Does anyone have any info on graft contraction/retraction/thickening?

I have had this issue for a while where (as per my surgeon's advice), one cylinder inflates more than the other, due to the graft contracting on one side.

I have been told that tachosil graft sometimes does this and it may improve over time with cycling or may not.

Does anyone have any info on this or recommend a surgeon that might be knowledgeable about this? I can't seem to find anything online.


Thanks,
J

Jj21,
I had grafting done in a surgery prior to implant and it caused shrinkage. At the time, I was told this would not happen.
But years later when I did get an implant, my surgeon told me the implant could stretch some of the loss in length, but he could guarantee me increased girth.
I remember when I first started pumping, the side
Of the graft hurt more.
I never noticed a difference in length.
When you pump to maximum, can you visually see a difference?
I don't understand how one cylinder could fill differently.
It would seem to me that unless a tube is twisted, they would both fill equally. Even at that, I would think if you pumped to maximum, they would both fill equally.
Curious
StepOne  

Quote from: Stepone on October 08, 2023, 09:06:08 AMWhen you pump to maximum, can you visually see a difference?

Hey Step,

Yes, there is a visual difference when fully pumped where the right side is flat and a bit softer; the left side is thick and round. The surgeon says this is due to the graft retracting on the right side, but when speaking to him, he also said that he never wrote which side he put the graft in his operation notes.

It use to be normal until about 2-3 months post-surgery.

Due to the loss in girth on the right side, it makes TEP, not worth all the trauma. I guess, all I can do is wait and see if it fills from cycling. Just couldn't find much info, and wasn't ever even aware that this could be an issue. I found a guy on FT with similar issue, but due to his tunica being scarred on one side, Dr Eid advised that after a year of cycling it will most likely fill, and that's exactly what happened for him.

J

When you cycle, I would be sure to FULLY inflate to the degree possible. After several minutes of inflation, I would give a few more hard partial pumps.

Hey guys,

I am wondering if anyone has ever come across these two issues before, keep in mind I am about 9 months post surgery and 4 months post partial revision (changed placement of pump and removed fluid from reservoir, no other work done).

1. There seems to be tubing behind my right testicle which is pushing the testicle forward and up, the deflate valve is also underneath he right testicle pushing it up. Sometimes it pushes up into my pubic bone area when laying down. Now, I sometimes have pain and discomfort in my lower right side abdomen to my right side scrotum.

This is quite uncomfortable, and I regularly need to lay down. It can be very troublesome when wearing tight clothes. I have heard of some people on FT with this issue. They are 60+ and I don't think they're as active as I am so they have just learnt to live with it.

Can anyone advise if they have been through this before?

2. When fully inflated the two dog ears seem to stick out still, although in a different way than when flaccid. It's like a bulge to the right on the right side and a dent on the left side with a bulge. This causes the inflated penis to bend to the left.

Has anyone come across this before?

Other issues are still the same, pain is very slowly subsiding. I will do a proper review once I hit 1 year from surgery in Feb 2024 and 1 year from revision in June 2024.

Things have been a bit tough, one of my best childhood friends passed away at only 34 years of age, I will be doing a speech at his funeral in 2 days and I would like to be out of discomfort when wearing a tight suit, but I guess I may just have to deal with it.

Any advice is greatly appreciated.

J

 

Jj
I continued to have pain for over a year, but it was sporadic or it would happen if I had a long sex session.
The dog ears are still present, but do get softer over time.
I have some tubing that I don't particularly care for, but I have accepted it.
I had problems with the pumps position for about a year, but that too has settled into a more comfortable position.
Sadly, I have always had small testicles, so I have had little problems with them and the pump/tubing.
I don't think You never mentioned this issue before, so what has changed?
 
Healing is a long and complicated process.

I hope things settle down.
StepOne  

Sorry about the loss of your friend J. 34, so young. Rest in peace.

Sonic - Thanks a lot for your kind words. This whole year has been quite tough.

Step - I always complained about my right testicle being hit by the valve and pushed forward and up, I moved my finger around the testicle and realised that there is also tubing behind the right testicle which is pushing it forward. It's good to know that things settled for you after a year, maybe I just have to wait it out. A lot of people are fine after 2 months, so I have been worried. But, I guess, everyone heals differently.

Thanks again.

J

I wish I could share similar experiences to give some advice, but I have never had any of these issues other than dogears in the first several months when deflated.

I cannot understand how you can possibly have dog ears fully inflated unless your implant is considerably oversized.  If the cylinders are inflated, they simply cannot fold.  They are very firm, smooth cylinders without any exception. It sounds like they are never fully inflating because they are too long to straighten out within the confines of your penis.  If that is true, the only solution is to hope you can force more length expansion through cycling and VED.

Hey guys,

MRI results are in, no major abnormalities other than the following:

1. The reservoir is on an angle and slightly scrunched. This could be the cause of the auto-inflating. The urologist advised, there is nothing we can do about it. I assume its not worth another surgery, and this urologist doesn't seem to think that erosion of the tips from auto-inflation is a possibility.

2. Fluid around the pump. The original surgeon when performing the revision also noted this. The urologist I am currently seeing advised that this is no cause for concern.

3. No infection, inflammation or inflammation of the prostate was indicated.

The thing I did do, due to some extenuating circumstances, I took ciproflocaxin, colchicine and naproxen (strong anti-inflammatories for prsotatitis). About four days prior to the MRI, I stopped all these medications. Since then, I have not had any prostatitis flare ups. I am wondering if this skewed the results. Either way, the prostatitis has stopped for now.

Length/Girth

I am cycling about 45m - 60m (includes 15m VED in the session) a day, 5 days a week . I will eventually increase this to 2hrs a day 6 days a week. My length is the same, about 1cm less than my pre-op length (with engorgement + implant fully inflated).

In regards to girth, I have not measured as, the graft retracting on the right side makes it difficult to measure. It's also a bit disheartening, I went through the trauma of TEP for girth restoration and my girth has been compromised due to graft retraction. My current urologist advised that this is common with TachoSil graft and that this should subside about 12-18 months after surgery.

Other issues are the same, sometimes I have pain, sometimes a lot of discomfort when wearing tight clothes. Right testicle is pushed up and forward in the scrotum due to tubing and the deflate valve. May subside in a few more months, we will see.

Final thoughts

I will do a better journal entry with some pics when I hit 1 year from my surgery, and again when I hit 1 year from my revision. All I can say is that, I really think it's worth going to a top surgeon in the U.S.A. High volume surgeons in Australia still only do 75-100 implants per year; this would be considered a low volume surgeon in America.

Just from having one consult with Dr Hakky, I can tell he is much more knowledgeable, concerned, and actually has come across a diverse range of issues when it comes to implants.

I haven't tried to have sex again as I just do not want to risk any more pain. I usually get numb after 20-30m of sex, and after ejaculating, I am in pain throughout the shaft and scrotum for a few hours.

I am a bit concerned that the device auto-inflates and there is really nothing I can do about it. Dr Hakky did advise that he could tell me a lot if I did an MRI, and that he could assess if the valve on the reservoir (not the deflate valve in the scrotum) was causing auto-inflation (which does happen). A consult with Dr Hakky will cost me $800 AUD, so, when things are better, I may book a consult with him and send him the MRI results.

The device auto inflates a bit, to the point where the dog ears are still there, so, I assume this isn't too big of a concern? What are you guys thoughts?

Something to remember

All you guys, especially younger guys, who aren't implanted, just remember - you want to avoid surgery in this area for as long as possible. If complications arise, they are very difficult to ascertain and fix. Further, the more surgeries you have, the more scar tissue, and (with some surgeons) the higher the risk of infection.

Final Final Thoughts

I think the best thing for me to do now, is to just cycle regularly and wait. Focus on my career an saving money so that I am never in this position again. If/when I require a revision, I would just be able to fly to America and use Dr Eid, Dr Clavell, or Dr Hakky.

This year has been a lot, 2 surgeries, prostatitis, was out of work and gym for months, then my childhood friend passed away at 34. Hoping for some better days.

Appreciate all your support and any advice. Always here if anyone needs.

J

If I were in your situation I would have to wonder if forcing the reservoir full by deflating and using a wrap on my penis would:

Stretch the reservoir capsule and encourage the reservoir to unfold.  I would figure I would have nothing to lose by trying.

Question:  Am I correct in understanding that with the TEP you are slightly shorter than you were the day before the TEP surgery?

Quote from: Hawk on November 04, 2023, 12:23:38 AMQuestion:  Am I correct in understanding that with the TEP you are slightly shorter than you were the day before the TEP surgery?

Yes, that's correct Hawk. Although, I haven't reached 1 year from the procedure yet. I also still get a lot of pain when cycling, maybe it will stretch more, will report back in a year.

Also, I have tried the coban wrap method, I did it for maybe 3-4 days. I  might try it again for a bit longer.

J

I wonder what causes your severe pain after sex. I really wonder if this is the implant itself or more related to the prostatitis.

Jj21 I have a question too.
Why did they remove solution when you had your revision.
I don't understand how there could be too much.
StepOne  

Sonic - I wish I knew too. The MRI showed no abnormalities, so, perhaps it is chronic inflammation? It is specifically after ejaculating.

Step - My reservoir was indented into the bladder, so, the original surgeon when doing the revision removed some solution. I was advised that, the indent into the bladder could be causing the prostatitis.

The MRI did show that the reservoir was kind of scrunched, this could be what is causing some auto-inflation, maybe irritation or inflammation? I really don't know.

I am kind of stuck, all I can do is wait it out and see how things are a year from surgery (Feb 24). If there are still issues, my only option is to save up and see one of the recommended doctors in America.

J

I wanted to post something positive here, amidst all the issues I have had, the scrotum skin which seemed attached to the pump seems to be better. I believe the skin by the incision site had thickened and was still very tender and sore. Over the past few weeks this has been improving and it is becoming a little bit easier to pump.

I would also like to add that, despite the fact I am 1cm shorter than pre-op, I would be happy if the retracted graft issue resolved. If the retracted graft resolved, I would still have a +5.3 inch girth and close to 6.5 inch penis which I would be happy with.

Over the next 7-8 months, with cycling, if I gained back 1-2 cm, that would be a bonus for me.

Anyone have any info on retracted graft or know of any surgeons who have dealt with this, I would really appreciate it. I might put up some pics later on.

Thank you all for your continuous support.

J

Glad to hear you're seeing some improvements brother. Have you noticed any improvement with the other side expanding fully? I think I remember reading before that one side wasn't inflating as much.

Quote from: IwillbeatPD on November 15, 2023, 09:56:24 AMHave you noticed any improvement with the other side expanding fully?

Appreciate your support brother. Unfortunately, haven't seen any improvement with the other side expanding fully.

The surgeon stated that it is due to the TachoSil graft which has retracted/constricted. But, he also did not write which side he placed the graft in his notes, so, it could be another issue?

Haven't been able to find much info on retracted graft online. No one else seems to have experienced this issue.

If this issue resolved, I think I would be happy with the result, considering that the pain/discomfort will eventually subside.

Might post some pics up soon.

Wish you the best for your procedure soon! Keep us updated with your journal.

J

Tachosil is eventually absorbed by the body right? If so, I think you'll have you answer with time once that happens.

Ok, I know what Tachosil is, but why are you posting it here?
StepOne  

Step - A TachoSil graft was used during my implant.

IwillBeatPD - Thank you. I am very hopeful that will happen. My understanding was that it takes 3 months to be absorbed, I am at 10 months now. But, another urologist said the same thing as you, that at 18 months it should resolve. All the best for your implant later this month! You made the right choice with Dr Hakky.

Something to note - I read a study regarding using grafts during implants, it states that in some cases, the graft retracts and curvature returns. The study advises that surgeons should use extra grafting to ensure this does not happen. When talking to your surgeon, I think it is important to note whether they will use a graft, what type of graft, and whether they take these precautions to avoid graft issues.
J

Could I just get some advice please from some knowledgeable members.

My erection angle lately has improved by going above 3 o clock. I noticed a few weeks ago, I would sleep on my stomach and my erection angle was going below 3 o clock. I noticed due to cycling every day.

If I sleep on my stomach (pressure on the flaccid) my erection angle will go below 3 o clock for a few days, if I cycle hard, and keep my flaccid up, the erection angle will go above 3 o clock, once even 2 o clock which was surprising as this has not happen since early on.

Do you think this is a sign of my crus not being fully healed? I am 11 months post-surgery.

Thanks as always,
J

Hey bud,

I don't know if I qualify as knowledgeable, but I would imagine you're long healed by now. 11 months is a very long time. The only way I could imagine it's not healed is if you injured it or something. I know I said this before but I really think you'd benefit a lot from the helicopter exercises when flacid. Since your main goal is to get your flacid angled down, I'd wear it down at all times. Id also focus more on the down angle when doing helicopters. Lastly, idk how I feel about sleeping on your dick though. I feel like that could be alot of pressure? I think I'll always be weird about laying prone now- but then again I've never been a stomach sleeper. I'd be interested to see a visual of what your problem is though. Like can't you crease your dick near the base and make it go down? I guess I got lucky with mine creasing there because it just happened early on, didn't have to do anything.

But since then, I constantly change the angle of my flacid, sometimes it's left, sometimes right, sometimes up. I can't wear it straight down because it's too long and hits the bottom of my briefs or pants.

Quote from: IwillbeatPD on December 14, 2023, 08:33:11 PMLike can't you crease your dick near the base and make it go down?

That's exactly right, my flaccid does not crease at the base, it sticks straight out for about half an inch from the base at about 3pm then creases down. So, that's why my flaccid in tight clothes can look like an erection, a part of it is sticking out. Hopefully that makes sense.

I had a partial revision where the right cylinder was taken out and right side of the corpora was dilated, maybe the right side of the crus healed differently?

Thanks for the advice. I just started Perito exercises, will incorporate helicopter exercises too.

I've got a video consult with Dr Hakky on the 22nd Jan, will see what he advises as well.
 

I think there is no way that your crus is not scarred in and healed almost a year after surgery.  It also makes no sense that how you sleep determines the angle of the inflated or the deflated penis.  However, regardless of how you sleep, the angle that you maintain your penis does, in my opinion, affect the angle.  Furthermore, the inflated angle and deflated angle directly correspond with each other.  If you work on getting a lower deflated angle, you will likely also decrease your inflated angle.  That is why I always stress wearing the penis in an up position for several months post-op.

I won't comment much on Perito because I have no respect or confidence in him.  You will notice, however, that he specifies bending the penis above the base, not at the base.  The crus can be compared to the hole that you plant a fence post in.  If you stretch out the scar capsule in the crus, then the post will wobble, and your angle will drop.  As your cylinders become more flexible, your penis can hang down because the flexible cylinders droop or bend, NOT because they exert stretching on the crus scar capsule.

BTW, most of the softening of the cylinders is because they are hydrophilic.  They absorb fat from the body, not because of bending, although it probably does no harm as long as you are bending out from the base, not at the base.

Thanks Hawk,

I am just looking for answers, I still have a few issues with my implant (pain, pain after ejaculation, sore/tender frenulum etc) which has been really affecting my quality of life. After reading all the journals, I know this is not normal. However, there is no doctor in Australia experienced enough in TEP/sub-coronal incisions and implants to assist.

Dr Hakky did advise that he has seen some of these issues before and they are common with TEP and sub-coronal incisions, which is why he stopped doing them. I have a consult booked with him on the 22nd Jan, but there is only so much he can assess via video.

If these issues don't subside by June 2024, I may opt for a revision with Dr Hakky (if he thinks a revision will help), will set me back about 50k AUD. Only other option is to remove the implant and give up on a sex life for life, which I am not willing to do.  

J

My intent is not to sidetrack your topic.  If it does, I might delete my post and any responses to my post.  It is also not my intent to have you waste energy second-guessing your decision.  I just want those who read the forum to consider all the facts.  Let's be honest.  At least 99% of men want a larger penis. Dr. Eid jokingly introduced me to the staff in the OR by saying, "We have an extremely unusual case here.  Hawk would like me to slightly reduce the size of his Penis. We all laughed at the absurdity that ANY man would ask for that. I think women's worst nightmare would be if men got to pick their own penis size.

As someone who lost 2+ inches in length due to Peyronies Disease, I understand the desire to regain every possible centimeter, if not every millimeter.  I personally, however, think TEP is very risky for what you get out of it.  Keep in mind that I regained an inch of my lost 2" with just a standard 25-minute implant surgery.

I really hope you get some improvement J

I agree 100 percent with Hawk and I had the same issue with Peyronie disease and a Nesbit surgery. Both of these problems caused me to lose 2 inches also.
The implant restored 1", but more importantly it gave me increased girth and a rock hard penis.
If you look at what women look for, it's all about how you do the deed, not the equipment.
StepOne  

One other comment J-

I know you mentioned a revision. I'm not saying you have a perfect outcome, and maybe things didn't go exactly as planned. But if you can have a sex life, and you're not miserable, I'd leave it as is until you NEED revision. Only you know how much this is affecting your quality of life. But I personally wouldn't opt for a revision unless I legitimately could not have sex. Or, if I was in real pain 24/7 or something that altered my daily life. I thought I read things got a lot better for you. Not perfect, but good enough right? With more time I can only imagine things will continue to improve.  

Thanks guys. I do agree, I think TEP is overrated, and the most you gain back is maybe 1 cm? Not worth the risks. I would also like to add that, the surgeon who did my surgery, advised another patient who I met on this forum (user Morphball)  that he performed a sub-coronal TEP where they actually had to amputate the glans due to a complication. Had I known this risk, I may not have gone ahead with a sub-coronal incision. Imagine going through peyronies, then TEP and an implant with the anticipation of regaining your size and getting your life back, to wake up from surgery with amputated glans (my heart goes out to that person).  I am not sure why my surgeon did not advise me of this risk, maybe it happened after my surgery. My question is, knowing these risks, why do these surgeons still perform this procedure? This is where I have respect for Dr Hakky, he will not perform TEP anymore due to the complications associated with it.

Things have been slowly improving, the improvements are very slow. There is still pain and pain after ejaculation. The flaccid angle hasn't dropped and the dog ear sticks out which makes it difficult to wear clothes and do activities that I would normally enjoy. It's been difficult to stay positive when you're constantly reminded by the pain or by being conscious of having to wear long clothes to hide a pointy flaccid with a dog ear that sticks out and looks like an erection. I enjoy going to the gym, having a social life, and I use to work in a professional environment wearing a suit. These are difficult to do with my current flaccid. Another user here mentioned that I should just wear 2 compression briefs and leggings, and although I appreciate the advice, it's 40 degrees celsius in Australia (104 farenheit) and humid as hell. There comes a point where the solutions are impractical and one must consider whether a revision is worth it. I was also advised that it may not be worth the cost going to America and getting a revision. Another user on FT advised to just wear a leg bag everywhere? Is this really practical? Wear a leg bag covering my crotch constantly? One must evaluate, do I live the rest of my life wearing 2 pairs of compression underwear and leggings and sweating every time I want to go out, or work in a professional environment? What about when I have kids and grandkids, how should I interact with them each day trying to cover what looks like an erection? At what point do we say, well, I am willing to undergo revision surgery to improve my quality of life, and I am willing to undertake the risks/costs associated. Is it worth the money, to improve my quality of life and bring peace of mind. And, perhaps, should one consider an AMS on their revision due to the more natural flaccid?

At this point, I am not even worried about size, or having a sex-life or anything like that, I just want to be able to live normally. Go to the gym without being self-conscious, be out of pain, work in a professional environment without constantly thinking 'what if I look like I have an erection.'

I am really just a bit down and venting. Imagine having peyronies for 5 years, then believing you will finally overcome it, to only deal with implant issues/pain for another year. And, doctors in Australia, will just say it's normal and to live with. Journals here prove otherwise. My surgeon actually advised that 6 weeks is recovery for a normal implant procedure and with TEP, it's 8 weeks. I am here almost 1 year later and I know something is not quite right.

I do apologise for the negative posts, and I do not want to put people off implants, as I can see how they can really improve your quality of life and give you back everything you lost to peyronies/Erectile Dysfunction. I just think it is very important to be aware of the risks associated with complex cases/procedures like TEP and choosing the right surgeon.

Thank you to everyone supporting me and this forum for all the knowledge.

I think as time goes on, things will get better. And, if not, a revision may be warranted.

J

Jj,
I am so sorry you are going through this. I can't imagine!
I would suggest you try to become less penis shy about your bulge.
All men have a penis, some men have large soft penises. Some are actors and some are just regular people, but it shows.
I would suggest try wearing your penis to one side or up and if it shows, just try to chill. After a while you will get used to it.
Allow yourself time to heal both physically and mentally.
There have been other guys on this site that worry about not showing, about their penis having a slight bend, about small penises, etc.
But in reality, even though their issues seemed unbearable, when they compare themselves to others, they find out "their" penis isn't bad at all.
You have a 22cm implant, as do I, and sometimes I wear tighter clothes, and sometimes my penis will show, but who cares.
And yes, after 4 years with my implant I still have dog ears next to the base of my penis, but when I wear my penis to the right, no one can see the dog ears. Of course over the years they have gotten softer, but all they can see is maybe a bulge from my penis.
Perhaps you should take some pics and let us judge what we see....or maybe offer suggestions.
Hey, we want to help you, try a few deep breaths and let us help you figure this out.
Oh yeah, there is a guy on here with a 26cm implant, so I am sure he has dealt with people looking at his crotch even more.
Please stay in touch,
StepOne  

Sorry you are going through issues so long after the implant JJ. I would personally only have gone with an implant and no circumcision. As we all know the more procedures done the more risk of complication. TEP was most likely overkill but no point thinking about that now because it's already done. I really hope things get better with time.

If I was in your shoes, I would only opt for another revision if I was forced to. You have already done an implant and a revision, remember the more surgeries the more risks. I guess you just have to deal with the issues for now and if you ever do a revision down the road def chose someone like Hakky.

Hey guys,

I have uploaded some pics, I will explain below. Let me start with, I am putting these here so I can assess the differences in June 2024. Only then, I will assess if it is better to just live with these issues or opt for a revision from Dr Hakky.

First 2 pics - Deflated flaccid Angle and bulge

As you can see, in pic 1, my flaccid sticks out for an inch and then goes down (I have pushed it down as much as I can in the pic). So, it sticks out at about 3pm for one inch and then goes down (when standing) to about 4pm. I can wear it to the left, however, this causes the dog ear to stick out pronouncedly. It also does not move to the right. As you can see in pic 2, when wearing clothes the dog ear sticks out. This looks like an erection, and has caused issues whereby I have to go to the gym wearing long shirts and be constantly self-conscious. When wearing a suit, I always wear a long waistcoat/vest with it, and have to constantly worry about looking like I hav an erection in a professional environment. In the pic I am wearing compression underwear, I have tried two pairs of compression underwear and although it pushes the penis down, the part at the base, and the dog ear, still stick out looking like an erection. I have had issues going to the gym, wearing professional clothes for work etc, watching what I wear when I am around my niece n nephew etc. I have also tried just loose silk boxers, and this causes the dog ear and the shaft to point out. This has affected my quality of life.

Retracted Graft

It is difficult to tell but if you look closely on pic 3, you can see that the right side is thin and slants, it does not inflate fully/properly. In the final pic you can see how my inflated shaft was post surgery, before I had any of these issues - it was nice and round. The surgeon advised that he thinks this is due to the graft retracting/contracting. I have searched the internet and ask doctors, couldn't find much info on retracted grafts at all. I can say that that area is painful and that I get less engorged than I would post-surgery.

If this issue resolved, I think I would be happy.

The surgeon also isn't 100% sure as he did not write which side he put the graft in his surgical notes. There is a slight possibility that it could be scar tissue or a kink, although, I think the surgeon would probably know best.

If anyone has any info on retracted grafts, I would appreciate it. Atm, I am just cycling and using the VED, but have not seen any improvement. The surgeon used a TachoSil graft. I will be starting the Perito exercises soon too. I only feel the stretch on the left side when cycling.

Pain

I still have general pain, a lot of pain after ejaculation (even after the prostatitis issue settled) and pain/tenderness by the frenulum. Really not sure what is causing all this, almost 1 year post-surgery. All I can do at this point is have faith, wait till June 24, then see if it's time to accept everything or opt for a revision.

I have been told to just have sex and enjoy the implant, and so far I have had sex once. However, having sex while anticipating pain is a difficult thing to do. I'm sure you guys with peyronies pain can relate. After ejaculating, I just feel like laying down and will be sore in the tips, shaft, frenulum and perinium area.

Dont let my post put you off implants, I have been going through a tough time and its just hard staying positive. I do anticipate that eventually, the pain, and pain after ejaculation will subside, and I will be able to have an active sex life gain.

On the 22nd Jan, I will be having a video consult with Dr Hakky and will send him my MRI results to review.

I will say, when choosing your surgeon, choose wisely. After doing some research, I found that Dr Perito, who is very well known and high volume has been sued due to having to two men ending up having to amputate their penis! (Coincidentally, I believe my surgeon trained with Dr Perito). You can find the article here: https://www.dailymail.co.uk/news/article-2083173/Dr-Paul-Perito-blamed-amputation-patients-penises-botched-operations.html

My heart really goes out to those two people.

Thanks for all the support.
J
 

I always had questions about your TEP, for example I never understood why your surgeon had to place a graft .... That is grafting and Not TEP. Tunica expansion procedure or TEP is creating small cuts along the length or breadth of the shaft to allow to expand and natural tissue to heal without the need for a graft. The moment the surgeon creates a large enough defect such that a graft is required , he cannot call that TEP. Moreover, I don't understand how he was able to cause a case of glans necrosis unless he just did a very risky manouver or compromised the entire blood supply to the glans during the surgery... absolutely bonkers.

Also are you taking daily tadalfil ?

Jj,
I saw your photos and as always photos are difficult to interpret. Thanks for posting.
So first, I know the dog ears are troublesome, but over time they do soften and become less pronounced. I know, but what do you do now?
I am not quite sure. In the past when it was soft it was easy to tuck down and it essentially molded into whatever underwear you had on.
Sadly you can't do that anymore because it has cylinders in it that just don't want to bend easily and that's why you have dog ears.
So I am not sure.
Hopefully HAWK will respond to you. He is the main man on this site and can offer you some suggestions.
You have a lot going on with various issues.
I understand your concerns and hope for some resolutions soon.
One thought is you have had a lot of trauma to your penis and you need to let things calm down.
Best to you,
StepOne  

I will start with the easiest.  Photo 3, which shows the "retracted graft," is so subtle that I see nothing but a perfect penis.

I see how your dog ear being out from the body is a concern.  I see how pain upon ejaculation is a concern.  I will respond in that order with my unprofessional point of view.

The cylinders will slowly evolve from the consistency of an empty water bottle to a piece of surgical rubber tubing.  That happens through the process of the cylinders absorbing body fat because of their hydrotropic properties.  That alone should address much of the dogear issue.  I technically still have dogears, but I have to search for them, and they are meaningless because they are so soft they feel almost like veins running through my penis. In addition, I think you can make improvements by taking extreme measures to deflate and training the cylinders to bend closer to the body.  Keep in mind that the cylinders are completely consistent throughout their entire length.  They have no predetermined hinge point.  The dogears happen largely at random.  If you weaken/soften the cylinders even very slightly at another place, the dogleg should occur there. I am convinced that you can repeatedly bend the cylinders closer to the base by both bending and squeezing them flat first in one direction and then direction then in the other.  First, the flat edges will be horizontal; next, you'll be verticle.  It will almost have to become a habitual thing you do any time you are lying in bed awake.

The other option is to do the very same thing but to the existing dog ear.  Squeeze the points of the dogears until they flatten in the opposite direction.  They will almost pop from one plane of flattening to the other plane of flattening.  This is not a squeeze and hold.  Once you properly place your fingers, squeeze and release at least once per second.  That will keep the dogear where it currently is but speed the process of it becoming softer and way more flexible.

Finally, pain with ejaculation.  Ejaculation is solely a process of the prostate and pelvic floor muscles.  There is nothing about an implant that should or even can cause pain on ejaculation, as far as I know.  Obviously, intercourse up to the point of ejaculation can cause penile pain if your penis is not 100% healed, but the act of ejaculation itself should not cause pain, and if it does, I would search for an unrelated cause.  I think that will be a prostate or a pelvic floor issue.



 

I will add to what Hawk said about dog ears because I was thinking the exact same thing. I guess I was fortunate enough for my natural dog ears to be right at my base, so it lays flat like a normal penis.

However, I want my flacid to be as natural as possible, so when I deflate I intentionally squeeze the dog ear section the make them bend the other way. My mind tells me over time this will create multiple crease points making your penis feel, move and hang more natural.

If it gives you any peace, I legit can't even tell about the graft not expanding part in your photo. I see a completely normal looking dick. Not trying to compare, but if you want to see a messed up dick, exhibit A was mine before surgery. I would have no concerns with my dick looking like yours.

The pain after ejaculation and dog ear thing completely agree, but I bet both will resolve with time. Have you ever looked at pelvic floor exercises/stretches/ kegels? Idk if that would help but if I had that pain I'd be looking into that to see what I could do.  

Pelvic floor issues are well recognized to the point that there are now physical therapists (PT) who are trained in pelvic floor rehab.  I would recommend seeking a referral and finding such a PT.
 

Thanks guys. I will try out the deflate and squeeze the dog ear technique.

I agree, the pain after ejaculation all started when I developed prostatitis, which all started after my implant surgery. So, it most likely is related to the prostate.

As for the retracted graft, it is very hard to tell in the pic, but one side is thinner and softer, as it does not inflate as much. Although, with blood flow it isn't as noticeable. At the end of the day, this compromises the girth, but the penis is still functional which is the important thing.

Once the pain subsides, I can have a normal sex life again and not worry about these things. If dog ear softens and the angle drops, I can wear normal clothes and live my life again.

It's just been very difficult staying positive when you're constantly in pain. Almost 1 year now.

I will re-assess in June 2024.

Thanks for the advice and support.

J

Quote from: GaussRifle on December 16, 2023, 07:50:03 PMAlso are you taking daily tadalfil ?

Yes Gauss, I take 5mg per day. Pre-implant, I would also take 100mg viagra as needed (before sex).  

Hey guys,

If I inflated to max then used the VED and pumped (the VED), instead of holding in the cylinder, could I use a cockring to keep it inflated? In which case, I could remove the cylinder (witht he cockring in place), and the penis would still be engorged with extra blood. This way, I could continue to do tasks while having a pumped/engorged penis with the benefit of extra stretching from the VED.

Appreciate your thoughts.

Sidenote: Length is coming back, and a lot of the pain has subsided. I will do up a proper post in a few weeks when I hit 1 year. I also have a virtual appointment with Dr Hakky tomorrow to review MRI results.
J

Hey JJ! Keep us posted on what Hakky says.

On the VED, are you saying you noticed length gain after using? Or you mean in general over the last year?

Quote from: IwillbeatPD on January 22, 2024, 08:13:42 PMOn the VED, are you saying you noticed length gain after using? Or you mean in general over the last year?

Hey, I think I could have worded it better, but I wanted to know if using the VED and holding the inflated penis in the chamber for 15m, would be the same as pumping with the VED then putting on a cockring (to maintain the extra engorgement) and removing the chamber and holding for 15m, would have the same effect.

Hopefully that makes sense.  

That's not what Hakky recommends he recommends cycling or doing reps with the VED Pump hold for a minute release & repeat. The purpose of that is bringing in OXYGENATED blood. You could put the cockring on and maintain your level of engorgement but your trapping the blood and preventing it from reoxygenating in the pulmonary system thus you are not getting fresh oxygenated blood like you would if you use the VED as prescribed by Hakky.

 

jj21:

I was on vacation for a couple of weeks and didn't spend much time online catching up on the forum. It was very nice to read that your pain is subsiding and your length is improving. You have been through a lot. Hopefully Dr. Hakky can guide you in these times.

I will be very curious to know what he had to say. Stay strong jj!

Thanks guys, my appointment with Dr Hakky got moved.

I will confirm with him, but it's so good to have these forums as my understanding was to inflate the penis to max then put the VED over and pump the VED then hold for 15 -30m. I thought this method was done to stretch the tissue as much as possible. I see, I have been doing it wrong all this time. Will start pumping and releasing like what was recommended when pumping the VED for peyronies. Is there a particular routine anywhere?

Trapper, can you confirm if you are able to safely do the Perito exercises with fillers? Something I will check with Dr Hakky too.

J

Quote from: jj21 on January 24, 2024, 12:10:49 AMTrapper, can you confirm if you are able to safely do the Perito exercises with fillers? Something I will check with Dr Hakky too.

J

I tried the Perito exercises shortly after preop but I'm much happier with my size now than I was so I haven't done Perito or VED for a few months. If you choose to try the filler I feel like the Perito exercises could cause migration of the filler but just my opinion.

Update:

Almost 1 year post surgery.

I am actually starting to like my implant. I just measured, and I hit 6.5 inches BP (without engorgement). This was my pre-op length. With engorgement, I am probably an extra 1cm in length. So, I would be about 1cm above my pre-op with engorgement.

My girth is a little less, due to the retracted graft. But, I may consider fillers to resolve this.

I gotta say, it feels good knowing you can have sex when, and however long you want. I can see how people grow to really love their implant. I can pump  to 80% and it just mimics a normal natural erection, it's round, reliable and just looks like a normal erection. At 90%, its a bit harder more girth but ovalish and flat. I remember when I was in my 20s and being with attractive girls, sometimes having threesomes (pre-peyronies), and I would have performance anxiety and not be able to keep it up. Sometimes, I would ejaculate too early. Imagine that experience with the implant, your penis would just be rock hard the whole time, what an experience that would be!

I was out the other day, and I got some attention from a blonde girl. I felt so great knowing that, if I wanted, I could probably start dating again and have an intimate sex life. With peyronies these are things that would make me depressed. I am generally pretty good looking, have a great physique and good background, when I'd get attention from girls (back with peyronies) I would have to cancel on them and just not pursue them, I didn't have any direction in where I wanted to go in my romantic life as I just didn't know what would happen with my peyronies. Now, I can have an active sex life and date as much as I want, and plan for a future .

The retracted graft issue is still there, I thought it was improving, but I am not entirely sure, I will do some measurements and pics soon. It's disheartening, going through the trauma of TEP + circumcision, to be left with less girth. Had this risk been known, I may not have opted to be circumcised. All we can do is accept it, and write our journey in our journals so no one else has to go through this experience. I can get fillers, but fillers are not without risks either. If anyone has any info on retracted grafting, I would appreciate it.

The pain after ejaculation is still there, but not as bad. I anticipate that, it will improve as time goes on.

Most of my length gains came in the last 6 weeks where I changed my cycling routine. Instead of doing perito exercises and VED (these were causing some pain and discomfort) for 30m each day, I just started cycling for 2 x 1hr sessions. I basically pump to max, then wait 20m then pump again (I can get about another 12-15 pumps in), then wait 20m then pump again (about 10-12 pumps in), that last 20m block is pretty excruciating pain!! I have to edge to get through it.

I am thinking when the pain while cycling subsides, I may try VED and perito exercises again, and after 3 months of VED and Perito exercists, I will probably accept whatever dimensions I have and opt to get fillers to compensate for the loss of girth.

Advice

Do you guys think, that, due to the pain while cycling, there are still gains to be made? I guess its impossible to tell, some people make gains past a year, and some don't. I also have a bend to the left, how normal is this?

The more I pump (high levels of inflation), the more pronounced the bend to the left is. Could be due to the retracted graft on the right side, I Really don't know. I usually pull the penis up and then pump so that it inflates straight.

As I am seeing growth, I am a bit worried on one thing. I initially had a 110ml reservoir, the surgeon, on my second surgery stated that he took out about 25ml as the reservoir was indenting the bladder. What risk is there that, as the device grows, I may run out of fluid?

Final thoughts

I must say, this has been a crazy journey. My sex life has improved but my personal life has taken a hit. The dog ear protruding out still sticks out and looks like an erection. This has taken a toll on my personal life. But, it could improve as the cylinders soften. The right side angle hasn't dropped as much as the left either.

I am going to put this message here for others. I've spent about 20k on my surgery (2 surgeries) including airfares and accommodation. If I choose to get fillers to compensate for the lack of girth, that would cost another 10k. That's 30k AUD, another 10k and I could have just gone to Dr Hakky for my surgery, and I believe, I wouldn't have many of these issues. My surgeon, wasn't much help once I started having issues, and he LIED in his post-operative letter stating that I was unhappy/obsessive due to the length and girth, and he stated he believed my anxiety was contributing to my symptoms. However, you can read this whole journal on this website (you can't delete posts on this website), and see that I have never had issues or complained about length/girth. Rather, prolonged pain, deformity, retracted graft etc. He was also complaining that he spent 45m talking to me after my 2nd surgery and I still had to email him for confirmation of some things once I was back in my state (is this not ridiculous?), we pay our surgeons 12k out of pocket, have to have a 2nd surgery due to issues and prolonged pain and they are complaining that they had to go beyond their 45m post-surgery consult and send emails?

See the difference in patient care, the surgeon who did my surgery downplayed the risks of sub-coronal TEP, yet he told another patient (user:morphball) that he had performed sub-coronal TEP and had to amputate the patients glans due to a complication (tissue necrosis I think), YET he still continues to perform the procedure.. Why? Money perhaps? In contrast, Dr Hakky stopped performing sub-coronal incisions due to the complications and risks associated with it, this tells me, he does what is in the best interests of the patient. As you know about my retracted graft issue on the right side, this is still a GUESS from the surgeon as he did not write which side he put the graft in his surgical notes - I think this is very poor form from a medical professional performing major surgery. I will also add that, Dr Hakky wanted an MRI as soon as I had my video consult with him, he said my surgeon should not have performed the second surgery and taken the risk. It makes sense, the surgeon probabaly should have requested an MRI and further diagnosed the issues before opting for a second surgery. Choose a good surgeon guys, you only get one penis, and this procedure is irreversible, don't take any risks. I really do not want anyone else to have to go through what I went through.

I will post some pics up in a few weeks.

J

J, there's only one reason you could be getting pain when fully inflated and that is because the implant is stretching the tissue. If the implant is stretching the tissue, then it's likely that you will continue to get an increase in size.

If you increase in size then there is some chance that you could get to the point where you run out of fluid. That just means that your penis will be bigger than it is now and rockhard. It's unlikely that you have so little fluid that it will cheat you out of any significant size gains. If I pump as hard as I can, with two hands, I can empty my reservoir and run out of fluid. It is meaningless, however, and a non-issue.


One thing I don't quite understand is that you pump up and then can later put in another 15 pumps. Typically a person pumps up as much as they can, and later they can squeeze in two or three more partial pumps. If they wait another 15 minutes they might get in one or two more partial pumps, I don't think you're pumping up nearly as far as you can on your initial pumping.  The sooner you get all the possible pumps in, the sooner you start stretching, and the sooner you can deflate and get on with your day.