Size for implant

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ScottNM

So my Urologist measured me at 12 cm's for implant. I am not using him because he only uses the titan. I am going with the LGX. Is that measurement the total length of the length of the penis or shaft?  

james1947

As I read and see a video also, AMS have a special tool to messure the length.
It is done by stretching the penis and measuring from half of the glans to the pubic bone.

http://www.youtube.com/watch?v=14S9JX1bntc&feature=related

Was very scary for me.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

jackp

Scott

The only accurate measurements for an implant are during surgery. You  are measured both proximal & distal in both the right and left side. Then added together for a total size.  It is not uncommon for one side to be larger than the other.

The implants come in different sizes starting at 12cm and increasing in 3cm length. If you measure 17cm the doctor would use a 15cm implant with 2cm rear tip extenders for a custom fit.

Jackp
http://jackp-penileimplant.blogspot.com/


ScottNM

So I measured myself with an erection and am 5 5/8". I used to be a good inch longer and a more girth. Will they fit a size to the current situation or will the 'cavity" and looseness be considered? I am not looking to get bigger, just close to what I used to be. I would hate to think I will be shorter than I am now and my girth is missing a bit from before peyroines.  

ScottNM

also, I just used my new VED and it measured 6". Its pulling almost an 1/2" more. How will the dr be able to do a good measurement when I am getting length back from the VED? My local doc measured 12cm which is 5"approx i believe. I think some of these doc err conservative on size. The tape measure doesnt lie. I am afraid Dr Milam will do similar. This bothers me. I also read about a guy on here that was around 8" and after op was 6". I hope Dr Milam gets me close to where I originally was.  

james1947

ScottNM

Dr. Milam is one of the best implant surgeons in the world, maybe the best. I am sure he will implant you the maximum possible length.
If you will get the AMS 700 LGX the length after surgery (and the girth) will expand during time with an additional 20%.
Jackp post bellow explains how the measurement is done. This is the only measurement that is reliable to know what is the maximum implant length you will get.

I am proposing you to read Jackp blog, you will find a lot of usefull information on the subject.

James  
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

Ben

I will have an AMS 700 cx in december. I have few questions about it.

- Does this cylinder permits a slight increase in lenght from day 1 of surgery to 6 months post op ? Because this make sense to me that even if it's only expands in girth the straight shape of erection makes the tissues also adapts in lenght.

- Regarding post op results and surgical measure of cylinders is being a grower or a shower have an impact ? While dilating the CC I don't think the surgeon does a very hard pull to measure.

- I had been very consistent with traction and ved over years and erected i'm 6.6, flacid pull +/- 7. I would have prefered an LGX, but apparently CX is ok for long and narrow penis (that's me). Do you know why ? The surgeon only implants CX, in a maner I consider myself lucky to fits his skill...  

Hawk

Ben,

I do not want to unduly concern you but there is an expression used for doctors (often by doctors) that goes "When all you have is a hammer, every problem looks like a nail".   You may be the perfect candidate for a CX.  If that is all he does however he will tend to see you as a very good candidate regardless.  It is not that he is dishonest but that he has a specialty bias.  From what I have researched here and talking to others that have had implants, a non-LGX, the cylinders are as long deflated as they are inflated.  My understanding is that at the moment surgery ends that is your length and I think it is safe to say you will not be under any undue tension like you are with an extender on.  If the cylinders were too long, the tension would fold or kink them which is NOT good.  That requires a replacement with shorter cylinders.

I do not think subtleties like being a "shower or a grower" matter.  You final length cylinder should be determined at the time of surgery, not from a stretched measurement pre-op.  At surgery a surgical rod is usually inserted into the cavernosa to measure the length from incision to the glans and then again from the incision to the distal (rear) extent of the cavernosa (the part of the penis hidden inside of the body).  These two numbers are added together and that is the size cylinder you get.  Keep in mind that cylinders come in increments and to most closely match you they get the closes size they can with out going over.  If it is short, they ad rear tip extenders to the back.  Even these have increments however and it is unlikely you get a perfect match in length although very close.  It is also best to have as much cylinder as possible and less rear-tip extenders since they do not inflate.  It gives you a an erection that sticks up more rather than a rigid erection that angles down.

In reference to why the "CX is ok for long and narrow penis" I am assuming it is because of the cylinder sizing but I am not sure.  It may be because it does not expand as much in girth.

Needless to say these are all questions that MUST be addressed to your surgeon unless you are resolved to be happy with whatever you get.  Not understanding exactly what to expect and why, is a formula for dashed expectations which is not good.
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

james1947

Ben

The AMS 700 CX is not the only implant that is just girth expander and flaccid length is same as erected.
TITAN OTR is same and many people are implanting it.
Maybe your doctor means that in his opinion the length of 7' is enough and adding just girth will do the job.
As Hawk have stated in a few posts is that the most important thing with an implant surgery is how many implants per year the doctor is making and how specialised he is in the subject.
I think if you find the doctor approach satisfactory and also maybe can't have a doctor that is specialised in LGX you should just review the expectations in a conversation with the doctor not to have some disappointment from the results.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

Ben

James1947 they are very few implanters in France. This surgery is quite confidential here. I've seen the n°1 in France (A. Faix) but his politics is : "I only do this surgery when injections don't work."
Three times he injected 20µg of alprostadil, and three times the same answer : rigid enough for intercourse, implant is not on option.

I was one day discussing at work about implant with an uro (I work in an hospital) and he said to me : I have a friend who can implant you. This surgeon have learned the techinque with the n°1 surgeon so he's kind of trustable.

He said to me that a guy from AMS will be in the operating room and he will pick the right sized implant during the surgery. He will implant a 3 piece one, but if there is too much difficulties he will do a 2 piece one. No much scar tissue made him says that the implantation will be easy for him and I will end up with a very good result. Anyway I prepare myself for 1 inch loss (maybe more?) even if he told me that the lenght will be +/- the same as before.

james1947

Ben

I suppose you get the best you can.
I will just say that I still don't understand why one should lose length or girth.
In my opinion and logic thinking, the length should be the same and girth improved.
Wish you very successfull results, easy and fast recovery.

James
Age 71, Peyronies from Jan 2009 following penis fracture during sex. Severe ED.
Lost 2" length and a lot of girth. Late start, still VED, Cialis & Pentox helped. Prostate surgery 2014.
Got amazing support on the forum

Hawk

There often is an increase in girth over the girth at time of implant back to at least your normal girth or maybe larger.  There is often a loss of length however because the vast majority of implants do NOT expand in length.  I will just pull figures out of the air for an example.  Lets say that before Peyronies Disease you were 18 centimeters and that after Peyronies Disease you were 15 1/2 centimeters.  Lets say the implant came in size 14 , 16, 18 cm and that some rear tip extenders came in 1 cm length.  IF the surgeon sizes you properly he would give you a 14 cm implant with a 1 cm rear tip extender and you would lose 1/2 cm  if he stepped it down a size either because he was in error or because he does not stock every size, he would give you a 12 cm implant with 2 or 3 rear tip extenders.  You would lose more plus you would have less inflatable cylinder in the internal hidden part of your penis and your erection would angle down but still be firm.

Keep in mind to keep this simple I did not mention that in reality if you had a 15 /2 cm penis at time of surgery you would also have a length of internal hidden penis that would add to the cylinder length but the concept is the same.  They have to give you the size just under what you have room for unless you are lucky enough to be a perfect match.

Those cylinders that do increase in length (AMS 700 LGX) apparently do not increase quite as much in girth so they do not like to use them in men over 7 inches long  A penis over 7 inches needs good girth to support it and give a firm stable erection.
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

Ben

For girth i've red that it also rare for cylinders to expand their full capacity because of penile limitation.
For lenght maybe the perfect match at time of surgery may cause cylinders to buckle if aluginea retracts after being suttured.

That's said the perceived lenght / girth during intercourse may be felt improved. WIth implant, even a bit shorter than before the lenght will not vary during intercourse. Now when I have intercourse (which is very rare) with a "so "so" erection I think I'm shorter that I'll be with an implant.

Thank you gentlemen for thoses kind words and pieces of advices and informations.