Size and Extrosion

[Fernando]

Last time I have been doing a lot of research on implants. Actually, I haven't done much more in my spare time ...
From what I've learned so far, the biggest problem with implants is infections.
But the biggest cause of discontent with implants is the loss of size.
Which leads us to think about the implant sizing.
Whether an aggressive or more conservative design is beneficial.
This is because another major problem with implants is extrosion. That is, the implant pierces the penis.
In your opinion, what is the reason for the extrusion of the implant?
Will the extrusion depend more on the type of implant, semi-flexible or inflatable, on the physician's experience and competence, or is it solely due to the too aggressive sizing of the implant?
Curiously, I didn't find many cases of extrosion in 3-piece inflatable implants.
Do you think the risk of extrosion in an aggressively sized inflatable 3-piece implant is high?
Or will the greatest risk be the inability to inflate the implant to the maximum due to the pain of tissue stretching?

I will try to explain myself better.
Will the best result with the implant be obtained with an aggressively sized implant to avoid the risk of decreasing the size after the operation, or can this cause the risk of extrosion?
OR, even if there is no risk of extrosion, can an implant that is too big make it impossible to inflate the implant to the maximum and thus not achieve a very good erection and firmness?

[mike123]

Hi Fernando. I can't answer your question directly, but I believe the term you're after is "erosion".

[Lost Sheep]

Last time I have been doing a lot of research on implants. Actually, I haven't done much more in my spare time ...
From what I've learned so far, the biggest problem with implants is infections.
But the biggest cause of discontent with implants is the loss of size.
Which leads us to think about the implant sizing.
Whether an aggressive or more conservative design is beneficial.
This is because another major problem with implants is extrosion. That is, the implant pierces the penis.
In your opinion, what is the reason for the extrusion of the implant?
Will the extrusion depend more on the type of implant, semi-flexible or inflatable, on the physician's experience and competence, or is it solely due to the too aggressive sizing of the implant?
Curiously, I didn't find many cases of extrosion in 3-piece inflatable implants.
Do you think the risk of extrosion in an aggressively sized inflatable 3-piece implant is high?
Or will the greatest risk be the inability to inflate the implant to the maximum due to the pain of tissue stretching?

I will try to explain myself better.
Will the best result with the implant be obtained with an aggressively sized implant to avoid the risk of decreasing the size after the operation, or can this cause the risk of extrosion?
OR, even if there is no risk of extrosion, can an implant that is too big make it impossible to inflate the implant to the maximum and thus not achieve a very good erection and firmness?

Erosion is a greater danger with the semi-flexible (also called "semi-rigid" or "malleable") implant than the inflatable because the inflatable only puts strain on the distal penile tissues when inflated, which is only a small portion of the day and not usually for very long. The malleable implant presses on this tissues 100% of the time. Continual compression of the penile tissues leads to decreased blood flow. If the flow of oxygen and nutrient laden blood is slowed enough, tissue death can result, and loss of those tissues a real danger. That danger is present in malleables more than inflatables, but if an inflatable remains inflated for too long, theoretically, it can happen there, too.

As surgeons gained more experience (not just each individual surgeon, but the entire cadre of surgeons contributing to institutional knowledge base on all inflatable implants), the discernment of the proper degree of aggression in sizing has become clearer.

I guess that it is common for a surgeon placing a malleable implant to be less aggressive than one placing an inflatable, but I have no idea by how much.

Several years ago there was an implant that was designed to lengthen between the deflated state and the inflated state. (Ultrex from AMS) There were some bad outcomes with the Ultrex, that prompted some surgeons to recommend reducing the length of the implant by 2 cm from the aggressively measured size to prevent what they called the "S-curve deformity. When the implant was inflated, the length expansion was limited, so the implant buckled into an "S" shape. The LGX solved that problem. I suspect the solution was partly by design of the LGX and partly by the knowledge and experience base of the medical community accommodated the length-expanding technology.

see these papers:
https://pubmed.ncbi.nlm.nih.gov/7490811/

https://www.researchgate.net/publicatio ... Strategies


A similar thing happened when jet aircraft were introduced to the air. Aircraft powered by piston engines driving propellers could begin takeoff rotation (nosing up) before reaching minimum flight (stall) speed without danger. Pilots attempting rotation before the jet aircraft reached stall speed risked a disastrous crash. It took a lot of crashes for the population of pilots to get that knowledge infused into their mental processes. A "learning curve" among the population of pilots. Likewise, the length-expanding penils implants had a learning curve which has now reached its culmination. So, aggressive sizing for non-length expanding and length expanding implants has now mostly been adjusted for by both the shared experiences of the population of surgeons and by the design of the implants.

[Fernando]

I'm really sorry.
You're right.
my first language is portuguese.
I used the term "extrosion" to think of the Portuguese word for erosion.

I appreciate your repair.
Forgive my inattention.

Hi Fernando. I can't answer your question directly, but I believe the term you're after is "erosion".

[Fernando]

Hello Lost Sheep,
Thank you very much for your message. It was really helpful and enlightening.
I actually read a medical text somewhere where the surgeon said it left about 2 cm of space between the tip of the implant and the glans. At the time I thought it was almost a crime, but now I understand why.I would like to hear your opinion on the risks of implanting an over-sized inflatable prosthesis.
Will an implant that is too big make it impossible for it to be inflated to the maximum and cause an unstable erection?

Thanks again for your mmensagem.

Last time I have been doing a lot of research on implants. Actually, I haven't done much more in my spare time ...
From what I've learned so far, the biggest problem with implants is infections.
But the biggest cause of discontent with implants is the loss of size.
Which leads us to think about the implant sizing.
Whether an aggressive or more conservative design is beneficial.
This is because another major problem with implants is extrosion. That is, the implant pierces the penis.
In your opinion, what is the reason for the extrusion of the implant?
Will the extrusion depend more on the type of implant, semi-flexible or inflatable, on the physician's experience and competence, or is it solely due to the too aggressive sizing of the implant?
Curiously, I didn't find many cases of extrosion in 3-piece inflatable implants.
Do you think the risk of extrosion in an aggressively sized inflatable 3-piece implant is high?
Or will the greatest risk be the inability to inflate the implant to the maximum due to the pain of tissue stretching?

I will try to explain myself better.
Will the best result with the implant be obtained with an aggressively sized implant to avoid the risk of decreasing the size after the operation, or can this cause the risk of extrosion?
OR, even if there is no risk of extrosion, can an implant that is too big make it impossible to inflate the implant to the maximum and thus not achieve a very good erection and firmness?

Erosion is a greater danger with the semi-flexible (also called "semi-rigid" or "malleable") implant than the inflatable because the inflatable only puts strain on the distal penile tissues when inflated, which is only a small portion of the day and not usually for very long. The malleable implant presses on this tissues 100% of the time. Continual compression of the penile tissues leads to decreased blood flow. If the flow of oxygen and nutrient laden blood is slowed enough, tissue death can result, and loss of those tissues a real danger. That danger is present in malleables more than inflatables, but if an inflatable remains inflated for too long, theoretically, it can happen there, too.

As surgeons gained more experience (not just each individual surgeon, but the entire cadre of surgeons contributing to institutional knowledge base on all inflatable implants), the discernment of the proper degree of aggression in sizing has become clearer.

I guess that it is common for a surgeon placing a malleable implant to be less aggressive than one placing an inflatable, but I have no idea by how much.

Several years ago there was an implant that was designed to lengthen between the deflated state and the inflated state. (Ultrex from AMS) There were some bad outcomes with the Ultrex, that prompted some surgeons to recommend reducing the length of the implant by 2 cm from the aggressively measured size to prevent what they called the "S-curve deformity. When the implant was inflated, the length expansion was limited, so the implant buckled into an "S" shape. The LGX solved that problem. I suspect the solution was partly by design of the LGX and partly by the knowledge and experience base of the medical community accommodated the length-expanding technology.

see these papers:
https://pubmed.ncbi.nlm.nih.gov/7490811/

https://www.researchgate.net/publicatio ... Strategies


A similar thing happened when jet aircraft were introduced to the air. Aircraft powered by piston engines driving propellers could begin takeoff rotation (nosing up) before reaching minimum flight (stall) speed without danger. Pilots attempting rotation before the jet aircraft reached stall speed risked a disastrous crash. It took a lot of crashes for the population of pilots to get that knowledge infused into their mental processes. A "learning curve" among the population of pilots. Likewise, the length-expanding penils implants had a learning curve which has now reached its culmination. So, aggressive sizing for non-length expanding and length expanding implants has now mostly been adjusted for by both the shared experiences of the population of surgeons and by the design of the implants.

[tomas1]

I think my CX was sized almost exactly the way I was prior surgery,
I have gained a little since then so I guess I was sized a little more aggressively than usual.
It doesn't present any problems for me.
After first inflation, I could feel a very small discomfort in the glans.
A fellow implantee here assured me that meant that it might extend more and it has.