Hakky and erosion?

[edjohn]

I don't think he's lying, or even half lying. If anything, my surgeon prefers IPPs, but his preference has nothing to do with risks and everything to do with concealment.

I am not trying to attack anyone or say that it disqualifies him from doing his job, I am just saying that the scientific studies show very clear differences between erosion rates. Therefore, if your doc said there is "virtually no difference," it is just plain incorrect.

[duke_cicero]

I don't think he's lying, or even half lying. If anything, my surgeon prefers IPPs, but his preference has nothing to do with risks and everything to do with concealment.

I am not trying to attack anyone or say that it disqualifies him from doing his job, I am just saying that the scientific studies show very clear differences between erosion rates. Therefore, if your doc said there is "virtually no difference," it is just plain incorrect.

If one airline had a 0.001% crash rate and another had a 0.002%, you technically could say one is "twice as dangerous," but no reasonable person would choose between them on that basis. The absolute risk is so low in both cases that the difference is swamped by other factors. Let's get real.

Anyway, the claim that IPPs erode far less often just doesn't hold up. Reported erosion rates for malleables range between 1.4% to 5.1% across studies, and inflatable implants show roughly the same neighborhood of risk. That means that the variation within each implant type, which driven by factors like surgeon experience, patient health problems, and what I was told and mentioned about device sizing and placement — is actually larger than any observed difference between the two types.

When you look at the largest actual real-world dataset that's out there, a 2026 analysis of around 30,000 patients, the revision/removal rates are 13.9% for inflatables and 13.7% for malleables, with p-value of 0.77 which is virtually indistinguishable from chance: https://academic.oup.com/jsm/article-ab ... 34/8488664

Claiming that MPPs erode meaningfully more often than IPPs based on small studies with overlapping confidence intervals is extremely messy and doesn't add up with real clinical significance. The rates of erosion are so low for both implant categories that the choice between them has more to do with cost and preference than anything else. Certainly not the fraction-of-a-percent difference in erosion data that no real study can even reliably confirm exists.

[edjohn]

Yes. Let’s get real. The numbers you throw out there are 2000 times lower than what I saw. Also don’t quite revision rates… you know full well there are a bazillion reasons to revise and we are discussing erosion.

Up to you to completely ignore a comparison of 4% to 2% but it’s still a reality. Do a basic search for ipp vs malleable without biased input and you will see over and over again “malleables were associated with higher risk of erosion.”

It’s worth noting (though not specific to erosion) that “dissatisfaction rates” were closer to TEN times as high vs IPPs. IMO it is highly preferable to replicate human erectile function and to downplay the disadvantages of malleables is just setting them up for disappointment.

[duke_cicero]

Yes. Let’s get real. The numbers you throw out there are 2000 times lower than what I saw. Also don’t quite revision rates… you know full well there are a bazillion reasons to revise and we are discussing erosion.

Up to you to completely ignore a comparison of 4% to 2% but it’s still a reality. Do a basic search for ipp vs malleable without biased input and you will see over and over again “malleables were associated with higher risk of erosion.”

It’s worth noting (though not specific to erosion) that “dissatisfaction rates” were closer to TEN times as high vs IPPs. IMO it is highly preferable to replicate human erectile function and to downplay the disadvantages of malleables is just setting them up for disappointment.

Up to you to mistakenly conclude that I tossed out airline figures for anything other than the sake of argument to illustrate a point about absolute versus relative risk—I'm not using them as a stand-in for erosion/revision rates. Which is obvious.

Up to you to completely ignore that "dissatisfaction" may mean something completely different to different people across different surveys—or that someone's definition of dissatisfaction might include needing more frequent revisions due to mechanical failure.

Up to you to completely ignore that I've never been unfair in my assessment of these devices, and have gone to the mat many times with weirdos like the user "tooyoung" in defense of (yes) IPPs.

Up to you, up to you, up to you.