic brain tumor at 40 waiting on your first implant, or is the goal to find a wife and raise a family at a time when a penis is essential to these life events?  If your penis is non-functional, and you wait until late in life to have an implant not only do I hope you have a great penis at 80.  I hope you have great knees, a great back, great eyesight, and great general health because you are sure as hell are not going to have any family to rely on.  :) :D :) :D

The philosophy that says a man in his twenties should wait at least until his 40's to have a functional penis is a philosophy that strains one's power of reasoning.
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Prostatectomy 2004, radiation 2009, currently 70 yrs old
After pills, injections, VED - Dr Eid, Titan 22cm implant 8/7/18
Hawk - Updated 10/27/18 - Peyronies Society Forums

RichardWilson99

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Re: Diminishing returns
« Reply #2 on: November 24, 2021, 12:53:36 AM »

Westerntown,

If you're interested in implants, you should reach out to other doctors that do implants. For example Dr. Eid is a great resource. Dr. Hakky also seems to be quite available. You can even reach out to your primary care physician and see if they can help you do some research/understand the procedure/consequences.

To your question: the more operations => the greater chance over your life of an issue from said operation just by induction. Time + our body just works like that, as we get older our body starts to fail. Given you're young, I would suggest waiting it out a few more years. It's an irreversible surgery and missing out on sex for a few years in your early 20's sucks, but dealing with an implant at such a young age can be even more stressful. The younger you are the faster your body heals back. Reading through Trost's posts, you'll see he mentions that things can improve and heal, but it takes years. Look at athletes that tear their ACL/MCL: they spend all day rehabbing and it takes a year to come back.

Are you able to get erections? Even with cialis? Erections/blood flow can really help. If you're penis is actually broken, then you most likely have no choice but to get an implant. But if its a tissue injury, give yourself a few years of focusing on your penile health and revisit. Just my two cents. I am doing the same.   
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30/Single
Dent/twist, base/right/underside 10/15 deg down/right. Major Erectile Dysfunction. (Nov 19).
VED, coq10, cialis 5mg (Sep 20)
Erections came back (Feb 21)--Dent got worse.
Kratom 2000mg 2-3x a week -- helped with erections, filling out when flaccid, mood.
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