Questions? Begin here !

[Nico_from_belgium]

Hi bionic brothers,

I would like to share with you a resume of most common questions that we all get through before and after getting an implant.
I would like to centralise all the excellent info that we have on this beautiful friendly forum.
So everyone who has some questions could get answers (or a beginning of answer) by reading this:


## Before Implant: Questions, Medications, and VED

### Common Questions and User Responses

**1. When should I consider a penile implant?**
- *Responses*:
- Most users move to an implant after oral meds, injections, and VEDs fail or cause side effects.
- Some men with Peyronie’s disease or post-prostatectomy ED opt for an implant sooner.
- Many say, “I wish I’d done it sooner,” especially after years of frustration with other treatments.
- Others stress trying all non-surgical options first, as the implant is permanent.

**2. What are the pros and cons of medications, injections, and VEDs?**
- *Medications*:
- Effective for mild/moderate ED; less so after prostate surgery or with severe ED.
- Common side effects: headaches, flushing, nasal congestion.
- Planning required can be inconvenient.
- *Injections*:
- Effective for many; some experience pain, scarring, or priapism.
- “Needle fatigue” and anxiety are common over time.
- *VEDs*:
- Useful for maintaining length and tissue health, especially pre-op.
- Many find them awkward or unromantic; some use VEDs for penile rehab post-op under doctor advice.

**3. Will I lose length or sensation with an implant?**
- *Responses*:
- Loss of length is a common fear. Most surgeons recommend measuring before surgery.
- Some report a temporary loss (0.5–1.5 cm), especially if ED has been present for years.
- Many regain length with regular cycling/inflation post-op.
- Sensation is usually preserved; orgasm remains possible for most.

**4. How do I prepare for surgery?**
- *Responses*:
- Pre-op instructions: stop blood thinners, shave area, sometimes use antibiotics.
- Some surgeons recommend pre-op VED use to maximize length.
- Strictly follow surgeon’s instructions to minimize infection risk.

**5. What about insurance and costs?**
- *Responses*:
- In the US, Medicare and many private insurers cover the procedure if medically necessary.
- Out-of-pocket costs (if not covered): $10,000–$25,000.
- Coverage varies internationally; some travel for more affordable surgery.

---

## Different Implants: Brands, Types, Incision Methods, and RTEs

### Implant Types

**Inflatable (3-piece):**
- Most natural appearance/function; cylinders in penis, pump in scrotum, reservoir in abdomen.
- Requires manual dexterity for pump operation.
- Most popular and highly recommended for natural feel.

**Malleable (semi-rigid):**
- Always semi-firm; can be positioned up/down.
- Simpler, easier for those with limited hand strength, but less natural appearance.

### Brands

**AMS (Boston Scientific):**
- *LGX*: Expands in length and girth.
- *CX*: Expands in girth only; preferred for men with fibrosis.
- *CXR*: Narrow cylinders for smaller anatomy.
- *Feedback*: AMS pumps are often considered easier to use.

**Coloplast (Titan):**
- Known for rigidity and durability; preferred for larger anatomy or severe fibrosis.
- *OTR (One Touch Release)*: Easier deflation.
- *Feedback*: Some prefer Titan for its firmness; others prefer AMS for comfort.

### Incision Methods

**Penoscrotal:**
- Vertical/horizontal incision between penis and scrotum; easy access for pump placement.
- Most common; scar usually hidden.

**Infrapubic:**
- Incision above penis, hidden by pubic hair; easier reservoir placement.
- Some find the scar more discreet.

**Subcoronal:**
- Near glans; rarely used except in special cases.

### RTEs (Rear Tip Extenders): Questions and Responses

**1. What are RTEs and why are they used?**
- *Responses*:
- RTEs (Rear Tip Extenders) are short plastic segments added to the rear (base) of the implant cylinders to help the device fit the length of the corpora cavernosa (erectile chambers).
- Surgeons use RTEs to “fine-tune” the fit, especially if the corporal body is longer than the available cylinder sizes.

**2. Will having RTEs affect my results?**
- *Responses*:
- Many users are concerned that more RTEs might mean less “working” (inflatable) cylinder in the penis, potentially reducing rigidity or causing a “hinge effect.”
- Some surgeons and users report that up to 2–3 cm of RTEs is common and does not noticeably affect function or appearance.
- A few users with longer RTEs (4–6 cm) report a slight hinge effect or less rigidity at the base, but most still achieve satisfactory intercourse.
- Several men say they cannot feel any difference and that a good surgeon will minimize RTE use where possible.

**3. Should I ask my surgeon about RTEs?**
- *Responses*:
- Many experienced members recommend discussing RTE use with your surgeon before surgery.
- Ask how much of your implant will be “working” cylinder and how much will be RTE.
- Some surgeons prefer to minimize RTEs for optimal rigidity, while others say proper sizing is more important than the absolute number of RTEs.

**4. Is having RTEs a sign of a problem?**
- *Responses*:
- Not necessarily. RTEs are a standard part of implant sizing and are used to ensure a safe, comfortable fit.
- Too few RTEs can risk cylinder erosion into the glans; too many may cause a hinge effect.
- The consensus is that proper sizing and placement are more important than the exact number of RTEs.

**5. What do users say about their experience with RTEs?**
- *Responses*:
- Most men do not notice any difference in function or satisfaction with 1–3 cm of RTEs.
- A few with longer RTEs notice a slight flex at the base but are still able to have satisfying sex.
- Many emphasize that a skilled surgeon will balance the need for length, rigidity, and safety.

---

## After Implant: Healing, Experiences, and Satisfaction

### Healing and Recovery

**How long does healing take?**
- Most return to light activity in 1–2 weeks; swelling and bruising peak in the first days.
- Full healing and clearance for sex: 4–6 weeks.
- Some experience tenderness at the incision or pump site for several weeks.

**What is the first activation like?**
- Usually 2–4 weeks post-op, sometimes with the surgeon present.
- There’s a learning curve with the pump; initial discomfort is normal but improves with practice.
- Regular daily cycling is recommended to maximize length and comfort.

### Length, Girth, and Satisfaction

**Will I lose length or girth?**
- Some men notice an initial loss of length (0.5–1.5 cm), especially if ED has been present for years.
- Many regain length with regular cycling and stretching.
- Girth is often maintained or increased; some report a “fuller” feeling.

**How does sex feel after an implant?**
- Most report reliable, on-demand erections and satisfying intercourse.
- Sensation and orgasm are usually preserved; ejaculation depends on prostate status.
- Some partners notice a difference in rigidity or angle but are usually satisfied.

**What are the risks and complications?**
- Infection (1–3%), device malfunction, and erosion are the main risks.
- Prompt medical attention is advised for fever, severe pain, or unusual swelling.
- Some report minor pump/tubing issues, usually resolved with practice or minor adjustments.

**What is the satisfaction rate?**
- The vast majority report high satisfaction, restored confidence, and improved relationships.
- Emotional adjustment is common; support from partners and the forum is highly valued.
- A few regret surgery due to complications or unmet expectations, but this is rare.

### Additional Tips and Advice

- Wear supportive underwear during recovery.
- Use ice packs as recommended.
- Follow all post-op instructions carefully.
- Discuss RTEs and implant sizing with your surgeon for peace of mind.

[Kodixx]

Wow that's impressive !