One hard year - my life with a malleable implant

[duke_cicero]

Hey FrankTalk. For those of you who don't know me, I'm Duke. For essentially my entire adult life, I was plagued with erectile dysfunction that did not respond well to pills, injections, or the vacuum device. I won't go into too much of my personal backstory in this post (you can read my original journal here, and my six-month update journal here), but I think it's worth giving a little bit of an introduction in case this is the first post by me that someone encounters.

Why am I writing this? Well, I'm one of the rare (but vocal, and very happy) owners of a malleable implant. I was implanted with a Coloplast Genesis in December 2024 by the great Dr. Laurence Levine in Chicago almost exactly a year ago. Because there aren't that many active users with malleables on this website, I think it might be useful to share my history, experiences, and perspective.

Buckle up, because Uncle Duke just brewed himself a nice big French press full of coffee. You're about to get the full, director's cut edition of my first full year with my malleable penile implant. As I've been prone to joking with myself, 2025 has been a really "hard" year, given that I've had an erection for the entirety of 2025.

The long story made short: When I was 20 years old, I got into a pretty bad bicycle accident—a head-on collision with another cyclist on an dimly-lit nature trail in suburban Chicago during the second year of my college career. Partly due to the fact that I was 20 years old and felt invincible, I decided to walk off the injury. Weeks after the incident, I discovered that I had only weak erections—even when masturbating, totally apart from the pressure of sexual encounters. The accident damaged something having to do with the blood supply to my penis.

As a consequence of the accident, I suffered for 14 years with crippling erectile dysfunction. I tried pills for years, which worked—but very inconsistently. Cialis never did anything for me, but Viagra occasionally did. I would take 100mg at a time and would get the worst headaches, nasal congestion, and blurry vision. Occasionally I would even get terrible nausea, which is something I hate more than almost any other physical sensation. And, the Viagra didn't even always work. If I had too much to eat, or too little to eat, or too much booze, or not enough, or not enough water, or if I was too tired ... the list goes on. It was just very inconsistent.

A couple years ago, I tried Trimix shots. When I nailed my corporal bodies just right with the injection, it worked decently well. I would have a strong erection for a couple hours. One time, I had a super-strong, painful erection for 3 hours. I blew my girlfriend's mind that night. But I hated the feeling of pressure—the feeling that I have to get this absolutely just right—and I was sometimes left with a pretty bad bruise on the base of my penis. Having a black-and-blue penis isn't exactly appealing, and that sometimes came with pain. Add to that the difficulty of storing the Trimix injections (they have to be refrigerated, and you shouldn't believe anyone who tells you differently about Trimix). I honestly hated the refrigeration part more than I hated anything else, even the crazy fact of sticking a needle in my goddamned penis. It made the whole process feel like I was threading a needle. And when the shots didn't work, I was left feeling like a failure—as I did with basically every other sexual encounter.

After losing yet another girlfriend to my inability to have satisfactory sex, I was done. That was it, for me. April 2024 marked a line in the sand. I was never going to be humiliated by this problem ever again. Either I would fix it, or I would resolve never to have sex again.

I live in a very big city (Chicago, in the downtown area) with a seemingly endless profusion of gorgeous women everywhere. But I was quite honestly thinking of moving to a tiny remote town in the middle of nowhere in Montata and being alone for the rest of my life. So instead of being a tall, handsome, upwardly-mobile guy (hey, it's true) surrounded by gorgeous women that he's not able to sleep with, I would instead move to the middle of nowhere and more or less solve the problem that way. I would be lying if I said that I never considered the possibility of ending my own life. But I have a rather unfortunate family history that entwines with that subject, and I made a vow to myself a long time ago that I would never do that.

After doing even more research, I naturally came to consider getting a penile implant. This is a life-changing procedure no matter the outcome, so I didn't take it lightly.

I read basically the entirety of this forum, watched seemingly endless YouTube videos, and read up on the history of penile implants—something that's been part of medical history for well over a century (albeit quite imperfectly). It's all really fascinating stuff. Here's an article that explains that ED has been part of the medical literature since Hippocrates wrote about it in 400 BC, and that penile implants have been attempted in some way or another since 1935: https://urologichistory.museum/the-scop ... ted-states

And I just have to say—the doctors who get involved in prosthetic urology (implants and the like) ... what's obvious is that this is a very small, warm, collegial group. All of these guys (and a few gals, too) seem to know each other really well. There's a very strong feeling of camaraderie. Getting to know a lot of these doctors para-socially by watching their interviews and discussions on YouTube was really eye opening. These surgeons work in a field that has a lot of stigma associated with it—because, of course, anything having to do with male sexual health has a stigma, or is wrapped up in whether or not you're a "real man" or some other decidedly acrid bullshit—but none of that matters to them. These surgeons are changing the quality of life for countless men, in one of the most tangible, essential ways available to modern medicine.

Here's a video that I really enjoyed, from a channel I've really enjoyed (the Wilson Memorial Research and Training Center for Penile Prosthetic Surgery): https://youtu.be/hFnLhgxT9jU

I won't get into the substantial, nitty-gritty, intense philosophical debates about why I ultimately chose a malleable over an inflatable. I can't give the kind of answer that will satisfy every single kind of person in every single kind of way. For anyone who's ever read their Plato, you know from the Apology of Socrates that this is actually one of the big gripes that Socrates has with even the concept of writing something down. Something that's written can only tell you what it tells you on the page; it can't respond to a person, and it can't evolve with the right question. Only people in conversation can do that. I'm only doing the best I can with the tools I have.

Even so, what I can do with some confidence and precision is tell you:

1. Exactly what thought process led me to get the malleable that I received
2. My experience in malleable implant surgery recovery
3. My experience using my malleable implant
4. My experience living with my malleable implant


My thought process for getting a malleable implant

My thought process on this was relatively simple. At the time I was implanted, I was only 34 years old. My hope is to live a long, healthy life—and I would like for my penile implant to also have a long, healthy life along with me. In other words, I wanted to minimize the number of revisions I might receive over the course of my life.

Again, my thought process might only be relevant to someone like me. But I'm rather risk-averse when it comes to things having to do with health. I wanted to limit the number of potential device-related or malfunction-related revision surgeries I might get in my lifetime. I wanted to limit the possibility of infection. And finally, I wanted to limit my out-of-pocket costs for getting the implant. It's worth mentioning that because of my unique insurance scenario, I would be paying for my implant entirely with my own money.

TIP: Appeal as many times as possible with your insurance provider. Your doctor will write a letter that explains the medical necessity of your implant. I've heard in some cases that insurance providers eventually relent. However, in my case, implants were explicitly excluded. However, once implanted, mechanical failure or infection seems to be covered by insurance. Always, always do your due diligence. Insurance companies are designed to tell you No. Be as diligent and as persistent as possible. There is always a solution, even if it's not a perfect one.

Because I wanted to limit all these different risks, I (again, this is my personal decision that might only resonate with other guys who have a similar mindset and risk tolerance) made the decision to go with a malleable implant over an inflatable. The cost difference between the malleable and the inflatable implants was on the order of roughly $10,000 USD. A revision would (at least potentially, I thought) have been coming entirely out of my own pocket.

I'd seen and heard the stories—there's a FrankTalk user who goes by "thedriver" who had four (yes, 4) separate IPP surgeries before finally settling on the malleable. He's written extensively on this forum. Again, this will almost certainly not be your experience if you go with an inflatable—and there are countless examples of very happy guys on this website (and even more who've never joined this website or don't even know about it) but I wanted to limit the possibility entirely by simply not going with that kind of device.

Because the malleable implant has fewer parts (it's just two rods—I realize it's much more complex than that and these devices are quite elegant, but basically it's two rods) and because there's no pumps to operate, there's much less opportunity for device malfunction. The rods would have to have been already compromised before they were implanted in your body. The manufacturing processes for these devices is pretty rigorous, so that's an extremely unlikely occurrence. It's more likely that something happens during surgery, given all the complexity of the human body and all the things that could potentially go wrong in any given surgical theater.

In addition to the issue of cost and mechanical reliability, what was also on my mind was the issue of infection. Infection loves complexity—basically, the more surface area you have on a given object, the more places there are for bacteria to hide. The rods of the malleable implant are about as simple as it gets, and infection rates for the malleable implants are even lower than they are for the inflatable implants—which is also pretty low, in the grand scheme.

So, then: which malleable implant would I choose? Initially I was quite excited for the Tactra, and I was scheduled for this. However, my surgeon's office called me the day before surgery and let me know that we could switch to the Genesis. My surgeon tested them out a few days before my surgery and was dissatisfied with the bend quality of the Tactra. He'd also had a lot more experience with the Genesis, so I was much more inclined to go with whatever he was most comfortable with.

TIP: It's worth mentioning that the Genesis is also the only malleable implant that comes with a hydrophilic coating. Basically, what this means is that the implant comes with a special coating that enables your surgeon to prep the implant by dipping it into an anti-bacterial solution before implanting it inside your body. On top of the fact that the implant is simpler and provides less surface area for infection to spread, the coating makes the likelihood of infection even less of a consideration. Remember when I said I was trying to be as rigorous as possible? This is the kind of thing I had in mind.

I'd also heard that malleable surgery recovery was much more straightforward than inflatable implant surgery recovery. Which leads me to my next subject...


My experience in malleable implant surgery recovery

Recovery for my malleable was honestly pretty simple. In the first 30 minutes or so after surgery, I woke to find myself back in the recovery room at the surgery center. A nurse gave me a jug and gently walked me over to a restroom where I could try to urinate. She mentioned that I might have trouble, but to my amazement, I almost filled the jug. Classic nurse behavior: She came into the room after I announced that I was finished and told me how proud she was that I filled almost the entire jug. I guess this doesn't happen that often. I'm a very special boy.

What I immediately noticed is that my penis was quite engorged. It looked huge. I wasn't too bruised at the time, but it felt bloated. I was wrapped in what's called a "mummy wrap," with bandages and gauze and a special cotton net underwear. There was also a cotton ball to keep the penis sticking straight out, but at the time it felt like my testicles must have been the size of a 16-inch softball. For the time being, I wasn't in any pain. I was just extremely tired and groggy from the anesthesia.

Immediately after surgery, I was given some cookies and a cup of coffee (the coffee came at my request). I was allowed to sit in the recovery area of the surgery center for about an hour before being picked up and taken away. Everything felt very efficient and controlled, which was oddly comforting despite the fact that I knew, quite consciously, that I was merely another data point in the enormous medical-industrial complex in America. Even so, it's good when things work.

I didn't have anyone waiting for me at the surgery center, so I hired a medical taxi service (basically like Uber, but much more expensive) to pick me up from the surgery center and take me home. I had to do this a couple weeks before surgery, and while it wasn't necessarily the easiest thing to do, I didn't personally want anyone that I knew knowing that I'd gone through with this particular kind of surgery. I still haven't told anyone in my personal life, and I figure it's doubtful that I ever will. Apart from my urology team, only you—my FrankTalk brothers—know about this. Maybe that will change in the future. I'm not sure yet.

I was given a script for Norco, which is hydrocodone, a powerful painkiller medication. But I didn't use it that much. I'd have to go back and look to be absolutely sure, but I think I only used the Norco for the first three or four days after surgery. After that, I stuck to Tylenol and ibuprofen on a regular basis, maybe three times a day.

I spent most of the first couple weeks watching movies, messing around on my phone, and reading. I enjoyed it, but I was ready to get back into real life. I work from home in a consulting job and my surgery didn't meaningfully impact anything having to do with my work.

Sleeping was basically uneventful—and that's the best case scenario anyone could really ask for. My nighttime was painless and sleep was deep and restorative. TIP: Do everything you can to ensure that you have the ideal sleep environment before going under for implant surgery. It's also just a good idea to get your sleep situation in check in general. Sleep is important.

TIP: I feel compelled to say that one of the things that was most difficult during surgery recovery was not masturbating for the first 5 weeks. Doctor's orders. It's absolutely important that you listen to your surgeon and your recovery team, especially when it comes to this. You do NOT want to mess around with potentially damaging your surgery site, harming your penis, or causing some kind of obscure complication with the implant. It's not worth it. But, after three weeks, I couldn't handle it anymore. I bought some lube and a feather (yes, a feather) from a fabric store and gently rubbed my penis until I had an orgasm. It was one of the most intense orgasms I've ever had in my entire life—and afterward, I laughed like an idiot. Did I really just get myself off with a feather? Yes, I'm afraid I did. But it kept me sane, and I didn't do myself any harm by using a firm grip with my hand.

After the first two weeks, I wasn't using any painkillers at all. I went to Christmas dinner with some very close friends of mine and didn't have any problems walking around Chicago or sitting at the dinner table. Notably, my chair at dinner wasn't terribly comfortable, but it didn't cause any pain in my groin or in my penis. I felt like I was sitting in my chair normally, and comfortably enough. A few days after the holiday, I met with another friend and had a late lunch. No pain, though I was wearing very comfortable soft wool pants. My penis was not too visible through the pants, but if you knew what to look for, you'd have a pretty good idea.

After four weeks, I had my first month check in with my surgery team at Dr. Levine's office. I reported no problems, and when I was formally examined, they noticed nothing awry. I received a subcoronal incision during surgery, and the physician's assistant mentioned that it was difficult to spot the scarring, which was good to hear.

I was cleared for sex 10 days after this meeting. I couldn't have been more excited.


My experience using my malleable implant

Using my implant for the first time was, honestly, life changing. I still almost can't believe that the day finally arrived. I don't want to go into all the crazy details, but I had sex basically uninterrupted for almost three hours in that first encounter. I did every position I could think of. I was totally exhausted at the end of it, and slept for almost 10 hours that night.

It's worth noting that the malleable implant (at least, my Genesis) is pretty sensitive to body heat from your partner after prolonged sexual encounters. I lean a little to the left (and I did before my implant surgery, too) and the first time I had sex, my penis/implant was slightly bent leftward more than I'd expect. It's not a big deal, but I definitely noticed it. A very small issue in the grand scheme of things.

I do not have problems in any position while using the malleable. There are some positions I haven't tried (the stand and carry position, for example) because there are problems with height differences between the women I've been sleeping with and it just hasn't been practical. But overall, there are no problems at all with any conventional sex positions, and I definitely feel quite fulfilled by my sexual encounters.

TIP: Use lube. Lube is awesome. It makes everything better. It's also important after you've had implant surgery, because (on rare occasions) your surgery site/scar line will be just ever so slightly sensitive, and long sex sessions might leave you just a little more sensitive after the fact. I've never experienced pain, only the minor feeling of a little bit of friction.

So far, after encounters with 21 different women, not a single one has had any suspicion about my having an implant. There has only been the shock and pleasant surprise that I'm ready to go at a moment's notice—and that I'm ready for another round even immediately after finishing the first.

Now, I've had to make a few small adjustments while living with my malleable...


Living with a malleable implant

Living with the malleable implant is very easy, but there are some things to keep in mind. These are only my own experiences—it's entirely possible that if you get a malleable, you'll have a different sense of how these things affect you. But here's the short list:

In the first few months, I couldn't wear stiff jeans. Jeans irritated my surgical site too much and I was uncomfortable. I experienced no real pain, per se, but I didn't like how they felt. I wore slacks, or joggers, or soft wool pants until my surgery site recovered. Now, it's no problem at all to wear jeans, and I do it all the time.

I lean to the left, and typically I stick my penis down my left pant leg. That's just something I never had to do before the implant. I've read that some guys with the inflatable implants also have to stick their penises down a pant leg, but I've obviously never had any experience with an IPP, so I can't comment. I figure this has more to do with there being a device inside your penis than anything else, since your stretched size becomes your implanted size, more or less.

I no longer ride bicycles. Given my history, you might think this was obvious (ha!), but so far, I've found it rather uncomfortable to sit on most kinds of bicycle seats. They're hard, apply a lot of pressure on the perineum, and I would hate to damage my implant and my penis—yet again—from another stupid experience on a bicycle. So I've just said goodbye to bicycles. I loved riding my bike, but I love it when my girlfriends ride me even more. Easy choice, for me. My preferred form of cardio is the elliptical, these days. And, of course, sex.

TIP: Before getting on the elliptical or going on long walks, I typically put a small glob of Vaseline on my penis to prevent chafing from the underwear that I use. I don't have any problems wearing any particular kind of underwear, but I use the Vaseline for added comfort every single time. It works great. I also think it keeps the surgery site skin in better condition, so I occasionally wear a little dab of it just because.

Other than these small notable considerations, living with my malleable implant has basically been uneventful beyond the positives. I'm honestly quite thrilled.


Concluding thoughts

Whenever I ask myself if I would do it all over again if I had to, the answer is always a resounding Yes. All the nerves and anxiety in the few days leading up to the implant surgery were absolutely worth it. All the uncertainty about whether my recovery would continue to go smoothly or if something would suddenly change—absolutely worth it.

To say that the implant has changed my life is a massive understatement. My implant has given me the ability to have intimate relationships again, to enjoy the magic of sexual intimacy in a way that completely removes the main source of anxiety I've had about it for almost the entirety of my adult life.

I didn't realize until recently (even though it'd pretty obvious in retrospect) that my inability to have an erection totally eroded so much of my inner resources. I'm a smart, successful, well-educated guy with good prospects. But none of that mattered, seemingly, because I knew (without a shadow of a doubt) that I couldn't perform in one of the most important domains in the realm of love and relationships. And over time, that chipped away at my confidence in so many other things—my intellect, my trustworthiness, my competence. I didn't have a say in it, either. That's just what happened.

Yes, I'm having successful sex every single time—and that's something I've never been able to do before. But beyond that, I'm also building a deep, abiding confidence in myself. So much of my life is coming back to me. I don't mean to be sentimental, but I have tears in my eyes as I'm typing this. This is one of the most important things I've ever done.

Thank you so much for reading. I'd be more than happy to answer any questions.

Best,
Duke

[Gringoinparadise]

Thanks for sharing your story in such detail, Duke. I’m sure I speak for all of us here when I say that it’s great to hear about your surgery results and the positive effects they’ve had on your life! I think everyone has their own unique reasons for when they make the very personal choice of getting an implant, along with which type of implant, which brand/model, etc. And unfortunately, no one really can guarantee that they make the right decision, no matter how much research they do. At some point, we all ultimately roll the dice and see how it plays out. Happy to hear you rolled a winner! Keep on enjoying the results (and making up for lost time)!

[LGXDownunder]

Thank you Duke for sharing all of that. It's a great story and such a positive outcome.
I often read your posts on here but didn't really have a full picture of your journey until I read this.
Your experience with Trimix injections almost mirrors my own. So glad that is behind me.
The life changing impact of an implant after suffering ED can be difficult to explain to anyone who doesn't have one.
And I agree that it isn't just sexual performance that ED affects. It definitely hits your overall self worth in my experience.
I totally understand your very well considered reasons for ultimately choosing the malleable. And it has worked a treat .

I did seriously look at going the malleable route myself before deciding on an IPP, but I'm also a heck of a lot older than you.
My thinking was that the number of likely revisions to an IPP before I'm either dead or too old to use it any longer was worth the risk.
But going malleable is something already in my thoughts for if/when I do need a revision, given my age and likely continuation of an active sex life.
I really like the simplicity of the malleable, and I don't think being an even bigger shower than I already am would be too problematic.
FWIW I try to not stow my dick down my pants leg, but it has to go somewhere and usually ends up there regardless .

[lasthope2.0]

Awesome report, Duke. Congratulations.

I like how you said “One hard year” . A hard year after years of ED is sweet indeed.

I'm very happy that the Genesis malleable worked out well for members like you and thedriver. Success stories like this must be shared far and wide, and they will offer tremendous hope to the world.

[ready2go]

one thing that surprised me while having sex with my malleable , when my fwb was riding me cowgirl, and she made me orgasm , but we kept going longer in other positions . And i "finished" again .
My recovery was very easy .my shaft was bruised forabout a week . And the glans were sensitive . other than that , It was only a waiting game for the stitches to dissolve .
Of the half dozen girls i have had sex with , only one mentioned anything about my penis and her question was ,after we were finished [a filipina] why does your dick not sleep ? hahaa . i just smiled and pushed it down and to the side . [ "not knowing"
including my wife , she was gone for a year when i had the implant and i have not told her i have one ,and won't tell her .],

bicycle riding ,i enjoy for exercise ,and in fact just finished an hour plus ride . But i tossed those asinine skinny seats and got a wide ,padded seat . No issue with comfort regarding the implant there .

[LetoMan]

Hey Duke, congrats on the one year anniversary. We share a lot in common, including life long ED. Like you, I was once a young, confident professional that had that one chip in his armor, and like you it was a brutal burden at times.

I wish I had gotten it fixed at 34. But I’m still pretty happy I fixed it at 49.

Here’s to many more happy years.

Leto