Hey guys. This is my first post on here. Some background: My Peyronnies disease first became noticeable about two years ago. At the time Iwas almost completely impotent. I had 2 arteries that were occluded in my penis and they were repaired with donor vessels from my abdomen. This repair essentially fixed my erectile disfuntion. It was an 8 hour surgery and took many months of recovery. Some months later I began to notice a stiffness in my tissue and a tightening up of my flaccid state. A Doppler was performed and it was decided I had Peyronnies. Over time my penis tissue has become less elastic in the flaccid state. In the erect state I have a 30 degree curve upward with a bend to the right. I have been using the restorex traction device and VED with success. I was able to regain some length lost from my surgery and my Peyronnies. My biggest complaint right now pertains to my flaccid state. The flaccid penis feels different than it should. Most of the time my penis is very tight and bunched up. It's almost like being dropped in cold water. When I was younger my flaccid penis would hang nicely and feel normal.Now it is constantly trying to tuck itself in. Not only does this look ridiculous but it feels terrible. My penis almost feels weightless and cold when it like this.It is kind of ruining my life. Is this what I must suffer through or is there some remedy? I have my first round of Xiaflex in April. I have been taking Pentox, Cialis and Viagra for over a year. My plaque is very palpable. It is a long band like a tendon that runs from the bottom to the top on the top side.
I'm a 34 y/o with Peyronies and Erectile Dysfunction. I'm able to have weak (80-85%) erections with little stability. Currently I'm seeing Dr.Carrion at University of South Florida. After 8 years of failed treatments with only Peyronies to show for it I decided that enough was enough and it was time for the implant. Long story short I had arterial surgery to fix both occluded penile arteries in 2016. The surgery was effective at first but after several months I developed Peyronies as a result of the trauma. Unfortunately after 2 Ziaflex injections my Erectile Dysfunction came back. I plan on having Dr. Eid to perform my implant surgery. I am concerned about erection angle with the implant. I'm young and healthy, does this have any bearing on having a good erection angle? Will my angle that I have know be what I have after the surgery? Is erection angle and stability something that can be improved upon?
Hey NagaSadow! Welcome aboard.
The arterial surgery you had was penile revascularization, or something else? Who/where have you done it, if i may ask? Dr. Goldstein from SDSM?
If you are planning on going to Dr. Eid to fix your Erectile Dysfunction with an implant, based on all the diaries i followed both from people still on this board and somewhere else, you are in very good hands.He also has an excellent resource of videos on his website as well, under penile implants. There you can check plenty of videos an read FAQ's on the subject! https://www.urologicalcare.com/penile-implants-prosthesis/about-the-internal-penile-pump/ (https://www.urologicalcare.com/penile-implants-prosthesis/about-the-internal-penile-pump/)
You also have a compilation of articles from our board with journals from members and a lot of technical information that will be relevant to you. https://www.peyroniesforum.net/index.php/topic,11131.0.html (https://www.peyroniesforum.net/index.php/topic,11131.0.html)
The erection angle does vary and there are a couple of factors at play. Your dr's videos witll give you a pretty good idea.
My first implant was a titan. I know that for several months the only positions we could use were missionary related. My erection pointed up at about 1 o clock and not very flexible. As time went on the cylinders got softer and not pumping up so much allowed me to push it down for other positions. It just took some time.
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The arterial surgery you had was penile revascularization, or something else? Who/where have you done it, if i may ask? Dr. Goldstein from SDSM?
If you are planning on going to Dr. Eid to fix your Erectile Dysfunction with an implant, based on all the diaries i followed both from people still on this board and somewhere else, you are in very good hands.He also has an excellent resource of videos on his website as well, under penile implants. There you can check plenty of videos an read FAQ's on the subject! https://www.urologicalcare.com/penile-implants-prosthesis/about-the-internal-penile-pump/ (https://www.urologicalcare.com/penile-implants-prosthesis/about-the-internal-penile-pump/)
You also have a compilation of articles from our board with journals from members and a lot of technical information that will be relevant to you. https://www.peyroniesforum.net/index.php/topic,11131.0.html (https://www.peyroniesforum.net/index.php/topic,11131.0.html)
The erection angle does vary and there are a couple of factors at play. Your dr's videos will give you a pretty good idea.
Thank you! Ricardo M Munarriz, MD and it was revascularization surgery. I'll watch those videos. This forum has been a big help.
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My first implant was a titan. I know that for several months the only positions we could use were missionary related. My erection pointed up at about 1 o clock and not very flexible. As time went on the cylinders got softer and not pumping up so much allowed me to push it down for other positions. It just took some time.
Sounds like a lot to go through. How was the recovery process for you? Why was the Titan replaced?
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Thank you! Ricardo M Munarriz, MD and it was revascularization surgery. I'll watch those videos. This forum has been a big help.
Hey Naga! I am surprised you had that surgery. Not many people do. Did you go through all the required exams nicely? I was checking him online quickly. No idea he was located in Boston!
How was the whole process to get that surgery? I'm very interested, since i was trying to have it too in the past. Managed to go to California and all for proper diagnostic on it but failed candidacy!
Quote from: pfract on May 07, 2020, 10:03:09 AM
Hey Naga! I am surprised you had that surgery. Not many people do. Did you go through all the required exams nicely? I was checking him online quickly. No idea he was located in Boston!
How was the whole process to get that surgery? I'm very interested, since i was trying to have it too in the past. Managed to go to California and all for proper diagnostic on it but failed candidacy!
I did. If I could do it over again I'd get the implant. If you have Peyronies it's just a matter of time before it causes Erectile Dysfunction or makes it worse. Not to mention the size loss.
As far as erection angle goes, I think not using or only using a very small RTE should give you your natural erection angle.
I know Dr Eid uses minimal or no RTEs.
Hey guys I'm finally getting my Titan implant installed. Any last words, thoughts, prayers before I go under? LoL 😆
good luck Naga! I can only imagine how exicited and scared you must be about this. :D
Good luck also! Quick recovery and keep us posted.
Best wishes to you!
You are safe with Dr. Eid, one of the best implant surgeons in the world. Relax.
Good luck Naga. I recently consulted with Dr Eid and will have penile implant surgery by him later this year. Let us know how things go.
Tshug why are you undergoing another penile implant surgery if you already have one. Do you need a revision?
Gaussrifle, unfortunately my surgeon here in Boston undersized my implant and has left me with what can be best described as a Concorde jet look where the head drops down when the implant is inflated. The tips of my current implant do not extend into the head of the penis. It sucks, but after meeting with Dr Eid he does feel it can and will be corrected with a correctly sized implant.
First of all I am aware that I need to update my last post on here with more information about my case and I will do that. I'm typing this on my phone. When im more comfortable I will use the computer to give more details. Im a 34 year old guy who basically went through 10 years of hell to get to where I am now. Basically I had a bicycle plus a separate sexual accident that led to a gradual decline in my sexual function. In 2016 I got help and was sent by a regular Urologist to a teaching specialist, Dr. Carrion at University of South Florida in Tampa. He is one of the best in the world especially when it comes to ER Trauma but his approach ultimately lead me to Dr. Eid. They sent me to Boston to get my Arteries repaired as both were occluded. This surgery was performed by Dr. Munarriz, a class A a$$hole. This surgery (Penile Revascularization) was much more traumatic than the implant and was pure torture. This doctor provided me with no post op instructions and they wouldn't answer my calls. This was bad because two months later I moved to a foreign country for a year. I basically went from 7.5 inches down to 5 and my doctor acted like that was fine. As a result of this surgery I developed Peyronies Disease. After that I was given the restorex device and it worked well at restoring some length. Then to treat the mild curvature and massive plaque I had they used the Ziaflex injections that put me in the ER 3 times with severe pain and swelling. It did end up straightening everything somewhat. So I am left with a large hematoma scar on the base that Dr. Eid will fix down the road. Because of this forum and you wonderful people I found Dr. Eid. He did the surgery on April 16th 2021. So 8 days ago. Ive been following the instructions but I worried there is a problem and its not deflating entirely. Also in regards to the Penile Revascularization Surgery, it's rarely done anymore and is very dangerous! Don't even consider it! Thats according to Dr.Eid.
I am so glad you are posting. Your warnings and your progress are vital to other men on this journey. I have NEVER heard of penile vascular surgery with a good outcome. One or two ended up with temporary improvement only to end up at square one. Many were a nightmare.
Quote from: Hawk on April 24, 2021, 02:41:20 PM
I am so glad you are posting. Your warnings and your progress are vital to other men on this journey. I have NEVER heard of penile vascular surgery with a good outcome. One or two ended up with temporary improvement only to end up at square one. Many were a nightmare.
Hi Hawk, thank you for your kind words. I feel I have a lot to offer and would love to help others as much as possible. I'm finally on the good side of all this but I want to get my post op just right. Deflating is proving to be difficult. That Revascularization surgery is terrible and is only being performed by bad doctors.
Welcome to the forum NagaSadow! Your postings are welcomed here. We have all had our dealings with penile problems, peyronies, Erectile Dysfunction etc...... You will help other men in their quest for knowledge and direction. :) Mike
Naga, thank you for your update and warning on Revascularization surgery. Also thank you for your thoughts and impressions of Dr Munarriz. When I had my appointment with Dr Eid he mentioned Dr Munarriz as a highly qualified penile implant surgeon in Boston in case I wanted to have my surgery closer to where I live. Dr Eid said he had written papers with Dr Munarriz in the past and that he does many implant surgeries every year. I plan on having my surgery later this year with Dr Eid, but scheduled an appointment with Dr Munarriz for next month to get his opinion on my first implant and his thoughts on replacing it. I'm looking for a second opinion because I still want to address the mistake made on my first implant by my other surgeon. I'm not looking to sue, but have the hospital address his mistake so that other guys don't have to go through it. It will be interesting to hear what Dr Munarriz has to say, but I will still plan on having Dr Eid perform my replacement surgery.
Quote from: tshug on April 25, 2021, 10:35:31 AM
Naga, thank you for your update and warning on Revascularization surgery. Also thank you for your thoughts and impressions of Dr Munarriz. When I had my appointment with Dr Eid he mentioned Dr Munarriz as a highly qualified penile implant surgeon in Boston in case I wanted to have my surgery closer to where I live. Dr Eid said he had written papers with Dr Munarriz in the past and that he does many implant surgeries every year. I plan on having my surgery later this year with Dr Eid, but scheduled an appointment with Dr Munarriz for next month to get his opinion on my first implant and his thoughts on replacing it. I'm looking for a second opinion because I still want to address the mistake made on my first implant by my other surgeon. I'm not looking to sue, but have the hospital address his mistake so that other guys don't have to go through it. It will be interesting to hear what Dr Munarriz has to say, but I will still plan on having Dr Eid perform my replacement surgery.
You are going to the right guy. Dr.Eid is number 1, period. He literally gives you his cell phone number to call anytime. He also has helped the other top 10 doctors.I would tell anyone that it doesn't matter how far away from NYC your are that your only option is Dr. Eid. Dr. Munarriz is a pure ass who's only motivation is academic accomplishment. Anyone who was still practicing Penile Revascularization in 2017 or later is a dick. My father who is an MD joined in on the questions prior to surgery was blown away at how rude and curt he was. He didn't want to answer the hard questions about efficacy. After the surgery he basically left me with self tugging exercises to prevent shortening. In reality I should have been given the Restorex device. I was butchered and lost 2 inches. Dr.Munarriz also refused to talk to me after my surgery and blocked me completely. Sorry for the rant.
Naga after what you went through you don't need to apologize for ranting it's understandable. I have the same feelings towards my first surgeon and after reading your thoughts on Dr Munarriz I'm having second thoughts about consulting with him in June. Thanks again for your input!
he basically left me with self tugging exercises to prevent
Naga can you share in description these exercises??!! Greatly appreciated!!!
Basically if I can remember correctly: I was to keep my flaccid penis stretched for a few minutes after peeing. Preferably over 3 times daily. This is worthless and does nothing. What should have been done is 3 times daily use of the Restorex device over 30 minutes a day. There should have been a stay home requirement for this as well instead of sending me back to work in a week. I can tell you from experience that the Restorex device is powerful if used properly. This doctor didn't give a crap about post op because he only cares about the surgeries and the papers.
Quote from: tshug on April 25, 2021, 08:57:36 PM
Naga after what you went through you don't need to apologize for ranting it's understandable. I have the same feelings towards my first surgeon and after reading your thoughts on Dr Munarriz I'm having second thoughts about consulting with him in June. Thanks again for your input!
Thank you! Means a lot. It sounds like your first surgeon made a mistake. I'll be honest, there are only a handful of people on earth who can do this surgery properly and Dr. Eid is their master and teacher. Everyman with Erectile Dysfunction should see Dr. Eid. He can also fix the mess other surgeons created. He will teach you about your unique situation the way no other doctor will and he will give you his cell phone number after surgery. Very few doctors do this.
I understand you point NagaSadow, but that is not correct. I have heard of other doctors doing that too, to their patients. But i do agree 100% that Dr. Eid is a top doc in it's field and deserves all the recognition that he can get.
I hear you. In my experience and my father's and mother's experience as medical doctors this almost never happens. With post op implant surgery you're going to have dozens of questions, sometimes in the middle of the night. It's so important that it can be one of the greatest services a doctor can offer.
I am not sure what we are discussing here, but if it is a doctor giving out their cell phone number and responding on evenings, nights, weekends, and holidays. I agree with Naga.
I have dealt with many top-notch doctors, including world-renown cancer doctors in Manhattan and Johns Hopkin. I have been a patient advocate for many people and accompanied them to medical appointments. I have never seen a doctor who made himself that accessible to his patients, not even close. I, of course, can't say no doctor in the world does it. I am sure there must be some somewhere, but I have never seen it in my 70 years of exposure. It is certainly rare to unheard of..
Agreed!!
Update Day 11 Post Op:
Walking around for extended periods is still painful even with Tylenol with Codine. I'm still fairly swollen in the testicles. Laying down on the bed with the heating pad, a bag of frozen peas, or taking a bath seem to be the best remedy. Cycling the device is incredibly painful but it must be done. I still can not pump it up to 100% because of the pain. The most tender part of the entire area is still the pump mechanism in the scrotum. I've been eating berries and grapes due to their antioxidants which are good for healing. I experimented with Arnica Montana for the swelling and I do believe it helps. Hopefully the pain gets better in the next 4 days. I get my stitches out by my GP doctor on Friday April 30th 2021 (Day 14). I'll update tomorrow (April 28th) on my pain and healing.
All sounds exactly like it should be at this stage.
You might consider a cold pack of the scrotum since everything is getting hot soaks every day. I would use cold and lay flat. A small cushion under your butt will elevate your scrotum relative to the rest of your body. I also think it is critical you lay as flat as possible during hot soaks. I noticed if I sat up with my upper body well above my scrotum with my scrotum in hot water that it had the reverse effect and promoted swelling.
It seems like Friday is a week early with stitches. I am pretty sure he told me 3 weeks before removal.
I recently got in touch with a 70 year old patient from The Coloplast Network. He told me to use a bag of frozen peas which I've been using to good effect. I just talked to Dr. Eid and he said 2 weeks or later but not less. That would be Friday for me. I'm in no hurry, maybe I can wait until Monday.
That gives you a week to schedule it when the most attractive nurse is on duty to remove the stitches. I hit the absolute jackpot when I got my stitches out. ;D We discussed my "nice semi-erection". She said she never had a patient with an implant to her knowledge and seemed interested.
Quote from: Hawk on April 27, 2021, 05:03:43 PM
That gives you a week to schedule it when the most attractive nurse is on duty to remove the stitches. I hit the absolute jackpot when I got my stitches out. ;D We discussed my "nice semi-erection". She said she never had a patient with an implant to her knowledge and seemed interested.
You lucky guy! I'm afraid my encounter will be with my old overweight male doctor, not even close to what you got! lol!!
Update:
Post Op Day 13
Overall the pain is almost gone completely. It was still painful when I cycled the device and I still can't pump to 100%. I'm still taking baths and icing even though it might be unnecessary. I'm wondering how much longer the jock strap will be needed to keep the penis in the pointed up position. Maybe you guys could answer that. I'll be getting my stitches out tomorrow from my poor GP. I've found using Arnie Care Gel really kills the pain.
Hi Naga-
It's good to see the pain finally subsiding. I definitely recommend reading Merixx's journal for a very detailed timeline of what he went through post-op. He really deserves an award for it and I suspect it will answer many questions that lie ahead.
I would like to ask how Dr.Carrion failed you? If you are uncomfortable answering in public, feel free to PM me here. My husband is considering him for implant surgery based on Dr. Eid's recommendation.
I hope day 14 is even better!
Hi there! First off, Dr.Carrion is the best Dr. in Florida for all things Urology related. He is a true teaching doctor and is a genius. In hindsight going directly to a implant was the answer. To his credit Dr. Carrion exhausted every method of treatment before recommending the implant. In hindsight 2 of these treatments shouldn't have been done. The Revascularization Surgery which to my knowledge isn't being done anymore and the Xiaflex injections.My path with him went from 2015 to 2021 without any resolution of my Erectile Dysfunction. As a result of the Revascularization surgery I got Peyronie's Disease which in turn made the the whole Erectile Dysfunction problem much worse. The Xiaflex shots straightened me out at a huge cost. Massive hematoma scar and worsened Erectile Dysfunction. All of that took 6 years. He's a great Doctor but my case went on too long. I would personally not go to anyone but Dr. Eid. Convenience and money be damned. This is a surgery very few surgeons get right. See Dr.Eid.
NagaSadow, are you happy with the flacid angle ? There are some members that are complaining about the flacid angle and how difficult it is to hide in underwear ?
No One is happy with the flaccid angle of a Titan implanted penis at day 14.
Ok Hawk, then how many months later are people happy with reasonable conconcelability ?
It's a weird anomaly that some have issues and others don't. I never had an issue, my flaccid is just like it used to be, and really was once my initial swelling went away
Quote from: gaussrifle on April 30, 2021, 01:02:34 PM
NagaSadow, are you happy with the flacid angle ? There are some members that are complaining about the flacid angle and how difficult it is to hide in underwear ?
I'm at day 14 post op. I talked to Dr.Eid and he says I can drop the jock strap. I did that and I ended up with some awkward moments at the mall. If you put your penis in the down position people will notice for sure. You don't want some dad kicking your butt in a mall over your "boner". I went back to the jockstrap for now. I know it takes a long time for it to smooth out. Pro tip: wear a soft surgical pad under under your penis to protect it from the abrasive jock strap torturing you all day.
This is what Dr.Eid told me about this problem:
"there is still much edema and inflammation around the cylinders inside the corpus cavernosa and this will dissipate gradually in the next 8 to 12 weeks. This will greatly improve the feel and look of the flaccid penis with the cylinders deflated. Also the Bioflex elastomer of the cylinders will absorb body fat and will become much softer over time. "
Quote from: TDix on April 30, 2021, 03:52:55 PM
It's a weird anomaly that some have issues and others don't. I never had an issue, my flaccid is just like it used to be, and really was once my initial swelling went away
There is high strangeness with Erectile Dysfunction and it's treatments in general. Prior to the implant on 4/16/21 my flaccid state would shrivel up completely and feel terrible if I wasn't taking Cialis. I had some folks tell me it was Hard Flaccid. Whatever it was I don't have to deal with it now. As far as what to wear I'm definitely having issues with it pointing down. It sticks straight out. LoL.
I had this typed out a response the other evening, but with several other posts, admin duties, and the forum open in several windows somehow, it never got posted. It is a repeat of one of my old songs.
I know Dr. Eid says you can get rid of the jockstrap, BUT personally, I would NOT wear my penis down. I would either angle it up in the crease of my leg, OR I would angle the base up and bend the shaft down about an inch from where the base enters the body. /\ This graphic looks like it is bent at mid-shaft, but you get the idea. This puts no downward modeling force on the crus scar capsule.
Why would I do this? Because I strongly agree with Merrix in his phenomenal journal. I do NOT think that the crus is totally scared in, healed, and stabilized. Downward pressure on the crus at this point will mold it some, and your erection angle will not be as high as it could be. You might ask, what is my proof.
Answer: Absolutely none. I won't pretend differently, but this is why I think this.
No section of the penis, scrotum, or reservoir is totally healed. Why would the crus be totally healed? As your flaccid angle drops, you WILL see a corresponding drop in your erection. More than one man who made detailed observations and notes Post-implant feels there is a connection between wearing your penis down early and a lower erect angle. If there is even a chance this could be correct, it is reason enough for me to wear my penis up.
Quote from: gaussrifle on April 30, 2021, 03:10:07 PM
Ok, Hawk, then how many months later are people happy with reasonable concealability ?
It is not just about concealability. It is not a binary thing. It might be concealable but look too erect for a public shower. It might be concealable, but not comfortable wearing it down. Every individual, every surgeon, every approach (scrotal, retropubic, coronal) are all different. It also varies greatly between the Titan and the AMS LGX.
The best source of that answer is in the journals of the men who have had implants.
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Excellent points. I'll keep wearing the jockstrap as long as needed. How long should I wear it?
Quote from: Hawk on April 30, 2021, 10:57:22 PM
It is not just about concealability. It is not a binary thing. It might be concealable but look to erect for a public shower. It might be concealable but not comfortable wearing it down. Every individual, every surgeon, every approach (scrotal, retropubic, coronal) are all different. It also varies greatly between the Titan and the AMS LGX.
The best source of that answer is in the journals of the men who have had implants.
Yes there is incredible value in reading these journals. Especially Merixx's Journal. I have been wearing the jockstrap which makes this a non issue for me minus that one day I chose to wear it down. My incision was scrotal with the Implant was a Coloplast Titan. With 21 and 22 cm cylinders for those that don't know. I'm confident that as my scrotum swelling goes does that things will get better and everything will start to look more normal. I'm betting on that taking 12 weeks based on previous surgery and Ziaflex injections.
I do not think you necessarily have to wear a jockstrap. Just avoid putting downward pressure on the crus. I personally
Would not but downward pressure on the very base of the penis for 6 weeks.
You are also right. Merritt journal is worthy of being published. It is the literally the most definitive penile implant journal in the world.
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I'll shoot for 6 weeks then. It's good to know I might be a able to move on to some more conventional underwear. I'll keep mining Merixx's journal for information at this stage of the game (16 days post op).
I do the same! Those journals are big time help and keep me motivated to write about my experience.
Day 28 Post Op
Still significant pain when inflating all the way, masterbating, or having sex. I'm cycling the device 2 times daily for 45 minutes. I'm still wearing the jockstrap because it does a better job that underwear at keeping things supported and contained.
Naha, I like your posts. I think the older crowd on here, to which category I fall into, is more reserve in their posts sometimes. I appreciate your frank statements.
I had problems keeping my penis upright too, so I wore a jock too for quite some time. For me it was the most comfortable.
I am amazed how some guys say they don't have pain. I had pain for a long time. It is just the way we heal, we are all different.
Stay strong and you will love your new improved tool.
To this day, when i am ducking, and I take a look of my tool going in and out of my spouse, I still think that it is thick, it doesn't look like my tool.
Best wishes,
StepOne
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Thank you Stepone for your kind words. I am a pretty forward person and I can see why some might not like my style. I'm going to have to get a new set of jockstraps lol. I'm putting them through the paces. I'm now on day 32 post op and I can only stay fully inflated for 20 minutes tops. It is amazing how some on here heal so quickly. I believe my future is bright and I look forward to a day when I can #uck like a jackhammer.
Naga,
You are right about healing and pain, all of us are different.
As far as pumping, I pumped in my jacuzzi for probably the first two months.
The warm water and the water movement seemed to take my mind off it. I also would have a beer and listened to talk radio which also kept my mind off it.
As time went on, I was able to pump it up and walk around naked as soon as I got up. I eventually got up to 1 hour.
It took me longer to be pain free, but at 25 months, it's no problem at all to stay pumped for an hour.
I experimented with several different jocks and found the larger size to be more comfortable. I sometimes would put a thin sock on my cock to make it more comfortable too.
Even now, sometimes I will wear tight boxers or low rise brief to keep my cock in one place. It all depends on what activities I have planned.
Good luck and be adventurous Lol
Hope you can soon use it.
StepOne
Wish I had a jacuzzi lol. I've moved to tight boxer Briefs and I wear it down now and I've definitely got some happy looks from the ladies lol. Before this my Flaccid would be in a shriveled state if I want taking my Cialis. Very strange. I haven't talked to anyone else who experienced this. I think it was a combination of Hard Flaccid, Peyronie's Disease and the many medications I was taking for Bipolar Disorder. The Meds by themselves made sex a rare adventure. The Titan has fixed all these problems and I'm happy.
Some would disagree but I would avoid bending my deflated penis down for at least 10-12 weeks. I think it will lower the angle of your erection because it puts pressure on the healing scar capsule forming around the base of the implant in the crus.
I would angle it up to one side or the other in your leg crease. Also, make sure you are TOTALLY deflated.
Naga,
I agree with Hawk.
My surgeon told me to keep it pointed up at all times. You can find tighty whities that will allow you to point up without going under the waist band, lol.
My surgeon specifically told me to wear it up.
StepOne