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

After displaying the various models, many of my patients will favor the AMS 700 with LGX cylinders and other features described below

Durability

LGX cylinders are as durable as the CX, the most popular IPP cylinder in the world.²

Controlled Expansion

Designed to allow for up to 15-20% elongation, depending on patient’s anatomy.²

Unrivaled Technology

The only penile implant that provides controlled length girth expansion.

Three more reasons to choose LGX:

• Momentary Squeeze Pump with Lock-out Valve and Deflation Button
• InhibiZone® creates a Zone of Inhibition, effective against the bacteria commonly associated with IPP infections³
• Parylene—coded reservoir designed to mitigate cylinder fatigue and improve reservoir durability

This product is not for men with active urinary infections or active skin infections in the region of surgery; with known sensitivity to silicone or the antibiotic rifampin or tetracyclines; with lupus erythematosus; taking warfarin, thionamides, isoniazid and halothane; or with renal disease. Implanting a penile prosthesis is likely to damage or destroy any remaining natural ability to have an erection.

Montorsi F., et al; “AMS Three-Piece Inflatable Implants for Erectilie Dysfunction: A Long-Term Multi-Institutional Study in 200 Consecutive Patients”; Eur Urol 2000; 37: 50-55

1. Data on file at AMS
2. Carson CC 3rd. Efficacy of antibiotic impregnation of inflatable penile prostheses in decreasing infection in original implants. J Urol. 2004 Apr;171(4):1611-4.

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

I believe I have some infertility problems associated with a varicose vein on my scrotum. I was also interested in lengthening at the same time. Do you perform this operation?  Can you do both at the same time? And what are the prices and payment options?   Thank you.

Donald

Good afternoon Donald,

A varicose vein on your scrotum would not produce infertility but a varicocele, (similar to many varicose veins) surrounding your spermatic cord could.

Please review the attached on phalloplasty and penile enlargement, length and girth.

In that a well performed varicocelectomy may result in some discomfort after surgery and lead you to procrastinate on early use of traction, I would suggest you have the more important operation for you done first.

Best wishes,

Harold M. Reed, M.D.

 I asked for the Ultimate AMS I was given the step down with out my conscent. Ilost 2′ and some Dimension. The Pump leaks and partially fills when its deflated. Can I get back my inches and a better girth?    Rudy

Good morning Rudy,

Thank you for your interest in what we do.  Hope you can relate to our gallery of “ups and downs.”   Have been doing implants since 1975, and probably have done over 2000.

Fortunately your AMS product has a life-time warranty applicable to any treating physician.

We have been known to perform some magic in situations such as yours, but you do need to be seen at the office so I can best advise you.

Please understand it may be as simple as revising some technical errors during your previous installation, but you do need to have this reversed ASAP as scar contracture will make it more difficult to regain the length loss.

Also bear in mind any operation is associated with risk.  The experience of your urologist and his focus to the problems at hand will help minimize this.

You may wish to initiate a consultation over the phone by sending us your name, address, and phone number in an envelope along with a check for 250.

All the best,

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

Just a quick question regarding traction following surgery.  What would be the minimum period of time that you would reccommend using traction in order to avoid retraction.  I would be happy with the immediate gains but would not want to loose them!.  I know that you suggest 8 hrs per day.  If this was done for a month for example would this period of time be sufficent to hang onto surgery gains?

Doug

October 14, 2009

Good morning Doug,

Right on.  Yes, I would think if you apply traction as we recommend for 4 to 6 weeks, you will certainly maintain what was accomplished in the operating room.  An incision does not regain full tensile strength for 6 weeks.

But for 3/8″, and never to use traction again, is it worth it?

Once that is accomplished, you could resume full time traction whenever you wish, and you will not have lost anything.

All the best,

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

as im going to be flying in from the UK. im going to be limited on how long i can stay in america for i was just wondering how long do you thing i should wait between having the two stages of surgery ie 4 weeks 6 weeks or longer? im eager to get as much done in one sitting as im going to be traveling a long way to have the procedures im intrested in…. and then  if the wait is only 4 weeks between surgerys…i could stay in the states in stead of flying home and then back???????
 
scrotal altreation (turkey neck pushed back?)
left testical enlargement
head glans enlargement
lengthening
and widening
and may be some pubic fat removal?
 
i know these can not all be perforemed at the one sitting (surgery) so i just wanted to know how much you think we could do at one go  and then how long before i can have the otheres completed??
 
ie stage 1 = glans enlargement,lengthening,widening and scrotol pushing back under the shaft?             then       stage 2 = fat pad lipo,testicular enlargemnt
 
im not looking for monster girth only a very modest increase of say 1″ all over,thanks again good doctor  Brian

Good morning Brian,

Lengthening, insertion of left testicular implant, and perhaps release of penile scrotal web, could be done at the same time.  Girth enhancement and glans enhancement need to be done separately as insertion of AlloDerm  works like a fixative to reduce length gains produced by traction.

Pubic liposuction could be done with either of these procedures, but is not advised as the transient lymphatic injury impacts on wound healing of the penis and scrotum. To do a proper job think of the pubic fat pad as an inverted U which extends down into the scrotum along side the penis.   This needs to go also. Tenderness for a few weeks in  that area, may cause you to procrastinate on use of traction,  which ideally should be done within a few days after surgery to maintain exteriorization of the penis.

Please understand the results in length are 35% me (with surgery) and 65% you (with traction).  To gain  an inch in erect length you would need to apply traction for am minimum of 6 months. 

Don’t rush to have the second stage done as you will obviate the potential gains with length enhancement.

You are spending a lot of hard earned money and we wish to have  as many assurances in place you will have a gratifying result.

Cheers,

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

 

 

About  two (2) years ago I had thickening 8 months after lenghtening. I was at 8 inches length. The thickening cost me -2 to -2 1/2 inches. I want my length back. A simple release of the adhesions would allow the “gtip ” to restore my original length.  This is my second inquiry and the first doctor said it was not a difficult procedure. I am older and in good health. I will diligently use traction once the release is made. Can you use a transcrotal incision?     Jimmy

Hi Jimmy,

Truly sorry for your loss.  There is so much I would like to say, that will be revealed after you become an established patient.   The attached file is enclosed only as it may be of interest. 

A transscrtoal incision is perhaps not the best apporoach as we need to be right over the scar tissue and adhesions when surgery is being done.  May I propose an infrapubic incision which (being on the lower pubis) avoids the shaft of the penis itself.   If the scarring is very involved a supplmental incision along the dorsal coronal sulcus may also be required.

Our office has become a clearing house for correction of these problems.  You are invited to call our amiable office manager Anne, perhaps tomorrow, and set up an appointment for consultation.

With every best wish for a speedy resolution,

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

 

 

Question for Dr. Reed:

I have lost 42Lbs., from 260 down to 218, on the way to 175. There is absolutely no increase in apparent length. The glans was the only part visible, and it still is. It appears that the fat pad has just sagged and replaced some of the original blubber with sagging skin and flabbier blubber. I presume this will not improve as the rest of the weight comes off, because it appears to actually be just a little worse now than when I started.

 I suppose plastic surgery could correct this. Do you do this in your office, what does it cost, and would Medicare cover it?

Hi “Headout”

Congratulations on your weight loss. As we age we lose lower abdominal and pubic skin elasticity. So there is often a blousing effect of the skin which doesn’t help your perceived outward length. The sheer weight of the fat that had existed also drags skin downwards. Providing more skin at the base of the penis tends to translate into at times an uncircumcised state.   This is best seen when we are standing in front of a full length mirror. Also remember, pubic fat is called “privileged fat” and is often the last to “melt” when you diet.

To check on the benefit that dermatolipectomy might offer, take both hands and lift your lower abdominal and pubic skin with any contiguous fat mass. See if you like that look.  The other alternative to regain a circumcised look is simply to redo your circumcision but the dermatolipectopmy is certainly cosmetically more appropriate in my opinion.

If you do the lift, this would give you some idea of how you may fare with a dermatolipectomy (removal of skin and underlying fat).

Headout, your many contributions to our message board are fully appreciated.

Harold M. Reed, M.D.

I’m curious if you use only one “sheet” of alloderm per procedure, or if they can be doubled up?…if so, how does that effect pricing? I am hoping to gain at least an inch in girth, if possible. Thanks..  Steven

Hi Steven,

May 26, 2009

Good morning Steven,

Thank you for your interest in what we do and visiting our web-site penisdoctor.com  Hope you can relate to some of the photos.

Having done AlloDerm for about 12 years, we have learned not only from our experience, but also attending the complications of others, that multiple layers is a blueprint for disaster.

AlloDerm works best when a capillary bed grows into the graft and this in turn is followed with an ingrowth of cells of your own making.  Afterall, AlloDerm is a dermal matrix.   In other words a scaffold designed to receive in growth of tissues.  When the strips are multiple, this never occurs on the inside.  This often a good hiding place for bacteria which may ultimately make their presence known clinically.

We are using “extra thick implantable” and beyond that requesting the largest in their inventory.  Just like every egg in an extra large box may not be precisely equal, one could be larger than others.

We can also extend the strip laterally to provide more girth if that is what you desire.  But you must have a larger than average penis.

We have learned the primrose lane to complications starts out when a patient says “money is no object, put as much AlloDerm in as possible.”  This also causes compression of  your blood supply and in turn results in many wound healing problems.

There is some much more information we would be delighted to put out to you after you initiate a consultation with our office.

Hope you had a restful weekend,

Harold M. Reed, M.D.

Phalloplasty Surgeon
305-865-2000