Man 40 Years Old, Seriously Considering an Implant. All the Questions I’ve Been Too Afraid to Ask… Until Now!

[MiddleAgedMiami]

Hi there everyone. I’ve been reading this forum now for a few weeks, but this is my first time posting here.

A little background on me. I’m a gay man who’s 40-years old. I’ve had psychological ED for a little more than 2-years now. I currently use cialis and viagra along with alcohol when I’m going to be having sex. Basically, I’ve had hundreds of sex partners in my life and never had an issue with erections until one bad hookup. That hookup has fucked me up psychologically as crazy as that sounds, now any new encounter is a coin flip as to whether or not I’ll get hard, and worst of all, the younger and more attractive the guy is, the more likely I am to fail. I can Fuck ugly guys all day long with no problems. Basically, I’m really tired of the psychological toll this performance anxiety is causing me. Casual sex, which used to be something really fun for me, is now something I worry a lot about. I only top, so I don’t have bottoming to fall back on (now, there’s a pun). It’s unbelievably ironic that I’m still able to attract top-shelf ass but my issue is I can’t perform. I would have always thought my issue would be no one wanting me as I got older, but the opposite seems to have happened. I have all these hot young guys who want to get with me, but I’m too mental to make it happen. It’s been very depressing.

Even though I can easily get natural erections when alone or with my partner (open relationship) or with certain regulars, I am seriously considering an implant because I don’t want to dread my hookups. As silly as it might sound, my ability to have casual sex is very important to my mental health. Some people collect stamps, or rare coins, my hobby is hookups. Currently, for me to have a half way decent chance of success I’ve got to be pretty drunk, which I hate, and I know is not a long term solution, and it will eventually affect my health, which is why I’m seriously considering the implant. The idea of being able to be Hard whenever I want it sounds like a dream come true, and would cure my performance anxiety. Nothing to be anxious over if I know it’s going to be hard. I’ve also discussed this extensively in therapy.

So with all that said, I naturally have a lot of questions, many of which have already been answered by reading a lot here (thank you). But I have a few more questions I hope you’ll all be kind enough to help me with:

1. I understand that an implant (3-piece) involves two cylinders on either side of your dick that get pumped with saline for an erection. I also understand that you maintain your corpus spongiosum (the tube running on the bottom of your penis that connects to your dick’s head). My question is, are you still able to flex this like before with an implant? To me it stands to reason that you should be able to since that is still original tissue. I know some of you have other medical issues that may affect this ability, but I’m curious, can any of you do this with your implant in place? I have a pretty pronounced corpus spongiosum when fully erect and aroused (see attached pictures), and I’m able to flex it for lack of a better word, making my dick’s head swell. Can you still do this? I find guys like this move when they’re sucking it.

2. Pump placement. I’ve got a fairly roomy ballsack, can they/do they place the pump behind the balls? Or does it always go in front? I have no dexterity issues. I honestly wish they had a model with a battery that could be controlled via a smart phone instead of that foreign thing in your balls. lol.

3. When you Cum does your dick pump/shoot out the semen like before or does it just ooze out?

4. Do you have the sensation that your dick is “alive” or does it seem dead or in any way artificial? Is it still warm? Seems like it would be.

5. Any of you have issues with casual partners sucking your balls and finding the pump? If so what do you say? I’m sure you have some go-to lines to gloss over it.

6. If I get this done I’d most likely go to Dr. Perito in Miami, since I live in Miami, he takes my insurance, and I understand that he’s one of the best surgeons for this in the country. Anyone have their procedure with him? Any thoughts about his practice?

7. Lastly, if you were me, would you consider doing this? Or am I jumping the gun?

Thank you for reading this long post, I’m sorry if any of the questions are stupid, and thank you for your time in helping me with my questions!

[master1c8]

1. To make a full answer you need a video call with some guy who have implant and just watch. It's too complicated to describe. For me everything is good
2. In cases which I see usually it go in front
3. Same as it was before surgery
4. It's warm and alive. Only difference which I see it's when I don't have a boner it still bigger than it was before surgery
5. In case of gay sex usually I tell that it's a device to make a sex as much time as I want. Never use word like "medical" or "ED", because it kill the mood
6. I got my surgery in Russia, because it's cheaper. if you have insurance Dr. Perito is amazing choise, but I can't you much about him
7. do this

[sswinsfba]

I have a pretty pronounced corpus spongiosum when fully erect and aroused (see attached pictures), and I’m able to flex it for lack of a better word, making my dick’s head swell. Can you still do this? I find guys like this move when they’re sucking it.

I can't but perhaps others can. I don't get much glans engorgement to begin with but that doesn't bother me.

2. Pump placement. I’ve got a fairly roomy ballsack, can they/do they place the pump behind the balls? Or does it always go in front?

Placement will vary depending on your anatomy and the surgical choices made by your doctor.

I have always had a tight sac but there was no problem fitting the pump in mine which sits perfectly at the bottom of my sac between my balls w/the bulb facing forward.

3. When you Cum does your dick pump/shoot out the semen like before or does it just ooze out?

I can't cum any more do to prostate cancer treatment. However, I've read reports by men here stating both. Some can still shoot bullets and others justs ooze. I just depends. On what? I have no idea.

4. Do you have the sensation that your dick is “alive” or does it seem dead or in any way artificial? Is it still warm?

I dick still has all of the sensation it always had. The implant feels "unnatural" because it's always partially inflated and is like walking around w/a semi hard on, which takes some getting use to for a preOP grower like me.

My dick is always warm but some people have complained about having cold dicks. There's a thread about it.

5. Any of you have issues with casual partners sucking your balls and finding the pump?

I haven't f*cked w/anyone yet since I got my implant 9 wks ago.

However, I never got anything from having my balls sac being sucked/played with and I would tell that to my partner. So, no deception would be necessary on my part.

6. If I get this done I’d most likely go to Dr. Perito in Miami, since I live in Miami, he takes my insurance, and I understand that he’s one of the best surgeons for this in the country. Anyone have their procedure with him? Any thoughts about his practice?

Perito's well known and his videos are very useful. However, I have no personal experience with him.

The question to ask him is whether HE is actually going to do your surgery or not. The reason being that he hosts a lot of visiting docs to train them in the method (infrapubic) that he uses for IPP implants.

If you only want him to do it. You should insist on it and hopefully he'll do it but, once you're under, there's no way to know if he really did it or not.

7. Lastly, if you were me, would you consider doing this? Or am I jumping the gun?

I'm not you but, as soon as, I knew that I had irrevocable ED, I decided to get an implant.

Your ED is not irrevocable. It's psychological and situational. You can still get it up; just not for younger/hot men.

If just f*cking older/ugly men is an option, you don't need an implant but, if you can't live w/o f*cking younger/hot men too, then it seems like an implant is your only recourse.

However, I'm not sure if the implant would still be covered by your medical insurer if the reason for your ED is purely psychological.

I know that there is no "medical necessity" required for an implant under Medicare (which paid for mine) but I can't say the same for any private insurers.

This is something you need to find out BEFORE announcing to your doc and/or your medical insurer that you think that the cause of your ED is purely psychological.

Good luck!

[sswinsfba]

Dup deleted. Post deletions should be permitted in this forum.

[ThailandBound]

Hi there everyone. I’ve been reading this forum now for a few weeks, but this is my first time posting here.

A little background on me. I’m a gay man who’s 40-years old. I’ve had psychological ED for a little more than 2-years now. I currently use cialis and viagra along with alcohol when I’m going to be having sex. Basically, I’ve had hundreds of sex partners in my life and never had an issue with erections until one bad hookup. That hookup has fucked me up psychologically as crazy as that sounds,

ED is ED, whether it’s psychological or organic. I’m sorry for your trauma my friend. Have you exhausted counseling options in this regard? If a different frame of mind resulted in improvement, I’d go with that first. You don’t want any regrets.

Even though I can easily get natural erections when alone or with my partner (open relationship) or with certain regulars the idea of being able to be Hard whenever I want it sounds like a dream come true, and would cure my performance anxiety. Nothing to be anxious over if I know it’s going to be hard. I’ve also discussed this extensively in therapy.

Your ability to get natural erections disinclines me to recommend the implant without exhausting first your counseling options. It is, after all, irrevocable.

So with all that said, I naturally have a lot of questions, many of which have already been answered by reading a lot here (thank you). But I have a few more questions I hope you’ll all be kind enough to help me with:

1. I understand that an implant (3-piece) involves two cylinders on either side of your dick that get pumped with saline for an erection. I also understand that you maintain your corpus spongiosum (the tube running on the bottom of your penis that connects to your dick’s head). My question is, are you still able to flex this like before with an implant? To me it stands to reason that you should be able to since that is still original tissue. I know some of you have other medical issues that may affect this ability, but I’m curious, can any of you do this with your implant in place? I have a pretty pronounced corpus spongiosum when fully erect and aroused (see attached pictures), and I’m able to flex it for lack of a better word, making my dick’s head swell. Can you still do this? I find guys like this move when they’re sucking it.

If you’re referring to that “surge/throb” in your glans when you squeeze your perinium, the answer is: it depends. Depends on your arterial blood flow in presently. Some here have that issue and for them “the throb” or glans engorgement is always an issue. If you can flex/throb it now, you should be able to after the implant. I can.

2. Pump placement. I’ve got a fairly roomy ballsack, can they/do they place the pump behind the balls? Or does it always go in front? I have no dexterity issues. I honestly wish they had a model with a battery that could be controlled via a smart phone instead of that foreign thing in your balls. lol.

I don’t have a particularly big scrotum, and the size of my sack concerned me. The reality is that the pump is perfectly placed AFT of the scrotum and behind the original neighbors. Nobody can see it when i’m naked. I posted a pic of my (trans, btw) girlfriend squeezing my pump recently. Look for the the thread “Photo of my girlfriend pumping me up”. It’s a recent thread. Not position of the pump. Very discrete location.

3. When you Cum does your dick pump/shoot out the semen like before or does it just ooze out?

Whatever you have now is what you will have post implant in this regard. Implant does not affect the ballistics of orgasm.

4. Do you have the sensation that your dick is “alive” or does it seem dead or in any way artificial? Is it still warm? Seems like it would be.

It feels most artificial when flaccid. Me, (and partner), can feel the cylinders moving around a bit when soft. It’s subtle, but apparent that somethings “different”. To this, i quote another forum member “i didn’t do this for maximum flaccid, i did it for maximum sex”. When hard, the cylinders fill, the shaft gets very hard. My glans and spongiosum swell. Nobody would know. Except to think “wow! this guy’s got a HARD dick”!

5. Any of you have issues with casual partners sucking your balls and finding the pump? If so what do you say? I’m sure you have some go-to lines to gloss over it.

I’m only 3 months postop. My girl knows about it and now loves pumping me up. But, yes, exploring fingers will feel the pump. Other threads here discuss discretion strategies. One i like is the brother who tells his new partners “look, i must tell you something special about me. I’m bionic. I had an issue down below that was remedied by a medical procedure. What it means to you is that i can get harder, and stay that way longer than other men. You’ll wonder if i feel all the usual pleasure. I do. I am bionic” Don’t use the term “penile implant”, or go on about your ED.

6. If I get this done I’d most likely go to Dr. Perito in Miami, since I live in Miami, he takes my insurance, and I understand that he’s one of the best surgeons for this in the country. Anyone have their procedure with him? Any thoughts about his practice?

I live north of you in Palm Beach County. I didn’t go with him, but i consulted with him. Because he’s truly a high volume surgeon, you’ll find yourself in a high volume waiting room, with frequently reported long wait times (my experience). When you finally meet him in his office you’ll have his undivided attention. Interesting man…you can tell him anything. Gay, straight, rough sex/anal sex interests…nothing fazes him. I liked him. Had to pay out of pocket so went with a different doctor (i’m happy with my choice). But yeah in a nutshell, i’d use him.

7. Lastly, if you were me, would you consider doing this? Or am I jumping the gun?

I had veinous leakage and so pills and injections were losing effectiveness. I still had good blood flow in. Thus, healthy tissue with no atrophy related shrinkage. 3 months in and my dick is almost back to normal. As Dr. Perito says, “the day of your last erection is the day your dick starts to shrink”. The implant may well not recover that loss. Probably won’t. You have obviously a healthy dick. My timing was perfect. You, up to you and Dr. Perito to decide.

Thank you for reading this long post, I’m sorry if any of the questions are stupid, and thank you for your time in helping me with my questions!

[googly3]

As others have pointed out, you are not a suitable candidate for an implant. Please go through these forums and read a lot of the previous posts. Your issue seems to be purely psychological and not physiological. Do you get morning wood? Random erections? If yes, you're definitely fine physically. I know it's hard to get over the mental part, but please focus on that or rather, don't focus too much if you know what I mean. Implant is a one way street, there's no going back

[frank66665]

but sorry you didn't mention the pills, why don't you take the pills?, an implant has many cons and few pros, you will never feel like your natural dick, you are absolutely not a candidate for an implant, if you go to an implantologist thirsty for money doesn't even take a minute to convince you to put an implant, start with cialis and a very light anxiety therapy that doesn't affect and worsen erectile dysfunction, your conditions are not implantable

[sswinsfba]

As others have pointed out, you are not a suitable candidate for an implant.

FWIW, I think saying that the OP is "not a suitable candidate" is too judgmental.

True. He really doesn't NEED the implant but, if he is suffering from ED and can't get around his psych issues, IMO it's his choice whether to get an implant or not, as long as he's aware of the risks of doing so.

Whether there's a doc that will do the surgery and/or a medical insurance company will pay for it, knowing that it is a purely psychological problem, is an entirely different matter.

[MiddleAgedMiami]

Thanks for all the replies. I appreciate your insights and perspectives!