Where to start? Contact multiple surgeons?

[steveking]

Do I contact the top dogs first and then ask what insurance I should get?


Also, do I try non implant way firsr? I am pretty sire I have VL (tested with doppler once) and pretty soft dick (like blood gushing out). Cialis kinda works. Viagra not so much. Injection works but i just cant do it. It gives me an anxiety even 1 hour before injection.

[silver daddy 1960]

Hi Steveking

I think most of the guys here on FT and Dr's agree that you should first make sure you have exhausted the other solutions before going implant. It is big non reversible solution (a good one in my opinion). I too used to stand there naked and sweat running down my legs holding that syringe unable to inject. I found FT and that lead me to Auto Injectors and help doing it. I found it was really pretty painless then and even stopped using the auto injector with time. If you want lets PM regarding the auto injector and injections. Granted the trade offs, every other day, scheduled sex and worry when it might wear out.

You dont need to go to the couple big dogs everyone talks of (i happened to live in NYC so Eid was a no brainer) the younger guy Dr's have been learning from some of the best. Check the list on this site, start there, but don't limit yourself, second opinions are necessary, and as everyone says look at the Dr's volume of surgeries.

Keep us posted, we are here to help.
Silver Daddy 1960

[Old Guy]

If you don't have insurance now it's doubtful any will approve an implant any time soon. There is a waiting period before big surgeries are approved, especially an elective one. And yes they want to see what you've tried already, usually meaning try all avenues first. (pills, injections)
As far as a doc, you want one who deals with men's sexual issues. A doc who has done a couple hundred implants or more is skilled enough to do the job. Then it's up to you to follow docs instructions to avoid infection or other problems.

[Cnidium]

If I was starting from scratch I would definitely be researching the top surgeons and interviewing them via virtual or in-person meetings. Then I would select the one that I felt offered the best outcome and move forward. If you don't know where to start the 3 I would recommend (and there are other great ones besides theses) are Eid, Hakky, and Perito. Do your due diligence on any name recommended, do not just go with one because he was named by a FT member.

[Elyrev]

You don’t mention your age or too much information on your degree of ED. Some people feel the implant is the last resort. However, in my opinion it does not need to be, once you are far enough along in your ED relaying on pills or injections for lackluster results. Check with your doctor, but at that point your condition is unlikely to improve and will probably get worse. I decided not to wait until mine was completely useless. I figured I was 54 still in good health, physically fit and responsibly attractive. I wanted to get back into the swing of things and have regular sex, not wait more years with a lackluster sex life. The recovery was hell for the first few weeks, then steadily better. I am 5 months out now and wish I would have discovered the implant and had it done several years ago. I have had more and better sex in the past two months than the entire two years previously. The mental health improvement of having a working penis that you can do anything you want with anytime you want as long as you want is a big bonus. If your regular doctor says your ED won’t improve- If it were me I would be interviewing a high volume doctor and scheduling the surgery ASAP.

[newbie443]

Do I contact the top dogs first and then ask what insurance I should get?


Also, do I try non implant way firsr? I am pretty sire I have VL (tested with doppler once) and pretty soft dick (like blood gushing out). Cialis kinda works. Viagra not so much. Injection works but i just cant do it. It gives me an anxiety even 1 hour before injection.

As you can see we each have a point of view on this. I will add mine. First of all I place a lot of importance on local care. Really difficult for follow up when the doctor is a great distance away. But you have to weigh your options. Sometimes local doctors are not the best choice. I would first look as close to your home as you can. If you can find a really good doctor close to you then start with that doctor. If not or you are not comfortable with any doctor close to you expand your search. You can use the physician finder tab at the top of this page or try Health Grades. When you find a doctors name put it in the search box above and see if anything comes up. Once you find a doctor then go and talk to him or her. Look for a higher volume doctor as studies show they have less cases of reoperation both for infection and other causes. Then ask the doctor if they do revisions or repairs. If they do not ask where they send men for that and that would be my next place to go. Then when your doctor selection is done talk with that doctor about your concerns and his or her opinions and make a plan with that doctor on how to proceed. In some cases the cost will have some men not able to go to the doctor they would like and you will have to decide if you will go to a doctor insurance selects.

I think that if you have a doctor that you develop a relationship and a history with then when the time for implant does happen this is the best thing for both of you. Even if it turns out to be for a short time before implant and hopefully you will find one close enough to you that the doctor will become your regular urologist.

Good luck with this and please ask any questions you have.

[CigareVolant]

I did a lot of research, mostly here on Frank Talk but other places as well. By the time I first contacted a doctor, I felt like all my questions had been answered, and I was confident that an implant was the right choice for me. I live in the SF Bay Area, and Dr. Karpman seemed to be the best-known, high-volume, local surgeon with lots of happy customers. So I called his office, said I wanted an implant, and asked for an appointment.

My first appointment was Thursday, June 9th and my surgery was Tuesday, June 14th, five days later. I'm sure that such a quick turnaround is unusual, but Dr. Karpman happened to have a free slot, and I grabbed it. Three months later I am yet another happy customer.

I honestly didn't feel the need to ask very many questions because so many of them had been answered here by other people who went to Dr. Karpman. I knew that he used the infra-pubic incision as opposed to scrotal. I knew that he used both Titan and AMS, but that he tended to steer people towards Titan. (Understanding that recommendation was actually the main thing I did want to ask about.) I wrote out a long list of questions, but I realized that I already knew the answer for most of them, and for others, the answer didn't matter. For instance, my erection pointed up high, which I liked, but I noticed that most pictures of implants are more straight out. I wished it was possible to keep my high erection, but even before talking to Karpman I concluded that I'd get the implant either way, so the question didn't really matter. I could have interviewed a second doctor, but I'm no medical expert. I figured that a high-volume doc with good recommendations was the best I could do.

I'm not saying this is necessarily the right approach for you. We all make decisions differently. But I will say that if you don't want to spend lots of time agonizing over this decision, you don't have to.

[stephen54]

Do I contact the top dogs first and then ask what insurance I should get?


Also, do I try non implant way firsr? I am pretty sire I have VL (tested with doppler once) and pretty soft dick (like blood gushing out). Cialis kinda works. Viagra not so much. Injection works but i just cant do it. It gives me an anxiety even 1 hour before injection.

How old are you and what's your broader ED story? Helpful for us here to better understand your current day perspective and offer up advice or at least compare experiences so you can sort through and see what may make sense for you.

Keep reading up here. You'll find no shortages of experiences you will relate with and advice and opinions to consider. Hit that search box top right and enter "insurance" etc, and you'll be able to filter through untold hundreds/thousands of posts. There's no shortcut for filtering through and reading conversations here. Invest the time. I just searched "insurance" for example and there are 5,531 posts here mentioning insurance. Once you get those results back you can further refine by drilling down within that. Further searching "precertification" for example - only 11 posts appear. So in this way you can refine, read, and fine tune your topics and questions. Regardless, you'll find most everyone here very willing to help. There's an "advanced search" function that's also helpful.

When you say "do I try non-implant way first" it seems you are asking that question in the context of both
1. Practicality (insurance, cost, doctor), and
2. Functionally (how you use your dick day to day, the erection process and experience)

On #1 - you should contact the "top dogs" for sure. You'll see 3-5 names appearing on FT like a strobe light, constantly. With good reasons. Great overall results, and some of them aggressively market themselves (which is not a bad thing, I'm not suggesting that at all). Contact them, have a comprehensive discussion, and get some baseline perspective about what you may be embarking on. I entirely agree with others' thoughts on, to the extent possible, finding a surgeon in reasonable proximity to where you live if possible. I'm not suggesting you trade off your perception of skill and competency against geography. But there is validity in thinking about aftercare, follow ups, things you're not thinking of today which may result in more return visits to their clinic than you (or they) might anticipate. Where do you live? There are some extremely competent, more under-the-radar high volume surgeons - mine included.

On insurance - no, I would not ask the surgeon or their staff "what insurance should I get" and if you do ask them I would not rely upon their answers. That's a waste of time because they cannot know with any certainty and cannot and should not advise you. They're not the right people to ask. The Plans are. And get it in writing. As you'll find, Cigna is not simply Cigna; BC/BS is not universally BC/BS. My BC/BS paid for my implant at 90%; another guy's BC/BS might not allow implant at all. There are thousands of versions of plans which have unique inclusions/exclusions based on how they're setup, what the cost structure is, what the employer offering the policy has negotiated with the carrier and decided to pay for, etc. There was a good post within the last week on this, track it down and read up - you have CPT and ICD-10 coding to consider and plans vary wildly and even those which cover implantation are more often than not going to require clinical documentation of other less drastic approaches having been tried, and failed, after x amount of time.

On #2 - If you "just can't do" injections, I would urge you to really deeply consider the implications of what implantation means. The entire picture, not just the instant-happy-hardon stories you'll read about here, and I say this as an extremely happy and satisfied implant guy. The basic concept gets debated endlessly on FT: "if I know an implant is inevitable at some point, why screw around with other modalities, let's just get it done and avoid all the other years of the other stuff". Fine. I see the thinking. Only you know how uncomfortable injecting is for you and we're all different. I didn't love the thought or reality of a lot of what injections required and brought, either, but in hindsight I am very glad I invested the 9 years in them before implant. 7+ of those years were erections and sex that was fucking mind-boggling. Just dumbfounding in its quality and duration, no other way to explain it. I had a step-wise approach in my mind - why get cut any sooner than I have to, assuming I'm getting the dick and experiences I want. For me, when I really recognized the ridiculous things a fine-tuned injection made possible, I was beyond hooked on that needle. It was 60 seconds of oddness traded off for hour upon hour of just stupidly exhaustive sexual olympics. Needle was the last thing on my mind within minutes of playtime beginning. So I'm just suggesting that if you're squeamish about that little 30 gauge needle, please consider your dick and sac being dissected and fake parts floating in you 24/7. It's all a risk vs reward calculation and it's obviously very individual.

[Salad Dodger]

Thankful for this site. It has answered a lot of questions and the recommendations have been invaluable. I had my initial implant earlier in the year with a urologist at the local teaching hospital. Great pedigree at a respected research hospital. Unfortunately, the AMS implant was sized incorrectly and the tips of the implant were shy of the glans which caused the head to be unsupported and floppy. I also had a bulge just above and to the left of my penis that I assumed was normal for the implantation procedure. The doctor assured me that the size would increase over time, but progress was glacial over 6 months. I wanted to get a second opinion and wanted to stay somewhat local and I noticed that Dr. Edward Karpman had pretty positive feedback on this site. Arranged for an appointment and after the corrective surgery a few months later, the reservoir bulge is gone and the Coloplast implant has restored the girth of my original penis. Have nothing but positive feedback from the scheduler at his office to his obvious skill in performing the operation. It’s difficult to get actual patient feedback on the web…until I found this site.