Archive for the ‘Augmentation phalloplasty’ Category

Phalloplasty, weights and traction

Sunday, August 1st, 2010

Hello Doctor I was wondering if you could help me with this question.  After penis lengthening surgery when weights are required for 8 hours a day, how is this done?  Does that mean that the patient would stand with weights on his penis for 8 hours daily?
 
Thanks
 

Bernie 
 

 

July 31, 2010

Good afternoon Bernie,

When we think of weights, more generally we are speaking of  traction which should be started a day after surgery simply with manual extension for 2 minutes (with you lying down) up towards the ceiling for two minutes and down (towards your feet) for two minutes, a least 8 times a day.  Give your penis a chance to accommodate.  You will notice towards the end of the two minute interval your penis is longer.  Also immediately following surgery, your penis has been wrapped, extended outwards, like in a cervical collar.  This helps too.

After 5 days the wrap is removed and slowly you will progress into serious traction graduating up to 8 pounds if your doctor feels your diameter is capable of that much tension without injury.

I could talk for many minutes about how traction should be and not be applied.

You can accomplish a good deal of the minimum 8 hours a day needed while on bed rest.

Sorry the information is vague, because without knowing you, or having a doctor-patient relationship with you, I cannot go into specifics, but I am available for consultation over the phone if you wish.

Our fee is 250 and this is a one time charge, thus there is no charge for your first visit at the office, excluding any lab work which may be needed.

Sincerely,

Harold M. Reed, M.D.
305-865-2000

BellaDerm vs. AlloDerm Phalloplasty for Girth

Saturday, July 31st, 2010

I am thinking about PE surgery and wanted to know the difference between alloderm and belladerm.  What are the differences between the two and which one gives a superior results as far as girth enhancement?

After girth enhancement surgery, with either alloderm or belladerm, can a second girth procedure be done?

How long after lengthening surgery can you start to stretch with thegrip?

Any thoughts on the Dr. E’s silicone implant and the late Dr. Perovic’s bio-scaffold?

How was it possible the patient in example#2 was able to get such a great girth enhancement?

Are you going to post some before and after pictures of patients with glans enhancements?

You are probably aware of the forum, mynewsize.com/forum and the owner/moderator, C. H, had trouble with his 2nd girth surgery. Good or bad, your name is not mentioned all that much on that forum.

Can the $250 consultation fee be applied towards surgery?

Thank you for your time.

Sincerely
Carl

July 27, 2010

Good morning Carl,

Thank you for your interest in what we do.

As consultation (by us) is an independent event, so we do not  co-mingle or reapply fees.  Nor do we try to sell.  We have told many a well hung man he can rest on his laurels and no surgery is needed.

Taking your thoughtful questions in  the order posed…

What are the differences between the two and which one gives a superior results as far as girth enhancement?Personally I do not see any difference in the ultimate result.  AlloDerm comes from a deceased donor, BellaDerm from a live donor (usually tummy tucks with massive amounts of skin removed).  The same corporation that sells BellaDerm also sell deceased donor products as well.

 

The maximal thicknesses are comparable, but BellaDerm comes in 20% lager widths, so when patients are buying volume and the doctor is charging the same amount for either, BellaDerm provides more volume for the same money.

After girth enhancement surgery, with either AlloDerm or BellaDerm, can a second girth procedure be done?Yes, but I think you’ll be happy enough with one application that you should not have any more girth enhancement surgery.

 

How long after lengthening surgery can you start to stretch with The Grip?We have our patients doing penis pulling exercises (manually) the day after surgery and it is not painful.  The Grip could be applied about 5 to 6 days after surgery (the zero day).

 

Any thoughts on the Dr. E’s silicone implant and the late Dr. Perovic’s bio-scaffold?Dr. E claims good experience with the product.  Our early experience with “crescentic” molds despite use of permanent mltiple Prolene sutures showed that as the spermatic cord occasionally lifts the testicle which is a normal thermo-regulatory mechanism, the capsule which tended to fixate to the scrotal wall separated from the testis and some patients reported “empty cup”.  We also did seminal analyses before and after cups and were really taken aback when they dropped to near infertile levels. 

 

Dr. Perovic my dear recently departed friend introduced the scaffold also pioneered by Dr. Kim from Korea.
At first they were impregnated with tissue culture cells of the implanted patient to permit more inward cell growth.

Dr. Atala noted research worker on tissue engineering and past president of the AUA has said if a scaffold is one cm or less in thickness, prior implantation of tissue culture cells growth is not needed.  Ingrowth of cells follows blood supply and capillaries will grow into a one cm. matrix without difficulty.

As for the results, I would suggest you speak to patients who have had this done.  I personally never used this product because we had excellent success with AlloDerm. 

How was it possible the patient in example #2 was able to get such a great girth enhancement?Example #2 had 3 layers of AlloDerm put in over 1 1/2 years.  We don’t recommend that, but this was his insistent wish.

Are you going to post some before and after pictures of patients with glans enhancements?

Yes, when we have some mature results.

You are probably aware of the forum, mynewsize.com/forum and the  owner/moderator, C. H, had trouble with his 2nd girth surgery. Good or bad, your name is not mentioned all that much on that forum.

Not aware.

 

Best wishes,

Harold M. Reed, M.D.
305-865-2000

BellaDerm for Penile Enlargement, MTF mission statement

Monday, June 28th, 2010

When considering a product for penile girth enhancemnt or augmentation phalloplasty, consider BellaDerm and the MTF mission statement.  MTF, Musculoskeletal Transplant Foundation, is a not-for-profit corporation.

About MTF

 

 

Mission Statement

The Musculoskeletal Transplant Foundation is a non-profit service

organization dedicated to providing quality tissue through a

commitment to excellence in education, research, recovery and care

for recipients, donors and their families.

Background

No longer in the shadows of medical practice and organ

transplantation, tissue banking and tissue transplantation are coming

of age. Today, over 900,000 Americans receive tissue transplants

each year. The Musculoskeletal Transplant Foundation, known as MTF,

is in the forefront of providing these life saving and life-enhancing

tissues. MTF was founded in 1987 by surgeons. It is a non-profit

national consortium of academic medical institutions and organ and

tissue recovery organizations across the country that recovers,

processes and distributes donated human tissue for use in transplant

surgery and research. MTF is headquartered in Edison, New Jersey,

with additional facilities located in Pennsylvania, California, Minnesota

and Germany, with recovery sites operated by MTF in Wisconsin,

California, Illinois and New York.

A leader in the tissue banking community, MTF’s work touches the

lives of many and, throughout its history, MTF has made a significant

mark on the tissue banking world. MTF has become the number one

tissue bank in the nation and is one of the largest providers of

allografts in the world, according to the American Association of Tissue

Banks (AATB). MTF provides the largest assortment of allografts

available for transplantation – more than 650 different configurations

of tissue including bone, skin and heart valves. Thanks to the

generosity of donors and their families, MTF tissue is used to enhance

the lives of patients in many ways – to help patients walk again, or

recover from debilitating and painful spinal conditions, or to salvage

limbs that might have been amputated due to cancers, to repair

complex traumatic abdominal wall injuries, reconstruct facial defects

such as cleft palate, or in breast reconstruction following mastectomy

– to name just a few.

Harold M. Reed, M.D.

305-865-2000

 

 

 

BellaDerm from Musculoskeletal Foundation MTF

Monday, June 28th, 2010

BellaDerm for penile girth enahncement is about implanting “like into like.”

Michael Kawas, President of MTF’s skin division, notes that plastic surgeons typically rely on other materials, some of them from animals (like pigs) and some of them are synthetic. “Now they will have an option to use human skin, which provides a more natural choice. We have gotten a lot of comments about the desirability of implanting “like into like” – in other words, implanting tissue from one human into another. It seems to be preferable to using animal products or synthetic materials ”

“We have a history of positive clinical outcomes using other MTF tissue”, noted Dr. Philip Bonanno, Director of the Institute of Aesthetic Surgery and Medicine at Northern Westchester Hospital. “Thus we’re comfortable using BellaDerm as a natural human dermal graft for support and reinforcement in many of our procedures.”

Donation of skin for BellaDerm is restricted to living donors who have given specific consent for their skin to be used for these types of procedures. To assure the utmost safety and quality, MTF has the highest standards for tissue donation. Living skin donations are held to the same high standards for acceptance and processing as skin which is recovered from deceased donors.

“It is very important for us to have confidence in the providers of all materials we use” continues Dr. Bonanno, “and MTF’s high standards exemplifies their commitment to providing only the best tissue possible for my patients.”

MTF is a non-profit service organization that has been dedicated to providing high quality tissue to health care providers for over 20 years. Since its founding by surgeons in 1987, MTF has received tissue from more than 74,000 donors and has provided more than 3.5 million tissue grafts for transplantation. For more information, visit www.mtf.org.

Harold M. Reed, M.D.

305-865-2000

 

Our BellaDerm rep Dina has taken a great interest

Monday, June 28th, 2010

in our BellaDerm patients. 

BellaDerm, the first human dermal tissue graft offered specifically for facial and body contouring procedures, is being introduced today by MTF, the Musculoskeletal Transplant Foundation, the country’s leading non-profit tissue bank.

BellaDerm is a unique acellular matrix, derived from donated human allograft skin. The new tissue has properties that are very appealing to plastic surgeons. In addition to coming from human donors, it provides excellent handling characteristics and the added benefit of being in ready-to-use form. It is easily accessible and ready for surgeon selection at all times. Unlike some other dermal tissues, it does not require refrigeration.

Belladerm provides supplemental support in areas of weakness. It has been used by plastic surgeons to address naturally occurring defects which may be found in areas such as the breast, lips, and face.

Now successful results are being realized in penile girth enhancement.

Please visit the BellaDerm web-site http://www.belladerm.org/  MTF (Musculoskeletal Transplant Foundation) the corporate entity is a non-profit organization.

 

Harold M. Reed, M.D.

305-865-2000

 

 

AlloDerm for girth enhancement, few questions

Sunday, May 23rd, 2010

Hi Dr,. Reed,

I am interested in your Alloderm girth enhancement procedure.  I currently reside in Atlanta, GA. If decided to have this procedure done, I would fly in.

I have a few questions:

- What are the payment options? Are there any specials right now?

- Where are the incisions made for this procedure? Under the head of the penis? At the base?

- What is the recovery time for this procedure? How long before intercourse?

- I read patients who undergo this procedure must stay 4 days, is this still standard procedure? Why 4 days?

- Do you perform this procedure on weekends?

- What tasks do out of town patients usually perform before coming into town for this procedure?

Thanks in advance for answering my many questions!

Sergio

Good morning Sergio,
Thank you for your interest in what we do.

Taking your thoughtful questions in the order posed…

What are the payment options?

You have to be prepaid before surgery.   Yes, we accept pre-payments
and many a patient has done that a 1000 dollars at a time. 
For a line of  Medi-credit, please try

Reliance Finance Company, LLC
http://www.reliancemedicalfinance.com/
1-888-502-8020

or

Chase Health Advance, USA only
www.unicornfinancial .com

or

Medicard Finance,  Canada only.
http://www.medicard.com/

or

www.carecredit.com
automated phone application #  is (800) 365-8295

Are there any specials right now?

No.

Where are the incisions made for this procedure?
Under the head of the penis? At the base?

Yes there is a 9 to 3 o’clock incision in the coronal sulcus,
the groove in back of the head of the penis and a vertical incision
about 1/2 to 3/4 on an inch long at the peno-pubic junction.  Both incisions
are closed very cosmetically and usually heal quite neatly
and fairly inconspicuously.

What is the recovery time for this procedure?

You need to be on strict bed rest for 4 days at the Baltic Hotel
following procedure, and keep a wrap on for 7 to 8 days.

How long before intercourse?

About 8 weeks,.

I read patients who undergo this procedure must stay 4 days, is this still standard procedure?

Absolutely.  A.  To prevent shifting and sliding of the dermal-matrix product,
and to minimize post-operative swelling and bruising.

Why 4 days?

Usually maxes out by that time.  I have to see you at the Hotel everyday.

Do you perform this procedure on weekends?

No.

What tasks do out of town patients usually perform before coming into town for this procedure?

Please initiate an over the phone consultation.  Our fee is 250 and is a one time consultation charge.

All the best and have a restful weekend,

Harold M. Reed, M.D.
305-865-2000

Fibrofatty nodules following fat transfer girth enhancement

Friday, March 5th, 2010

I had phalloplasty in 1995. Results were good for about ten years but I now have a lumpy and distorted penis (especially during erections) from the fat injection nodules now having moved around. Do you remove those or do any penis reconstruction. I know that several West Coast Doctors do this.

However, I live much closer to your area and wanted to see if you have experience in this area. I have some digital pix that I could forward to you, if that might help.    Donald

Good morning Donald,

Thank you for our interest in what we do.

Please visit our web-sites http://penisdoctor.com/
and http://srsmiami.com/ (the latter not so much for
you) but you’ll see we specialize in genital reconstructive
surgery.

We are very familiar with FF nodules and their removal.

Ideally an incision should never be made on top or even on the sides of the penis, exception the circumcision line.

The attached is posted only for interest and some pre-op suggestions.

If you believe I am the doctor for you, please initiate a consultation over the phone with our office by sending us your name, address, and telephone number in an envelope along with a check for 250. 

We’ll get started ASAP.  We’ll have a lot to talk about.

Cordially,

Harold M. Reed
1111 Kane Concourse, Suite # 311
Bay Harbor Islands, Florida 33154
305-865-2000

AlloDerm versus PLGA and skin flaps

Sunday, February 14th, 2010

I have been interested in PE for quite some time but have put it off until I found the right procedure for girth. I stumbled across a Dr Lim I believe is his name (?). He performs a ‘flap’ surgery that carries more blood to the penis over time. He says the more you stay erect over this period of time the larger it becomes and stays that large. Have you heard of this? What do you think and have you tried this? They say it can be combined with other forms of girth enhancement such as alloderm or dermal grafts etc. What do you think about PLGA Scaffolds and the Elist implant as compared to the other forms of girth enhancements? My penis is average size but I would feel more secure if it were bigger especially in girth. I know I don’t want fat inserted. Thanks for your time.

Tyrole

Hi Tyrole,

I have never heard of him, honestly and the technique of flap surgery is not used by any urologist I know of.    Try to get some more background information, such as articles, photos etc.

We do know of PLGA scaffolds and the “implant” technique and do not recommend this.  I have seen others install PLGA scaffolds and the product is vey friable (tears easily) like an old dried-out sponge that turns to dust when rubbed the wrong way.  Unless great care is taken it may fall apart during installation.  Also be wary of simultaneous surgery.  The results can be anywhere from lackluster, to disastrous.   AlloDerm which we have used for 15 years is very reliable when properly installed.  AlloDerm can be installed via a tunnel and drag technique, for PLGA scaffolds the entire penile shaft skin (as a rule) has to be degloved and sewn back together again.

More involved.

Sincerely,

Harold M. Reed, M.D. FICS

Senior Member of the American Urological Association
Member Society of Genito-Urinary Reconstructive Surgeons
Founding Member and Treasurer of American Academy of Phalloplasty Surgeons
Founding Member Sexual Society of North America

Status post circumcision with sloppy look and peno-scrotal web

Thursday, January 21st, 2010

Dr. Reed:

About a year ago I was circumcised by my urologist.   He did not respect my request to leave as much inner foreskin as possible. Nor did he respect my request to remain awake and aware during the procedure. The outcome is a low and sloppy look with suture marks all around.  He also pulled scrotum skin up the shaft leaving a turkey neck web.  The result is that my penis looks much shorter and I cannot penetrate as deeply. 

The frenulum was left.  It is very sensitive and pleasurable upon initial penetration but after thrusting and becoming more erect it becomes painful.

I’d like to have a recirc if possible and have the turkey neck trimmed back and the frenulum removed.

Would photos help in evaluating if this is doable?   Can you give me some idea of fee?…healing time?

I’m 65, gay, and love sex.  But due to what I’ve described, find myself not having it as often as my partner wants.

Oh yes, I want to be as aware as possible and see as much of procedure as possible.

Thanks,
M.  O’Day

January 21, 2010

Good morning Mr. O’Day,
Thank you for your continued interest in what we do.

For most patients we recommend you stay here overnight following your revision procedure, and you can throw in a safety factor of an extra day.  Your sutures should be removed 12 days fter revision by a health care professional.

You can be seen in consultation and done the same day.

Yes of course, we wish to see you before you take off.

Taking your other thoughtful questions…

2.Can the frenulum be removed without total loss of sensation that it offers?We remove the frenulum on most patients, and of the 10 % or less that request it not be removed, 80% return and say, “now Doctor, please remove it.”   Truly doubt there will be any difference in sensation, but if there is any concern then don’t have it removed.,

 

3. When I am erect, turkey neck is barely visible but my balls are pulled up the shaft.  Is this the usual situation?  I very much want my balls lower for penetration again!If you have hyper-retractile testes or so called “yo-yo” testes, there is a procedure to correct for this.

 

How much scaring is left by scrotal cuts? Usually a fine white line that lays out like an inverted “Y” with limbs about 3/4″ at most in each direction.

 

How long is healing?Healing continues over 6 weeks for maximal tensile strength but cosmetically certain refinements such as fading of all redness an take up to 13 months.

 

How many weeks before sex is possible?You could resume sex typically in 6 weeks. 

 

4. Could lengthening be doen simultaneously? No for this reason.  Successful lengthening depends upon use of traction within a day or 2 after surgery to maintain what was accomplished in the operating room and build upon that.  If you have a circumcision revision, your penis will be much too tender for traction and also you will rip you suture line apart. 

 

How much would that cost in addition to other surgery?If you have orchidopexy (to prevent rising in your scrotum), that fee is an added $2,500.  Lengthening as a procedure unto it self is $4,500 and this is posted on our web-site.

 

Michael, have a serene weekend, and again many thanks for considering our facility,

Harold M. Reed, M.D.
305-865-2000

Testes hung up in mid scrotum after testicular enhancement

Sunday, January 17th, 2010

I am interested in penis lengthening and possible eventual girth enhancement. I had testicle implants with a west coast doctor and have been ‘stretching’ with some results, however I’d like to make my testicles hang lower. I also have somewhat of a ‘turkey neck’. I would like to know if you can relax the chords on my testicles to make them hang lower and would also like to know what you can do for the ‘turkey neck’. I’d like to know if I can do either of these in conjunction with penis lengthening. Thanks.  Parmuth

Hi Parmuth,

Thank you for your interest in what we do and your excellent clinical presentation.

Several thoughts come to mind.

If the doctor has entered the membrane that surrounds your testicles, this type of surgery frequently results unfortunately in adhesions that bind and fixate the testes  in one position.

That is why our implants are placed in front and below the testes.  We have also noted degradation of testicular function if entry is made into the testicular membrane, the tunica vaginalis.

Peno-scrotal webs are fairly easy to correct.  Please avoid the Z-plasty incision, as this looks like the “mark of Zorro” when it heals

Please review the attached letter and do visit our web-site.  Look at all the documents and photos.  If you feel I am the doctor for you or my level of expertise could provide the best advice that you are seeking, then please initiate a consultation over the phone with our office.

Harold M. Reed, M.D.
305-865-2000