When to start the process???

[Hogbond]

I'm a married 46 yo and have had mild-to-moderate ED for the last 5 years. I've previously used 25 & 50 mg Viagra with good results but the inconvenience of taking it ahead of time on nights I hoped to get lucky got old, so I switched to 20 mg Cialis, which I've been pretty satisfied with for the last 2 years. The daily pill is easy, but Cialis definitely doesn't provide the firm erections like Viagra did.

I've been reading through this group for a while and am very intrigued by what an implant could provide in both strength and readiness of erections. I know that it will ultimately be the answer for me, but I have no idea when to start the process. Do I cut to the chase now or wait til even the heaviest doses of Cialis or Viagra no longer work?

Also, I'm both intrigued and concerned about how my penis and the implant would work together. I am definitely a grower - flaccid length varies between 2-3" with full erection 5.5-6" measured from the pubic bone.

I assume the implant will keep me closer to the erect length even when flaccid simply by its presence. Is that true?

How does the surgeon decide which size implant to use, and how do the surgeon and I decide which device is best for me?

I appreciate your help and your sharing of experiences.

[LGXDownunder]

I'm a married 46 yo and have had mild-to-moderate ED for the last 5 years. I've previously used 25 & 50 mg Viagra with good results but the inconvenience of taking it ahead of time on nights I hoped to get lucky got old, so I switched to 20 mg Cialis, which I've been pretty satisfied with for the last 2 years. The daily pill is easy, but Cialis definitely doesn't provide the firm erections like Viagra did.

I've been reading through this group for a while and am very intrigued by what an implant could provide in both strength and readiness of erections. I know that it will ultimately be the answer for me, but I have no idea when to start the process. Do I cut to the chase now or wait til even the heaviest doses of Cialis or Viagra no longer work?

Do you know the cause of your ED? At 46 it's likely that you will need to consider having more than one revision surgery, as implants don't last forever and longevity is variable. Most advice for your age bracket will be to try all of the other conservative treatments first, especially if you can still get reasonably reliable erections from pills. Depending on your location insurance may also be a consideration in qualifying for an implant. Implants are great but they are also a one way street. Once implanted you can't go back to having natural erections, or from pills etc. I wrestled with the idea longer than I should have before committing to an implant, but I'm also 25 years older than you, and had zero erectile function even with 100 mg Viagra.

Sex is wonderful again and I've never been harder in my life. Implant strength hasn't been a problem even during very rough PIV sex.
In terms of readiness I can have a rock hard erection on demand whenever I want one. My dick stays fully erect until I decide to deflate the implant, even after I've already climaxed. After months of cycling I can pump from flaccid to more than hard enough for penetration in 28 seconds (timed). That seems pretty much bread and butter performance for most correctly sized and installed IPPs regardless of brand/model, and without significant complications. But of course those things will vary between individuals.

Also, I'm both intrigued and concerned about how my penis and the implant would work together. I am definitely a grower - flaccid length varies between 2-3" with full erection 5.5-6" measured from the pubic bone.

I assume the implant will keep me closer to the erect length even when flaccid simply by its presence. Is that true?

I'm assuming you are considering an inflatable penile prosthesis (IPP). Malleable (MPP) is another option if you haven't considered it.
Results varies from person to person. I was also a grower and probably had a similar difference between flaccid and erect.
Now I'm a shower, significantly larger flaccid and maybe 1 to 1.5 inches between that and fully erect.
Once sufficiently recovered, cycled and pain free, in my experience penis and implant work together just fine.

How does the surgeon decide which size implant to use, and how do the surgeon and I decide which device is best for me?

It's usual to discuss that with your surgeon during pre op consultation/s. They often have a preference or have more experience with particular brands and/or models. They should also take into account your own symptoms, preferences, objectives and individual anatomy. But final measurements are unknown until they dilate you in the OR, when you will likely be unconscious. Keep reading on here to get an idea of what you think might suit you. Then find an excellent surgeon and be armed with questions.

[ElbowRoom]

You’ll know when it’s time because your mindset will shift from “maybe I should think about it” to “I definitely want to do this.”