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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

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,

DE Lightfoot

Dear Mr. Lightfoot,

Taking your thoughtful questions in the order posed…

Additionally, they have never really dangled to my satisfaction. With this in mind ….

1.  The testes may be elevated either because the spermatic cord is too tight for various reasons or the scrotum which is a hammock of sorts is not dependent enough and your testes simply have settled down as far as they can go.

2.  Does the implant procedure itself eventually cause the scrotum to  stretch and therefore not draw up as radically?

No although a purse string suture can be placed above, this does not work predictably well.  What will work is a small belt, if you will, made by companies such as http://www.leatherpost.com/static/TC001.html or http://www.leatheretc.com/Merchant2/merchant.mvc?Screen=CTGY&Category_Code=Cock_Rings  Use it with care as you do not want to injure your existing testes.

3. How much down time after surgery? 

Plan on spending 3 to 4 days on bed rest at a near by motel before returning home, and you could be in an office environment in about 2 days after that.

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.

AlloDerm has by far and away become the most popular way to enhance penile girth.  Sure we lived through the liposuctioned fat transfer years with the lumps and bumps and reabsorption and inevitable touch ups. and then dermal-fat strips for phalloplasty with the harvesting scars, our were neater than most have seen, especially those 1/2 inch wide violacious bands of Zoro on the lower mid back which fortunately the patient doesn’t have to see everyday.  “Dr. Reed, please mail me a copy of the photo you just took, I want to show it to my doctor.”

With AlloDerm you don’t have to worry about atrophy and fibrosis, as long as you don’t stack it, it’s already dead.  It is a sterile dermal matrix.  Cells of your own making will grow into it.  If a dermal-fat graft doesn’t get an optimal vascular hookup within the first five days, the final result can be anywhere from necrosis in an extreme example to length contracture with palpable tethers (fibrosis)  to fat atrophy.  I started out with a 6 1/2 penis and now have only 5 inches?

Oh, we’ll put some AlloDerm, over that.   Not such a good idea.   If there is a poor blood supply, the AlloDerm will not work.  AlloDerm always works best when it is supported on both sides by a rich vascular bed.

That is the key to tissue ingrowth.   That is the difference between a reach for the moon operation on the penis and phalloplasty performed by a phalloplasty surgeon.  Our phalloplasty pictures are available on our web-site, befores and afters.  Please be sure to click Next Photos (below each photo) for the whole gallery.

Harold M. Reed, M.D. FICS

305-865-2000

QUESTIONS: I would like to know the costs of both surgeries, how long is the recovery and before I can have sex, and also, will there be any scars or signs of surgery?
Carter

Hi Carter,

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

I am a phalloplasty surgeon.

We hope you can relate to our phalloplasty before and after photo and phalloplasty image gallery.  Please see if the incisional areas have healed acceptably to you.  Yes, if someone looks carefully enough, there may be a trace of a scar.  We also do AlloDerm.

Our phalloplasty cost is posted on our web-site.

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

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.