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Hi Everyone,

I was watching a video from Dr Ghattas, one of the highest volume implantologists in the world (according to him, even more than Perito, which over 800 implants per year).

In the video, he argues against the popular belief that it's best to preserve the natural tissues as much as possible. He, on the contrary, argues that natural tissue eventually dies anyway due to the pressure of the implant. So it's best to make sure the biggest implant possible is installed. He argues that even if a result looks great on day 1 with great engorgement, it can lead to a floppy glans 2 years later because the tissue surrounding it dissappeared anyway. So he implies that preserving the natural tissue is not a good idea. I am not an expert but this was my understanding of the video. Feel free to correct me if i understood it wrong.

Something to note: This video is focused on malleables. But i wonder if it applies to inflatables as well?

People in the forum who got inflatables: Did your natural engorgement / blood flow change over the years? Did it get worse or better? Did your penis shape change in any way over the years?

I am very curious about how the long term results look like.

Link to video: https://www.youtube.com/watch?v=lGIEROoydmQ
It is in arabic in the beggining but he switches to english later.

Fascinating observation and questions. I received my Coloplast Titan Touch in November 2018. After the healing process and over the years I've found that my sense of engorgement after some sexual stimulus (visual or physical) still remains and can be divided into two areas. Blood flow to my glans still happens and quite nicely I might add. Even 'deflated', the erection feeling is fulfilling! I must add that my shaft is still at 'parade rest' but (in my opinion and with eyes closed) the blood flow around my shaft that accompanies the flow to my glans seems to make my penis warmer, larger and more like my pre-bionic time. To achieve erection I still must pump (about 22 to 25 times) to match the fullness of my glans but the 'feeling' is still there. Even with the two drugs I'm on to address my bladder cancer and necessary procedures (Tamsulosin and Finasteride), my sexual sensations have not been diminished. I am thankful that the feeling is there even if the 'pre-cum' is not.

Agreed. I had my implant since 2017. Once healed i was still able to get blood flow and engorgement with stimulation, even in the flaccid state. I have had recent failure of the implant and still get decent blood flow when excited. Revision now scheduled for 6/27. Cant wait to get back in the saddle again, literally !!!
Bandit

Discovernew, I'm only 4 months post-op so I'll offer this FWIW. My understanding is that one of the benefits of deflating to the flaccid state is to keep extended pressure off the remaining tissues, allowing for normal blood flow. For me, and I think for lots of guys, engorgement is a huge benefit to the experience. Also, for my wife, the engorgement is the same kind of indication to her of my natural response to being excited for being together -- like it had been in the past. I've continued to take low dose Cialis daily just for that reason. I'm hoping the responses to your post indicate engorgement stays with the implant for a long long time.

Bandit, best wishes for a successful revision next month !

- Chuck

Discovernew wrote:Dr Ghattas argues that natural tissue eventually dies anyway due to the pressure of the implant. People in the forum who got inflatables: Did your natural engorgement / blood flow change over the years? Did it get worse or better? Did your penis shape change in any way over the years?

With all due respect I disagree with Dr Gattas.

He may be right that the natural tissue dissolves away, but I don't think that means one should get the fattest implant possible. A thicker rod can restrict blood flow in the blood vessels and that can lead to ischemia...which will lead to necrosis. They can also put pressure on the urethra, causing urinary problems and problems with ejaculation.

Not everything is about size...think about function.

Kodixx wrote:
Bandit, best wishes for a successful revision next month !

- Chuck

Thx Chuck !

I agree yes, my natural tissue has gotten noticeably thinner over the years with my implant. Dr Eid also has told this to his patients and in an interview

Mark1974 wrote:With all due respect I disagree with Dr Gattas.

He may be right that the natural tissue dissolves away, but I don't think that means one should get the fattest implant possible. A thicker rod can restrict blood flow in the blood vessels and that can lead to ischemia...which will lead to necrosis. They can also put pressure on the urethra, causing urinary problems and problems with ejaculation.

Not everything is about size...think about function.

The size of a malleable implant directly affects its function. If undersized, the implant will flop and wobble, failing to provide adequate axial rigidity—usually within a year or two. This is primarily a matter of physics.

For example, if a penis accommodates a maximum of 11mm and receives an 11mm implant, it will remain stable with sufficient axial rigidity. However, if a penis can accommodate 13mm or more but is fitted with the same 11mm implant, it will not maintain the same stability as the 11mm-compatible case. Most malleable revision surgeries result from improper sizing—either undersizing or oversizing.

If the implant causes urinary/ejaculatory problems, persistent pain, nercosis (from the tunica albuginea and beyond-and not the sinusoidal tissue within the corpora) or extrusion/erosion then yes that's probably an oversize..but largest implant possible isn't an oversize at all...that's why he mentioned "possible".

You can review Mbambo's journal—he was operated on by Ghattas, and you can see how comfortable he is post-recovery and how satisfied he is with the rigidity.

At the conference, everyone, including David Ralph, agreed that sinusoidal tissue will soon be gone (though some retain it for a few years).

I watched the video and the discussion session. Maybe I'm misunderstanding, but Dr. Ghattas appears mainly to be reinforcing best practices, not advancing new territory or disproving an assumption. It's impossible to entirely spare the cavernous tissue, since some of it needs to be displaced for the malleable implant to be inserted. Apologies if I misunderstand — I found it a little difficult to follow Dr. Ghattas.