Some penile implant surgeons size up implant only up to the head of the penis

[whatevery]

Many do that. I personally know one who does that. I was wondering why so I entered this into a google search and got this AI generated response:

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Penile implant surgeons measure and size implants to fit the corporal bodies (the shaft's internal chambers), not the glans (head), because the implant fills these chambers, providing rigidity, while the glans remains naturally engorged with blood during arousal, so the implant only needs to match the length of the shaft up to the base of the glans to avoid complications like pain, deformity, erosion, or a "floppy glans," ensuring optimal fit and function within the body's limits. Oversizing the cylinders past the natural limits of the tunica albuginea (the penile sheath) can cause damage or erosion.
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It would be nice if someone of the statue of Dr. Clavell, Dr. Eid, Dr. Perito or Dr. Kramer who from what I understand don't do that commented on this caption.

[wolfpacker]

Surgeons size the implant to the end of the corpora. Wherever that lands in the glans may differ based on individual anatomy, but they are aiming based on corpora not glans

[whatevery]

Not sure. Some say that the implant would cover the length of the penis, others say it's up to the head only, and to expect decrease in size and possible floppy head. All LGXs and Infla10s that I talked to (4) say that had an increase in size. Most of CXs and Titans (3) say that there was no decrease.

One Titan implantee told me that there was marginal decrease (0.5") to his size but he was implanted by the surgeon that told me that there would be some. That's why I'm wondering about this and wish that one of the surgeons that's frequently mentioned here commented on it.

[duke_cicero]

I think maybe the doctors who say they do that are either irresponsibly over-sizing their patients, or are telling you this because the functional purpose of the implant is to expand into the available area—and given individual variation in penile tissue, there's a chance that you might get some movement mildly into the outer edge of the glans. But generally, erosion risk is the main consideration for avoiding this, as far as I can tell.

[tomas1]

I'm pretty sure my surgeon used both internal measurements and possibly added a bit to size me. I did gain between 1/4" and a cm. Stopping short of the glans sounds amateurish to me.

[LetoMan]

If they are doing that, they are doing it wrong. The AMS user guide provides that it is supposed to fill the entire cavernosa, and that if the measuring tool doesn’t reach “mid-glans” that they should dissect until it does.

My understanding is that there is correct sizing, and there is incorrect sizing. You are either at risk for floppy glans if undersized, or at risk for erosion if oversized. I’m sure there are the rare instances of inexperienced docs that might screw that up, and even an experienced one that had a bad day, but I think that anyone that does it regularly understands the instructions. Deviating from the instructions without a very good reason is a very easy basis for a lawsuit. No doc is doing that lightly.

What may be at play is that the ultra-high-volume implanters might hint at the idea that they know something that everyone else doesn’t. Or rather, they probably don’t hint at it, they just don’t correct the perception that they do. Certainly they are experienced at proper techniques. But having some “secret knowledge” runs contrary to medical risk management. The standard doctors are held to legally is to do what is universally vetted and acceptable practice. That’s why docs publish new techniques and have those peer reviewed… that way they limit their risk. If they were to deviate from standard practice - for example, by ignoring the instruction to dissect until the measurement reaches “mid glans”, then they either need a very solid basis to do so, or informed consent from the patient (the patient would need to be told that they they are deviating from standard procedures, why it was being done, what the risks are, etc.). It’s much easier for docs to simply show through peer review that the novel technique is better, rather than try to keep it to themselves.

Here are the AMS instructions: https://www.bostonscientific.com/conten ... ulti_s.pdf

[whatevery]

I'm not sure how high volume of a doctor is, the doctor that told me to expect likely loss of size because she'd be sizing it up to the glan. She is a straight-forward Coloplast doctor who told me that she could implant anything because she went through training.

If that's what Boston Scientific tells its implanters to do however, I doubt that Coloplast advices much different.

[edjohn]

The only dissecting they will do is cut through scar tissue (which is not found in most patients). If the CC stops shorter than mid glans, they cannot just cut further and put in a longer implant or they are literally eroding you surgically. That would be ridiculous.

A good surgeon is giving you exactly what you need, which is the full, stretched length of your CC.

[LetoMan]

The only dissecting they will do is cut through scar tissue (which is not found in most patients). If the CC stops shorter than mid glans, they cannot just cut further and put in a longer implant or they are literally eroding you surgically. That would be ridiculous.

A good surgeon is giving you exactly what you need, which is the full, stretched length of your CC.

I’m pretty sure that’s what I said, and if you read the link I cited and quoted from, it says to dissect through the fibrotic tissue to reach mid glans, not to cut through the tunica. The answer was given in the context of someone saying that they stop short of the glans, not an argument for cutting the tunica.