Is it time for an implant, or should I continue with a modified sex life?

[IwillbeatPD]

Hey guys!

As much as I wish I could say I missed you all and your support- I was hoping to never be back on here. Unfortunately, I am, and I need some advice.

I am 37 now, if you know anything about my past- basically I have Peyronies Disease with a hinge mid shaft. There is some hour glassing but that is the least of my concerns tbh. At this point, my biggest concern is being functional. Taking 5-10mg of tadalafil before sex has helped me maintain a regular sex life. I can have sex, but carefully. I sure as hell can't let the girl on top of me, and I am always worried my dick is going to snap in half. Obviously not a good feeling. Prior to Peyronies Disease, I enjoyed a intense sex life. Certainly never worried about my dick snapping in half. One time when I had sex recently my dick easily folded a little when it slipped out and I freaked out. It hurt like hell and I legit thought I'd have to go to the hospital. Thank God, nothing was truly injured, but I did feel a small bump later where that incident happened. Obviously a result of the minor trauma. After that, I am still at the same place and can have sex, just the same hinge as always.

My question is: At 37 years old, would it be a stupid decision to get an implant when I can have sex currently? Keep in mind, while I can have sex, every time is risky. I have to be super careful, which makes mentally feel inadequate having sex. I'm much bigger than average at about 8.5 inches in length and almost 6 inches in girth. So I am thankful for that, but I feel like I can't use it! I don't think my length has decreased at all since Peyronies Disease, but the girth has, especially after the point of hinging.

I read all these stories about how with a titan implant people recover girth, and in some cases even GAIN girth. Not to mention it would cure the hinge and the hourglass would be gone or else significantly better. So I would be functional AND look much better cosmetically.So of course I'm over here weighing my options. I don't want to have that surgery by any means, but I am also picturing having a rock hard, non hinging and non hourglasses dick with a strong girth. I think I'd feel like superman.

I get the hesitation being younger due to potential revisions. I'm in my prime right now, I feel like it would be a dumb choice to be having "careful sex" the next 5-10 years when I'm in my prime, and then get an implant and be able to have better sex once I'm older. Who's to say I will even live to be 60 you know? I hope lol, but we never know right?

I have an appointment with Dr. Clavell in Houston to talk it through- even if I don't get an implant. Just want to hear what he thinks.  


Can you all please give me your thoughts on my situation? I would kill to be able to have normal sex again, without worrying about tadalafil, the girl being on top, not having to be careful all the time, etc. I also definitely don't want surgery, but I would be willing to if I was happier. I just need you all to give your opinion after hearing me rant. If anyone can relate to my situation I know it's you all.

Thank you so much!

[Sonic]

After reading this post, as soon as I saw the name of Dr. Clavell my answer is easy. Go for the implant. It is very clear based on your post that you are not happy with your current situation and really you only have 2 choices. Either accept your current predicament and keep on living with careful sex and anxiousness about fracturing your penis or get an implant. The answer for me here is easy and it should be for you too. I know you are worried about revisions, anyone would be, but fact of the matter is you have access to one of the greatest implant surgeons worldwide in Dr.Clavell, If I am not mistaken he usually uses the AMS implants and has the most experience with those.

You could probably have him fix you up with and titan as well but I have only heard positive stuff about him. He will most likely recommend you to get implanted on. My advice is do it and don't waste your time thinking about it, just do it, go through the painful recovery process and then enjoy a sex life free from the worries and constant fears about penile fractures which in this case really is a risk more so than just an illegitimate fear.

Good luck brother!

[LWillisjr]

I feel like you are trying to ask "Should I get this or not". I think that is a question for your surgeon. A good surgeon is not going to do an implant surgery because you want one. He/she would discuss pros/cons and if your surgeon agrees you would benefit from it, then you can make the final decision. I know several guys with implants who like them. Be sure to consult an experienced surgeon.

[IwillbeatPD]

Thank you Sonic- I tend to agree with you. It's either live like this forever and potentially get inured and lose length- or fix it. I do understand the fear of the implant, but I think what people are forgetting is, it's not like they have a working dick to begin with. For me, the only reason I've hesitated is that I can have sex, it's just risky and not nearly as satisfying as before. So to your point, I either accept a below average sex life while risky potential injury. Or I get the implant and potentially have an amazing sex life again with no risk of injury.

Willis- Yes I absolutely will talk it over with the doctor. But I feel like he will give me the pros and cons and ultimately I'll have to make the decision. For this post I was more just wanting to hear everyone's thoughts. Aka...am I crazy for considering an implant if I can still have some kind of sex, even if it's not good. It's a tough decision for me.

[morphball]

I'm in a very similar position to you, I'm 33, have had Peyronies Disease for 3 years, can have sex, just, but like you say it's very risky. I'm in Australia and consulted with Dr Chris Love a few weeks ago, the same surgeon that did JJ's implant. He recommended the implant with the TEP procedure to restore some length and girth, the same as JJ.

I've really thought about it for a long time and had the same back and forth as you. I've decided to get the implant and I'm booked in for the 3rd of October.

Honestly since making the decision I've felt an enormous sense of relief that the ordeal that has been Peyronies Disease is going to be over. I'm aware of the risks and that it's going to take time to heal, but hopefully in a year from now I can get back to enjoying sex without having to worry about causing further injury. The only thing I'm slightly torn on is whether to do the TEP as well or just the implant, but I think in my case with the damage that Peyronies Disease had caused, TEP would be beneficial.

I was about 8 inches before Peyronies Disease, but closer to 6 inches now and have lost a fair bit of girth and rigidity as well. But have religiously used both RestoreX and VED and my stretched length is still about 7.5 inches, so I'm hoping that will translate over to the implant.

Only you can decide what is the right decision for yourself, but if you're in the position where you're wondering, until you bite the bullet and get one, you're always going to keep wondering whether you should do it. If none of the treatments seem to be helping I would say do it. My condition has only slowly worsened over 3 years, despite all of the therapies, but I feel like I also have it enough time to really know they weren't working. If it hasn't quite been a year for you, it may be worth waiting a little longer, but at the same time in some ways now that I'm getting an implant anyway, I wish I had just done it sooner. The silver lining is that I have gained a resilience and strength of character through dealing with Peyronies Disease that I did not have before.

Hope something in my story helps you man, my thoughts go out to you and everyone else on this forum as we all know how challenging Peyronies Disease is mentally, physically and emotionally. Wishing you all the best no matter what you choose.

[Pfract]

Like others have said... Your concerns and thoughts are valid but you should be bringing this up with a surgeon that you choose to go after you do your research.

If this things go well, it's amazing. If not... You will be in a world of pain and trouble to get it sorted out. Look at jj21's situation, unfortunately. But it is a very viable solution for a lot me men.

Have you read through the diaries here?
 

[Gap63]

I am sure Dr Clavell will give you the answers you are after, btw he uses AMS or Coloplast and will advise which is better for your case........................my only regret was not getting am implant alot earlier than I did.


Also start writing down the questions you have now, review them every few days and ad more as you think of them, it will be beneficial at the consultation with the Doctor reading off your checklist.......................if you havent watched on Youtube Dr Clavell has many videos of common questions that he gets asked, well worth watching.

[IwillbeatPD]

Morph- Thanks for sharing man. I think it's smart that you gave it time. I will for sure wait at least a full year. If I do an implant I'd prob do it in January 2024 which is almost a year and a half. I also don't want to wait too long and lose a lot of length or girth. I love your positive outlook. I think we all face challenges in life and it's great to see you being patient and looking for the silver lining.

Pfract-I did read some early on, and a few lately. Some worry me, and some are very positive and give massive hope. Seems like everyone tends to freak out in the beginning that something is wrong, but most adapt with time and everything is fine. Trusting that going to Clavell would give a lower probability of issues.

Gap-Love the idea of writing down questions. This is a big decision and definitely want to do that. I'll go check out those videos!
 

[nevertheless]

You must be pretty close to maxing out restorex if your erect length is 8.5? RestoreX has been helpful to me in the week+ I've been using it. I might be in the minority but I think the stretch feels incredible.  

Totally get what you mean about being paranoid about sex. My partner is much more gentle and tender so usually not a huge issue but we were doing reverse cowgirl this weekend and she was going to town. Incredible position for my curve and was absolutely mind blowing but all I could think about was breaking my dick and eventually had to ask her to stop because the anxiety outweighed the pleasure. And I know am thankful I can have sex at all since many can't. Dang hinge just makes everything so difficult.

Hope you get some answers and figure it out.  Surgery terrifies me and I hope it doesn't come to that, but I also recognize it has totally transformed many lives here. I'm hoping for official diagnosis this month of whatever it is I have, peyronies or otherwise. Keep us updated!  

[IwillbeatPD]

Nevertheless-

Thanks man! You are fortunate to have a partner who seems very understanding and patient. I've tried the girl on top, and like you said...it was possible if it was still gentle but scared the hell out of me. Prob easier for you because your partner knows your situation. For someone single like me who doesn't openly discuss it with women, they have no idea which means at any moment they could make one sudden move and my dick snaps in half lol. That's quite literally how it is. I'd love to hear what everyone else thinks, but for me it's like a mental thing of knowing my dick isn't rock solid. Crazy how much it can affect mental state within or outside of sex. I'm not a depressed person by any means, but now days when I see a girl, instead of thinking "the things I would do", it's more like..."would she snap my dick in half or be understanding of my situation" Not a good feeling obviously. I am fortunate I guess that I can have sex now. I just have to choose the position so I'm in control and make excuses when the girl wants to be on top. But I really do think if I have no major concerns after meeting with Clavell that I will go with the implant. I do certainly want to ask my questions to him and hear his opinion- then will decide. But prob Jan 2024 for my surgery just to make sure I've allowed plenty of time to decide. And yes, about the restorex it is pretty much maxed out on the last notch even with the longest extenders. Great to have a good length, but what good is that with the hinge you know? If anything, the longer dick is even more risky than a shorter dick I feel like. Now I feel like I took my old
Dick before Peyronies Disease for granted lol.  

[nevertheless]

Probably over share - but my partner also doesn't get tremendous pleasure from vaginal intercourse (or dildos or anything, which helps my insecurities haha) and never has. She enjoys it and it gets her excited/primed, but it's mostly for me/general connection, so she's super understanding and patient, never pushes anything that makes me uncomfortable.

I'm very new to the idea of peyronies. I thought the curve and a hinge was totally normal and everyone's penis was like that. Had no real reason to consider otherwise. Becoming more careful the more I'm learning about it because I don't want to do more damage.

RestoreX has already added over half an inch to my stretched length and it seems like my curve is a little better it seems, but also on cialis so hard to tell what is doing what. I think I have lost length but never really knew because it's always been curved and my injury happened when I was a fairly young teen so probably wasn't done growing. Don't really want more length honestly, both my wife and I are happy with where I am size wise, so we will see what happens.

Isn't there another easier surgery for hinge? I forget what it's called. But basically strictures to help it be more stable. I'll try to figure it out later. But I've been taking in so much information I might be mixing things up.  

[IwillbeatPD]

Yeah just another plus for you that she isn't a huge fan of vaginal sex. On the other side of things, I could never date a girl who was some type of porn star with my current dick. Imagine telling someone like that "you have to be gentle" lol. Point is, you're in a great position and I'm happy for you! Maybe you could just avoid surgery all together if y'all are happy and it doesn't bother you.

There is a surgery called ETG, extra tunical grafting. I looked into this heavily. If your dick is stable enough and it's mostly the cosmetic part that bothers you- I think it can certainly fix the cosmetic part 99%, and probably help SLIGHTLY with stability. However, what turned me off from this was reading that Dr Trost said it doesn't help at all with stability and is purely cosmetic. I tend to agree with Dr Trost. I mean think about it. Go wrap some paper towels around the hinge part of your dick...it might feel a little more stable...but now go let a girl ride on it- the paper towels are going to do nothing under force. So for me, if I still have to be just as careful and worried after ETG- it's not worth it to me. For some people I think it could be great though. Maybe even for you since your partner knows your situation. I'm sure it's a very costly procedure and I also feel like it's not covered by insurance like an implant would be. Another deterrent for me.

[nevertheless]

I'm not very concerned with cosmetics at all - it's been like this forever. I don't want my condition to worsen or to fracture or anything else. Care about stability and not being so dang sore after sex like I always am.  

[IwillbeatPD]

I'm not very concerned with cosmetics at all - it's been like this forever. I don't want my condition to worsen or to fracture or anything else. Care about stability and not being so dang sore after sex like I always am.

Happens to me everytime after sex too. It's worse if I have sex multiple times or make it last a very long time. Never happened before Peyronies Disease.  

[nevertheless]

RestoreX and Cialis (unsure which or both) are making me quite a bit harder, which seems to help the hinge. Maybe I had more ED than I thought.  

[IwillbeatPD]

RestoreX and Cialis (unsure which or both) are making me quite a bit harder, which seems to help the hinge. Maybe I had more Erectile Dysfunction than I thought.

Same here! What dosage do you use for Cialis? I've experimented with 5 and 10mg before sex. I don't do I daily. Honestly I think 5mg is enough as long as I'm really turned on by the girl. 10mg ensures I'm rock hard no matter what. When you have a hinge even a little bit of softness makes it 100x worse. Risky, even. So I'd say at a minimum I'm taking 5mg before sex. Makes me curious how 15 or 20mg would be though- there was a guy on here before who said he used to take 20mg lol.

I've also noticed, I can get hard enough for sex with a natural erection, I just have to stay constantly stimulated or else the hinge would be bad. When I get a natural erection I have zero pain. When I use tadalafil my dick would hurt when erect sometime. Which tells me it's probably stretching the plaque- I imagine that's a good thing. Which is why I also encourage everyone here to try to get good erections without the VED. I won't knock the VED but it did nothing for me and I think the risks outweigh the suspected benefit. If it's just blood flow to your dick you can get that naturally by creating an erection(assuming you can)

[nevertheless]

I take 5mg daily. Have been for about Week now. It's supposed to help not just with ed but stretching and healing in general since more blood flow.  

[IwillbeatPD]

I take 5mg daily. Have been for about Week now. It's supposed to help not just with Erectile Dysfunction but stretching and healing in general since more blood flow.

I heard that too. I did also notice more night time erections. But idk how I feel about taking it daily. I'm not a fan of medicine in general.  

[nevertheless]

I feel that. I'm viewing it as temporary though. When I stop seeing results from RestoreX, I plan on weaning off, but will obviously listen to uro on what he thinks.

Also working on losing a bit of weight (20-25 pounds to my ideal weight) and working out more to help them get better naturally. Also eating better, alcohol only a few drinks a month, etc. hopefully all of it together will help!

[IwillbeatPD]

I feel that. I'm viewing it as temporary though. When I stop seeing results from RestoreX, I plan on weaning off, but will obviously listen to uro on what he thinks.

Also working on losing a bit of weight (20-25 pounds to my ideal weight) and working out more to help them get better naturally. Also eating better, alcohol only a few drinks a month, etc. hopefully all of it together will help!

That's a good plan! I think a low dose is pretty harmless.  

[IwillbeatPD]

Hey everyone-

If anyone else can share their opinion I would truly value it. You all are really the only people I can talk to about this. Of course I'll be talking to the doctor as well but I would really like to hear you alls thoughts.

I have a few options and I'm trying decide on which route I want to take. As mentioned above I can have sex, but carefully due to some hourglassing/hinging.

My options:

1. Do nothing, continue taking tadalafil before sex and using restorex. Be super careful during sex and hope for no injuries that worsens things.

2. Try extra tunical grafting. Dr Trost specifically said this does not help from a functional perspective and that it's only cosmetic. However, common sense tells me it might add something like 5% stability from the graft. And hourglass would be gone. I still don't think I'd ever be able to have normal sex with this option, even though my penis would look normal. I'd still be worried about hurting myself.

3. Implant from Dr. Clavell. I am fortunate enough to live just a few hours from one of the best implant doctors around. Keep in mind I'm 37, and I absolutely don't want this option. But is this worse than having careful sex my whole life and risking injury? And is it worse than constantly thinking about breaking my dick or feeling inadequate when I see a woman and think about sex? It messes with your mind for sure.

Also, how do we attach photos here? I'd like to post my current condition. I'm not even sure how "severe" my hourglass is. You all might think it's terrible, or that it's so minor you wouldn't even worry.  

[Trapper]

just my two cents. Try injections first to see if that resolves your issue and if you can't have sex the way YOU WANT with those get the implant from an world class surgeon. With HG it's likely you have some midseptal or distal scarring. regardless a lot of MD's are jokers that can't properly diagnose that with a doppler.  I'd get an evaluation from your chosen surgeon and get his input.

Regardless though if you've tried pills at very doses and you do not respond to them in a manner that you like or their side effects or those of injections are not tolerable to you then YOU ARE a canidate for the implant[/b].

Also, I would take into account the lost time you are losing for every month you put it off I would advise and I have heard at least two top surgeons endorse the timeline of giving things 6 months to a year to see if things improve However I would tend to go with 6 months but to each their own just keep in mind the recovery can be tough and the implant will certainly not fix you overnight it is a process as you can read on this very forum.  

[IwillbeatPD]

just my two cents. Try injections first to see if that resolves your issue and if you can't have sex the way YOU WANT with those get the implant from an world class surgeon. With HG it's likely you have some midseptal or distal scarring. regardless a lot of MD's are jokers that can't properly diagnose that with a doppler.  I'd get an evaluation from your chosen surgeon and get his input.

Regardless though if you've tried pills at very doses and you do not respond to them in a manner that you like or their side effects or those of injections are not tolerable to you then YOU ARE a canidate for the implant[/b].

Also, I would take into account the lost time you are losing for every month you put it off I would advise and I have heard at least two top surgeons endorse the timeline of giving things 6 months to a year to see if things improve However I would tend to go with 6 months but to each their own just keep in mind the recovery can be tough and the implant will certainly not fix you overnight it is a process as you can read on this very forum.

You know that's actually a really good point to consider. And actually I appreciate you not just screaming implant and pointing that out. The most I've tried on the pill side is 10mg of tadalfil. I mean I was pretty hard but I feel like I never get a true chance to evaluate how hard/stable my dick actually is when having sex on 10mg. I wish I could just pull out and be like hold on let me check my dick lol. I do think it's harder on 10mg than 5mg. Makes me wonder about 15 or 20mg. But that's also a very high dose and at some point there becomes a risk from that as well. I'm sure it can't be healthy for you to regularly be popping 20mg of tadalfil. I know they use even higher doses for BP reduction- but still. Never been a fan of medicine. Not willing to mess up my whole body for just my dick. If anyone has any thoughts on the safety of 20mg of tadalfil feel free to weigh in. I guess my point is. Even if 20mg got me hard enough to be content, is that even safe long term. My blood pressure is already low from being so athletic.

On the injection note, I'm assuming you mean trimix and not like Xiaflex or something. This is also an interesting one that I haven't explored. Mostly because people here have said that causes scarring long term. Also you have the refrigerate the medicine right? I travel a lot so that would be a problem. Not to mention having to inject your dick before sex you can easily pop a pill at dinner,I can't be pulling out a whole syringe doing an injection lol. Also it not a controllable erection right? You get hard and stay hard for hours? Or it's like tadalafil where it's only erect when aroused?

[Trapper]

Yes, if you haven't tried max dose of the pills 100% try that first then if that doesn't give you satisfactory results try mono-mix, bi-mix or Trimix.

I would highly recommend you try everything before the implant just to make sure you don't like them or they are unacceptable solutions prior to getting the implant because once you get the implant injections will be closed off to you. Also, I still use the pills even with the implant just because I like it an I want my tissue as engorged as possible for sex lol

[IwillbeatPD]

How much difference did you see in your erection on say 10mg of tadalfil versus 20mg? Was it a noticeable difference?

Also what about tadalafil versus trimix? Any difference in erection quality? I heard trimix is even better than pills.

 

[Trapper]

I absolutely noticed a difference between 10 and 20 and much preferred the results with 20mgs. Again, trimix gives a significantly stronger erection than 20mg of Cialis. As long as your cardiovascular health is good no reason you can't up the dosage definitely try max dose of viagra and cialis before moving to the injections and the injections before moving to the implant.  

[IwillbeatPD]

Alright I'm gonna try the 20mg, at least once, to see what happens lol. Just have to make sure I have a girl over-can't let an erection like that go to waste lol

Maybe I'll try 15mg first and see! Even that for me would be crazy I'm sure as I'm pretty hard with even 10mg. It would be nice if a higher dose created more stability. I also feel like it would be good to really stretch the plaque and tissue that much.  

[Stepone]

Hey bud,
I was just looking at your signature line. Unless I am mistaken I don't know if anyway to fix a hinge without surgery.
I could be wrong.
But if you elect to have surgery, most hinge repairs cause a decrease in length.
I had a surgery to fix the hinge and it fixed it, but it shorted my penis by a little over an inch and my girth decreased the same.
The only thing that gave me a hard thick long dick again, was an implant.
If you are suffering from ED too, you might want to consider an implant before subjecting yourself to a surgery that will only fix some of the problem.
Not sure if this helps.
StepOne  

[IwillbeatPD]

Thanks Step!

I read a lot of your posts here and appreciate your input. I know you have a lot of experience so I value that. I was thinking the same as you. I feel any type of surgery I do (the only one I'd even consider being ETG), I'm sure all would result in a size loss-and there's still a chance it doesn't even fix the problem. Add in the money and downtime- it's not worth it to me.

On the flip side, almost everyone who I know who's received an implant seems to have moved on with their life and don't even think about it anymore- they're generally happy-which seems to match the high satisfaction rates you read about regarding implants.

At this point for me it's really just tough to decide if I want to continue having safe sex using tadalafil to overcome the hinge...or if I want to just do the implant and move on with life without worrying about my dick breaking all the time.

Im right on the fence right now, because I can have sex carefully and it's fine. I think if it got any worse at all it would be a clear decision to get an implant. I am meeting with Dr Clavell soon to talk about the implant and will continue having careful sex in the meantime. What

I guess I need to decide is, what if I never get worse/ or better, and stay the same. Do I want to continue that forever or just do the implant. I think im pretty long now at about 8.5 inches, with a girth of about 5.5. I heard with a titan you actually gain some girth, not to mention the hinge would be fixed. Can't even imagine having a good sized dick that is rock hard and stable-never having to worry about erections or stability. Seems like a dream come true at this point. But I know it's not that simple as there are risks involved with an implant (although minimized with Clavell), and I'd end up needing a revision down the road. I hope I'd recover fast being 37, but the downtime for the first month would be tough as I work out daily and am very active.

I still remember a comment you made on another post, Step. You said sometime you still look at your dick and think...wow that's a thick dick lol. Thought that was funny because I'd be thinking the same thing. Now I look at my dick and think damn, that hourglass doesn't look good. With an implant and the hourglass mostly gone, with that strong girth...I'm sure id be looking down thinking "that's a big dick" lol.


Decisions, decisions...someone just tell me what to do lol

[richie2222]

I'm in a very similar situation to you.  Have peyronies for about a year and a curve to the left about mid shaft.  Probably about 25 degrees?  I'm kind of nervous sometimes to have sex but try not to think about it.  I don't think you stated your curvature degree?

I've read a lot of stuff on this forum when I was diagnosed and it seemed like a lot of people had complications from xiaflex or surgeries.  I really wouldn't do it unless it was a last resort.  Me and my wife have sex like twice a week without issue and my penis functions fine.  I've lost some length but I am not doing anything else unless it was 100% necessary.  I take 2.5mg of tadalafil and did restorex for about 3-4 months.  It seems to be stabilizing I think.  Way too worried about having surgery on my penis or xiaflex shots

[IwillbeatPD]

@richie- One thing in your advantage is being married.I'm sure your wife knows she she will make adjustments if needed. It different if you're single and dating as I'm def not explaining to anyone I date that they have to be careful with my dick.

If you can have satisfying sex I wouldn't do surgery either- esp if you're married. I was still having sex regularly and honestly not being that careful. But a while back I slipped out and even the slightest force caused it to bend and it hurt like hell. After this I felt another little bump in that spot but no other changes. I'm explaining that because from what I can tell people with a hinge only tend to get worse from what I've seen, not better. Once your dick isn't stable any little thing can trigger it or make it worse and god forbid you have a real
Injury and have to go to the hospital. I can only imagine that would result in a definite length loss. So for me, the implant is a way of keeping my length and avoiding what would seem to be a likely sex injury at some point. Not to mention, can't even imagine the mental relief of never having to worry about my dick again. No stability issues, no erection issue and no deformity issues. I DO NOT want the surgery either, but I don't want all the consequences listed above even more.

[Hawk]

I will be brief because I have more to do than I have time to do it.

I always say, "If you have to ask if it is time for an implant, you probably are not quite there yet."

When something just clicks, and you have had it with: devices, supplements, drugs, preparation, and cautious procedures, you are ready.  You just feel, "OK, I AM DONE WITH MY CURRENT ROUTINE.  I HAVE HAD IT".  THEN, you are ready for an implant.  

I cannot say you cannot consult before that or even get an implant, but you will always be torn, undecided, second-guessing, and hesitant until you get to that point.  When you get there, you will NEVER look back.  Your doubts are behind you.  Oh, there might be that moment 24 - 48 hours after surgery where you think, "WHAT HAVE I DONE?". but that is very fleeting.

A couple of days after I set my appointment with Dr. Eid, my wife said, "I don't think when it comes right down to it that you will go through with it."  I laughed and told her she had NO CLUE because this WAS A DONE DEAL as far as I was concerned.  I fought the fight for over a decade, but when I realized an implant was a real sound option and I had access to a great surgeon, my mindset changed overnight.

Good luck

[Stepone]

Hey guys, I am where Hawk is on making a decision to go bionic or not.
Each one of us makes a decision for various reasons.
I made mine because
1. Viagra and Cialis no longer worked
2. I was using injections into my penis and this was damaging my penis and it was shrinking.
3. I regretfully had a penis surgery years before to fix a hinge, but it left my penis shorter and thinner to what it was.
4. The injections were no longer giving me quality erections that lasted.
5. I wanted my girth back and as much of my length back too.
My surgeon asked me what was most important girth or length and I said girth.
I gained more girth than I ever had and recovered some of my length.
I and my spouse are very happy.
In reality it took me a good 6 months before I really accepted my new penis.
In reality the new penis looks so different to me from my old penis, it doesn't look like mine. I like it, but it's different.
I hope this helps.
Maybe make a list of reasons to get/not get an implant.
I had a friend that was single and he played with various women. He never had a woman that didn't like it, as a matter of fact, he said they liked how long he stayed hard.
Good luck and best wishes.
StepOne  

[FrankPD]

I really don't know but I do know what it is to be very careful.

I wish you the best.  


 

[jj21]

Hey IWillBeatPD,

I just noticed your post, and I appreciate you always showing me support on my posts so I wanted to add my thoughts regarding your situation.

Firstly, let me tell you that, Pentox, Daily Cialis and 50/100mg viagra (viagra used only as needed), allowed me to have a functional sex life again. This may help you keep going in the interim. Keep in mind that the 5mg cialis is the daily dose, 20mg is the as needed dosage (pre-sex).

Daily VED and restorex definitely helped. I favour VED over restorex, and I do believe it helped a bit with hourglassing/hinging. Most urologists do recommend using it before implant surgery. There is a post in the improvement forum here which shows my VED improvement, I do think it helped a bit with hourglassing. Always be cautious when using these devices. A combination of pentox, daily cialis and VED, seemed to allow more bloodflow into the penis, more oxygenated tissue, and improve girth/healing. This can help with hourgassing/hinging.

In regards to whether you should get the implant, I have a few questions:

- Do you feel your condition is worsening or improving?
- Have you tried VED/Restorex for a few months, and has it helped?
- Do you feel Erectile Dysfunction is getting better or worse?
- How satisfied are you with your sex life?

As you've stated, you're 8.5 inches in length and 6 inches in girth. You may require an implant which is over 26cm. It's very important you discuss this with your surgeon, as you do not want to end up with excess RTEs. I think, as you mentioned Dr Clavell, you will be in good hands.

In regards to girth, Dr Eid states that, with a 24cm XL titan (the 26cm is also XL), 6inch girth is definitely possible. I think a contributing factor can be how much natural engorgement you retain, and as you have advised that your Erectile Dysfunction currently is quite good, you may retain a lot of your natural engorgement and 6 inch girth can be achievable. In the event that you lose girth, fillers are an option.

I think you will know when you are ready. A determining factor for me was that, it got to a point where I could not have sex at all. Further, I had accepted all outcomes of the implant, if I lost size, had an infection etc, I was ready to accept it all.

From all the journals I have read, you are in very good hands with Dr Clavell, alternatively, Dr Eid or Hakky seem to be great choices too.

A contributing factor may be whether your condition is improving, worsening or stable. If it is improving, it may be better to focus on VED/Restorex for a few months. IF it is worsening, it may be better to opt for the implant sooner to retain size and engorgement.

Hope this helps!

Best of luck, always here if you need.

J
 

[Hawk]

My gut feeling is that with a penis that size, I would only consider a Titan.  The more length, the more rigidity becomes an issue, and the greater the girth, the more the girth of the Titan will be a factor.  For an average 5' or 6' penis with a 4.5 - 5.5" girth, either would probably do, but you definitely do not want the AMS 700 LGX that expands in length.  Its lack of rigidity would be a factor in a penis over 7 "

I have always felt that the AMS 700 LGX or the Titan are the two choices.  If you lose the natural flaccid provided by the AMS 700 LGX, why would you opt for a larger blocky pump?  Just go with a Titan, get a smaller pump and more axial rigidity and probably more girth, not to mention that it comes in more length increments so you are less likely to need uninflatable great tip extenders.

[IwillbeatPD]

Hey guys-

Thank you all for your valuable input, I really appreciate have support from all of you.

I met with Dr. Hakky today- amazing doctor. This was my first appointment with anyone incredibly qualified on Peyronies. We talked through my history, he showed me a titan implant model that I got to play with. This was great because I got to inflate in and deflate it first hand to see how it actually felt. Ultimately. Hakky said I would likely need an implant. He said due to my length that the hinging was an even bigger problem. I showed him a video of my erection on 15mg of tadalfil and he said it was too risky to have sex like that.

He essentially said I should try injections before anything else, and if that doesn't work and I can't have the sex I want an implant would be the next step. He said I would likely need a titan 26cm XL and he would only use an RTE if absolutely necessary. He said due to my low body fat I would see some tubing on one side. He also said due to my length the dog ears would be prominent. I am ok with both of the above and really was already expecting that from the journals I've read here. I could actually really appreciate his transparency as I think a lot of implantees don't get this and end up disappointed.

He wanted to do a Doppler scan and bi-mix injection in the office which I was not prepared for, but did agree to-so I knew how I'd react for future injections. Plus I wanted to get the scan out of the way so I didn't have to fly back just for that. The injection made me about 70% hard, not sure if that's what's supposed to happen. From what he explained it sounds like the injection gets you most of the way there, then when aroused you get the full 100%. He did a Doppler scan while erect and pointed out calcification and plaque. I think it was worse than I thought actually. He also mentioned I don't have venous leak but did mention some potential issues with blood flow. Makes me wonder if my erections have really ever been adequate.

Next steps: Continue taking tadalfil 5mg per day, try higher doses before sex. Also experiment with the trimix I was prescribed today and see if I can be hard enough to safely have sex. We have a follow up virtually in a month and I'll be able to discuss how the trimix has been going. If I can have normal sex with the injections-I'll continue that as long as I can. If I can't or it's still a problem, I will likely proceed to an implant.

I raised some questions with him about intense exercise/powerlifting/bodybuilding type workouts. He seemed confident that would not be an issue. I always wondered if things like crunches, squats, etc would be a problem with the reservoir or maybe moving things around. So that was reassuring. If anyone else wants to weigh in on that I'd appreciate it.  

[Sonic]

I will be honest. Based on what he said, an implant is your destination wether it be now or later. Do not waste time with injections when you know you are going to end up with an implant anyway.

Here is the situation: You have been shown you have both calcification and plaque. You have been told you will likely need an implant. You have access to one of the greatest surgeons possible to perform the surgery in Dr. Hakky. Don't waste time, do it asap so you have the procedure over with so that you can resume with a normal sex life as soon as possible.

These are my two cents.

[ohnoohno]

Sounds like you're on the right path. Hakky seems great and I agree him letting you know potential disappointments upfront shows the type of dr he is.

I too am curious about how strength training/sports training go with an implant so that's good to hear. I train in MMA so lots of rolling about and stuff, hope that'll be alright but will have that discussion with whichever dr I can get when it comes to it.

It seems like you guys in the US have it sorted with the insurance + access to the best surgeons for Peyronies! If I had that ready at my disposal I believe I would have gone for the implant by now.

Interested to keep following your journey, whatever you choose to do here. Take care

[jj21]

In regards to the reservoir, I am quite lean currently and cannot feel anything.

With deadlifts, squats etc, a lot of the journals I have read indicate that you will have no issues and should be able to lift heavy etc just as before.

I would also be cautious with injections. Injections seemed to have contributed to some peoples peyronies.

J

[IwillbeatPD]

I actually tend to agree with you two about the injections. All I've read is that they will eventually cause problems and are no way a sustainable solution for someone like me who's 37- even if they did work for now. In Hakky's words, it would just buy me some time. In his example he said "even if it could hold you off until you're 40". While I do see his point, I also feel like that would be prolonging the inevitable. And actually, could cause shortening/scarring with time from injections or injury. I think for now I'll experiment with higher tadalfil doses when needed, and might give the trimix a shot and see how it feels. If there's not a significant difference between injections and tadalfil I won't do injections anymore. Deep down I feel like him, and most doctors, just want you to try it to say you've done everything. But Hakky did say himself I was going to need an implant at some point if I want to continue sex. At the same time, he was very clear in saying he would not push me one way or the other. 110% did not feel like he was pushing me into an implant, but rather being informative about my options.

I'll be very anxious for my one month follow up after trying his recommendations. We'll see where I'm at then, but I do feel like ultimately I'll tell him I want the implant. I still remember one of hawks post where he talked about how he spent years of his life with all of this stuff...VED's, pills, injections...and when he got his implant he was able to throw it all away and just live his life. That's how I'm feeling at 37. I want to have a normal sex life, not be carrying around a bag of things I need to have sex. The amount of time spent using restorex daily- that's an hour. Taking tadalfil daily, injections, VED...before you know it sex just isn't even enjoyable. Even with all that, I'd still be constantly worried about injuring my dick and ending up with a shorter penis. Sorry to rant, but the pros of an implant far outweigh the cons for me.  

[jj21]

I think for now I'll experiment with higher tadalfil doses when needed, and might give the trimix a shot and see how it feels.  

5mg daily taladafil (every day), and 100mg viagra as needed (30-60m before sex), worked wonders for me.

Just be careful, I seemed to injure myself more from having sex, which resulted in more scar tissue, ED over time etc.

Hope you overcome this, one way or the other.

J

[ohnoohno]

Totally agree with what you're saying IwillbeatPD about Hawks post regarding spending years of hassle and money doing all this other stuff just to have a normal sex life when an implant can just put you somewhat back to normal.

The stress of having a pump, pills, injections etc to prepare for sex is does not sound fun. I would rather get the implant. Even with the thought of revisions down the line, 1. who knows how long we'll be on earth for so might aswell enjoy the now and 2. technology could improve between them to make revisions better/last longer etc.

I think the main thing with an implant is getting the right doctor for the inital first step surgery.  

[Hawk]

If at any point you try injections, be CERTAIN to apply pressure on the injection site for two minutes to prevent any bleeding into the tissue and do NOT take any blood thinners (NSAIDs etc).

Injections are painless and awesome at giving you an erection, but they have the potential downside of causing scar tissue.  Just monitor yourself and stop if you notice any scar tissue and do objective measurements at least once a month.

[Stepone]

So here are my thoughts on this question.
I too had a hinge and narrowing and Erectile Dysfunction.
I could get hard, but not long enough to achieve ejaculation.
I used pills and eventually had to go to needles.
Pills worked for years, but then over time they became less effective and my doctor wrote prescriptions for an injection that only a pharmacy that did compounds could do.
The injections did hurt and it was a procedure that definitely diminished the excitement of sex.
Eventually even the tissue damaging injections failed to keep an erection and sex was becoming so dreadful. I would think how long will it stay hard, how hard will it get? It was destroying my sex life with my spouse.
The implant was not an easy thing initially, it took me nearly a year to understand and feel totally comfortable with it.
Without over thinking it, getting my implant was the best thing ever. I wished I had done it sooner.
That being said, the only horror stories I have read, is when someone chooses a new surgeon. The trick with a successful implant is having a high volume surgeon.
Please take the time to research this life changing surgery.
Only choose a surgeon who does over 100 surgeries a year.
Remember this is your penis, it deserves the best.
And also don't be doing crazy things you read on the internet, there are lots of crazies that recommend products and procedures that can damage your penis.
Hope this helps.
Oh yes, read some journals of regular guys getting an implant from excellent surgeons.
Stepone

[IwillbeatPD]

Thanks Step/Hawk-

I've been fortunate to have you all for first hand advice on and off the forum- and I am truly thankful for that. I mentioned to Hawk the other day I've definitely had my ups and downs. Sometimes I'll go months without thinking about it and I'll try to resume life as normal as possible with a modified sex life. Other time, I just feel down like I need to just do the implant and be done with it. I definitely think due to my length it's necessary to get the implant. These were also Hakkys words. Having such length at 8.5 inches and only average girth, it's not a good mix. Then add in a hinge and hourglass midshaft-it's just so risky. Not to mention the cosmetic deformity.

After much thought, there are two things holding me back. If you all could offer any advice on these I'd be so appreciative.

1. The hourglass. I'm confident a titan xl will give me more than enough rigidity to where stability will never be a concern. But I'm wondering how an implant would affect the appearance cosmetically. As of now it doesn't look good. Kind of like a bottle neck effect mixed with hourglass. Almost like my penis is two separate pieces. I've read that some surgeons do incisions on the plaque during the implant to allow it to expand. I'd be using Dr Hakky and I think I'm a video he mentioned trying to break up the plaque before inserting the prosthesis. I'm curious from those who had a bad deformity, and what your experience was like after getting a titan? If it got better, how much better?

2. Working out. I guess I'm what you'd consider somewhat of an "extreme athlete". Mostly just gym workouts, but I go hard-really hard. Fitness is a huge part of my like and to not be able to do the things I do now would be a major consideration in this. I fully understand there's a recovery period. Hakky said 6 weeks. But I've also read of people who experience pain for long periods of time after. I can handle a small amount of discomfort or a twinge of pain here and there, as long as it's not bad enough to prevent me from getting back to my workouts. What do you all think a reasonable time frame would be before I could get back into hard training again? I'm assuming at 6 weeks it would be slowly easing into it only.

[Hawk]

I think there is no doubt that a Titan would stretch out the hourglass to the point that there was no trace during inflation. If it did not do that from day one, it would surely be greatly reduced and completely resolve it over a few months of cycling.

Everyone heals differently, but this implant will not restrict your activity in the least when it comes to the long run.  You can start working out in 6 weeks, and it might be another month or 6 weeks before you are doing maximum heavy squats (maybe sooner, especially at your age).  On the other hand, your body will appreciate the break, and your muscle memory will jump back into shape fast, so don't fret over a minor break.  

[Sonic]

I think I already have said this earlier in this thread but if Hakky is your surgeon, based on your story then nothing should be holding you back. He is one of the top 5 implant surgeons in the world, you have access to him, you literally have nothing to lose. The chance of success and satisfaction with him is probably over 90%. Get it done and move on with your life and put this behind you. The more you wait the more you will regret not doing it earlier.

If I had the chance to do the operation with Dr Hakky I would literally do it right now if I could.

[IwillbeatPD]

Here is a photo at the onset of my symptoms in October 2022 (left photo), versus current September 2023 (right photo).

https://ibb.co/HKjSvbR

Even though I'd like to try to delay the implant, I also feel like things will only get worse and the longer I wait the more length/girth I could potentially lose.

From my own observations of the two photos, it actually seems like I'm a bit longer (maybe due to the straight stretching with restorex), but girth decreased from the point of hinge onward. The other weird thing is actually being straighter now than I was with my congenital curve.

[Hawk]

The other weird thing is actually being straighter now than I was with my congenital curve.

That's not weird. Peyronies Disease plaque causes bends and curves.  They can be in any direction.  You can start straight, bend right, then left, then back to straight.  That seldom represents improvement.  It is just progressive scar tissue replacing elastic penile tissue.

As bad as your penis looks to you, I think that is modest and well within what a Titan could correct. You have to consider that the longer you wait the smaller implant you could end up with.

You could see a Xiaflex expert but it is less effective with hourglass deformity.