penisdoctor.com

Ali from Pakistan

iam 36  yeas olad man.In trumatic accidant my penis cuuted .now iwant to construct it.

Ali from Pakistan

Hi Ali,

In Europe a phalloplasty can be obtained for $15,000 to $30,000.  A completed phalloplasty requires several stages and the likelihood that all stages will proceed without any complication or produce a perfect result without revisions is quite remote. 

Anticipate revisions and discuss with your intended surgeon what you may reasonably expect as related to his/her technique.  Please confer if you wish with Dr. Stanley Monstrey in Gent, Belgium or Dr. Sava Perovic or Dr. Miroslav Djordjevic in Belgrade,  Serbia (djordjevic@uromiros.com).  All are excellent surgeons.

Dr. Monstrey does an excellent forearm flap.  I have personally seen each do this surgery
several times.
 
An ideal phalloplasty will produce a phallus that looks upon close inspection to be a penis with good glans (head) formation and a corona (rim).  The phallus must be completely sensate and beyond that orgasmically sensate.  Within the phallus shall be a urinary channel of decent caliber so the patient can void urinating from the glans as with normal males. 

Additionally there needs to be a mechanism for producing a penetrable erection.  Alternatives include: an inflatable penile prosthesis carrying a 50% complication rate and in genetic males having an average survival of 6 to 8 years (less in transgendered patients); or a semi-rigid prosthesis (possibility of extrusion from continued pressure); or a bacculum (silicone rod) which is inserted into a special channel just for sex.

Many dance steps to go through.  Also there will be a noticeable deforming harvesting scar which represents the donor site, could be in the forearm, back, lower abdomen, or thigh. 

We do not perform primary phalloplasty but will do revisions.

Sincerely,

Harold M. Reed, M.D.

305-865-2000

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

 

 

Thank you for your reply.  I hope you don’t mind additional questions.
Do any of your patients ever opt to have testicular implants removed after installation?  Even if there is no occurrence of infection, does this procedure ever “go bad” even after some time has elapsed?
 
Do any of your patients have trouble adjusting to testicular implants?  I ask this because it’s hard to imagine having a foreign object in my scrotum.  My testicles are very sensitive because of their small size.  Do implants add to or detract from testicular sensitivity?  (I am not asking about scrotal sensitivity.)  As I am on testosteroone injections, would implants have any effect on how my testicles currently function?  I know that implants would not function in any way like a real testicle.
 
As I live in Arizona, does your clinic offer discounts for air fare or hotel accomodations?  Do you provide shuttle services to/from your cllinic to hotel?
 
Thank you again for your time.

Mikail

 

Good morning Mikail.

Taking your thoughtful questions in the order posed.

1. Do any of your patients ever opt to have testicular implants removed after installation? 

Yes, one patient did and brought to the office two perfectly normal implants.  Could not relate to his complaints and he continues to come to the office and have other procedures done.  So one out of about 200 to 300 cases.  The implants were removed abroad.

2.  Even if there is no occurrence of infection, does this procedure ever “go bad” even after some
time has elapsed? 

Not to my knowledge.
 
3.  Do any of your patients have trouble adjusting to testicular implants? 

Not one.

4.  Do implants add to or detract from testicular sensitivity? 

Neither.  The implants are outside the membrane that surrounds your true testes, so there is no known adverse effect on there function.

5.  As I live in Arizona, does your clinic offer discounts for air fare or hotel accommodations?  Do you provide shuttle services to/from your clinic to hotel?

Compared to other phalloplasty surgeons and considering our experience and results, we find our fees to be reasonable.  Shuttle service is available for about 19 dollars at both Fort Lauderdale Airport FLL (Go-Transportation formerly Share a Ride) and at Miami MIA with SuperShuttle.  Any starter in a kiosk at ground transportation
will help you.

We do recommend you stay at an advanced tourist class hotel, the Baltic Hotel, where the resident owner manager Christine, has shown a great partiality to our patients.  The Hotel is an 8 minute ride from the office and I will be seeing you there after surgery daily for a few days.  Yes, you pay for the hotel usually
about 85 per day.  Gourmet Danish and coffee is served every money and many convenience restaurants of almost every ethnic stripe will deliver.  There is also a small refrigerator in our room and an abundance of supermarkets nearby.  We have had doctors and attorneys, professional people, and people of means stay there.  There were very pleased with the value they got for their money.

We try assiduously to avoid merchandising or selling procedures with package deals.

Have a restful Sunday,

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

Hardly a week goes by that we do not receive an inquiry from someone with “get-there-itis”.  Wants length and girth simultaneously. Please understand while some doctors do offer this, many of their practices have been bought out by businessmen who dictate their mode of operations.  Of course, this is a popular sell, but does it work as well as staged surgery?  I think not.  Most patients complain of inadequate length gains, and also some wound healing problems.  The penis does not appreciate too much simultaneous surgery.  If you have simultaneous surgery, you will not be able to apply traction for a good 6 weeks, lest you tear your incision line apart. Better to have lengthening done, if that’s what you require, use traction immediately afterwards to maintain what was accomplished in the operating room, and build upon that until you are satisfied.    Then, go on to  widening with appropriately longer strips of AlloDerm.

If you are result oriented, believe me, this is the proper way.  I have been a phalloplasty surgeon since 1986 with close to 3000 case experience since then.
 

Harold M. Reed, M.D.

Dear Dr. Reed,

Interested in penile lengthening. What are expected erect gains? Can you perform a vasectomy as well?

Mike

Hi Mike,

Many thanks for your E-mail inquiry and visiting our web-site http://www.penisdoctor.com/enlargepenis.htm

We hope you can relate to our phalloplasty before and after photo gallery. I am a phalloplasty surgeon.

Our phalloplasty cost are posted on our web-site.

Yes, we can perform simultaneous vasectomy at a discount.

Patients who have lengthening usually leave for home the next day. You could probably return to an office environment in 3 days.

Or consultation on Thursday, surgery on Friday.  Monday, back to work.

From surgery anticipate a 3/8? increase in length and with dedicated use of traction, 8 hours a day in divided sessions, anticipate a 1/8? gain each month such that after 6 months you’ll have 3/8? plus 6 x 1/8? or 9/8?. We say about an inch longer erection in 6 months. Flaccid lengths will be corresponding longer.

Whenever you stop using traction whatever you have gained is permanently yours. If you continue, more length gains will be accrued.

We do not do simultaneous surgery, such as any combination of length, girth of shaft, girth of glans, circumcision, or pubic liposuction.

Hardly a week goes by when some disillusioned patient done elsewhere calls us for a revision. And we told you so.

Generally speaking the penis does not appreciate simultaneous surgery with a few exceptions.

With AlloDerm, we can say quite conservatively you can anticipate a 3/4? gain in circumference which is permanent as far as we know having followed patients for 8 years or so who have had AlloDerm. Most patients will do a lot better than that. AlloDerm patients must be on strict bed rest with the exception of getting up to use the commode or eating in their room for 4 days. Surgery is the zero day, and we certainly recommend you stay at the Baltic Hotel (877 622 5842) so I can see you daily as your penis will continue to swell for several days, and your dressing will be replaced often to accommodate a larger sized penis.

Mention my name for a discount.

AlloDerm is like particle board, when immersed in body fluids, it swells and swells for several days. This spreading of the collagen fibers is helpful to permit ingrowth of a capillary bed and new cells of your own making.

Early mobilization is the great enemy of good graft take. Again plan on staying in your room, stocking up on food or sending out for food. Good Italian, Greek and Chinese restaurants abound with delivery service only a telephone call away. I’ve have been known to go shopping for some patients at Publix. You won’t starve.

If you have AlloDerm surgery on Tuesday, you could be back in an office environment on the following Monday.

Most likely you will have many questions and we are available for consultation only, if that suits your purposes. Candidates who wish to schedule surgery with our facility are required to have phone consultation with a favorable response to questions of concern. Assuming this, you will be given the nod to send in a 50% deposit which is non-refundable.

If you are over 40 or are on medications, please call the office before scheduling surgery, as a letter of medical clearance may be required. If you are a smoker, you must stop completely for 2 months before surgery (girth enhancement especially) and please never again.

Smoking causes vaso-spasm, impairs wound healing, produces excessive scarring, tissue necrosis, irritates and inflames pulmonary membranes and enhances anesthetic risk. However, most of our penile surgery is done under local anesthesia with IV sedation.

This goes also for any products containing nicotine or nicotine like agents including nicorette gum, nicotine patches, Nicotrol inhalers, and second hand smoke. Again not for 8 weeks before and not for 8 weeks afterwards. Hopefully never again.

Please no aspirin or aspirin products, no anti-inflammatory drugs such as Motrin, Advil, Alleve, or Cox 2 inhibitors such as Celebrex or Vioxx for a week before surgery. No Vitamin E or excessive alcohol or spices for a week before surgery as this may promote bruising. Bruising can be reduced (many believe) with Bromelain 500 mg 1 twice a day, Arnica montana (Boiron brand) dose 30C (take 4 small tablets sublingually, 4 times a day), vitamin C 500 mg (3 times a day) starting 1 week before surgery. Do take these medications unless there are specific reasons why you choose not to and let’s discuss it beforehand.

Boiron brand is available at Whole Foods and on the web at http://www.vitaminshoppe.com for “pennies” and we do notice a difference. You will need 2 vials.

We hope to have the pleasure of serving you whenever your travel plans include the South Florida area.

With regards,

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

305-865-2000

Phalloplasty is a general term derived from “phallus” or penis and “plasty” meaning to modify by plastic or reconstructive surgery.  I am a phalloplasty surgeon, one of a few phalloplasty surgeons doing these procedures in the United States.  Our office is located in a upscale pocket park community, Bay Harbor Islands (greater Miami).  We are equidistant between the Fort Lauderdale and Miami airports.  Choose whichever airport has the best fares and for added ground savings try SuperShuttle if at MIA or GoShuttle if at FLL.

Phalloplasty cost is moderate considering my 35 years of urological experience, our Quad A (AAAASF) approved surgical facility and societal memberships which include founding member and treasurer status.

Phalloplasty before and after photos are posted on our web-site http://penisdoctor.com/photo1aa.htm and you can see from these phalloplasty images, we know what we are doing.

Harold M. Reed, M.D.

Senior Member of the American Urological Association 
Founding Member of the North American Sexual Society
Member of the Society of Genito-Urinary Reconstructrive Surgeons
American Academy of Phalloplasty Surgeons (founding member and treasurer).                                                                         

 Hi Dr. Reed,

I am a 35 year old white male in good physical health
albeit a little under weight for my 5 7 frame. I am very
curious to know how many of your patients undergo 
penile enlargement for no other reason than personal
satisfaction? I ask this because I want to be bigger 
just for myself. I guess it’s like buying a Mercedes
when your old car is just fine. You just want to feel
special.  

Does this kind of thinking bother you and do you try
to discourage people like me from surgery?      

Kal  

Dear Kal,  

For most, the operation (phalloplasty, augmentation phalloplasty)  is a cosmetic one and not
medically necessary.  I believe during arousal for both
your partner and yourself, being well represented is a turn-on. 

My responsibility is to tell you, you are normal if that is
the case.  Normal is a range that includes 88% of the all measured. 

We do note however, that a good majority of our patients
are below the median and can sympathize with their wanting to catch up.    

Please see our phalloplasty before and after photos and phalloplasty images.  The phalloplasty costs are posted on our web-site.

Harold M. Reed, M.D.

Dr.Reed,

My name is Stan. I am a 55 years old and very fit.  Approx 10 years I underwent lengthening and widening with dermal grafts. I was 5 7/8 erect and 4 1/2 girth. I am now 7 X 5 3/4 midshaft. As my wife likes girth and I am tired of using the pump. I am considering girth enhancement with alloderm.  The dermal seems to have decreased from just under the head to approx midshaft.  Can alloderm be used in conjunction with already placed dermal? As I want no more than 3/4 – 1″, to take out the dermal and replace with alloderm would make my girth less than it is now.  Also, how many sheets of allo do you typically use and what is the size of a sheet. 
 
Any information would be greatly appreciated. 

 

 

 

Hi Stan, 

 

We had had experience with AlloDerm for almost 10 years now and before that we did dermal-fat grafts, and before that transfer of liposuctioned of fat (autologous fat transfer or AFT) .  As a phalloplasty surgeon I evolved into the AlloDerm because it seems to be the most predictable performer.  Liposuctioned fat transfer can result in uniform or zonal reabsorption and the formation of fibro-fatty nodules or lumps under the skin. 

Dermal-fat grafts are living and in order for them to survive as soft as one might feel under the skin before surgery, they do need to pick up a sufficient blood supply.  Otherwise they will undergo some degree of atrophy which translates into fibrosis, the lowest common denominator of wound healing before necrosis.  Fibrous grafts tend to lose of course the original girth as the fat cells die off first, but worse yet they contract and result in shortened penile length. 

AlloDerm is a cadaveric product, and has no immediate biological requirements such as early re-vascularization.  If your dermal-fat graft in the distal shaft is not bothering you, you could consider Allo-Derm placed over it.  If it is truly fibrous, I would remove it, as AlloDerm should rest between a sandwich of healthy well vascularized tissue for a good take. 

We use extra-thick AlloDerm but avoid stacking sheets as this can predispose to a wound infection.  There is no blood supply whatsoever between the layers, and all it takes is a small amount of skin bacteria  which healthy tissue can repress.  The thicker a man’s penis is when he sees me, the less impact visually one extra thick layer of AlloDerm has.  Think of “a drop in the ocean.”  For men who have not had previous girth enhancement, we say about a 3/4″ increase in circumference.

Your circumference of 5 3/4 is OK and you may wish to rest on your laurels.  Most likely with AlloDerm you will get up to 6 or more inches.  In cosmetic surgery there is an expression, “less is more,” meaning that overdoing things can lead to complications.

Please do see phalloplasty before and after photos and images on our web-site.  The phalloplasty cost is also mentioned.

 

Hope this addresses your questions.  

Best wishes,

Harold M. Reed, M.D.

305-865-2000                                                                                                                   

 

 

 

What a loss and how does this happen and what can be done?  In this particular patient I pulled on the head of the penis and the tips were not in the mid glans but at the distal shaft, a loss of 1/2 to 3/4″ right there.  Had an expandable implant been installed with usage the patient might have gained another 1/2 inch.

When inappropriately short implants are used, the penis may just scar down to a smaller size and the only remedy is to try traction before another procedure or a penile lengthening surgical technique which can vary from pubic dermatolipectomy, release of the suspensory ligament, or release of the neruro-vascular bundle and urethra and apply a patch graft to help extend the corpora.  This is very advanced and risk laden surgery as opposed to simply installing an expander cylinder, but requested by a very insistent patient.

Being a phalloplasty sugeon, we have several phalloplasty before and after phalloplasty photos and phalloplasty images on our web-site along with phalloplasty costs.  Augmentation phalloplasty is highly specialized surgery.

Harold Reed, M.D.