Archive for the ‘Phalloplasty surgeon’ Category

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

Penile Implant, not what I asked for

Saturday, October 31st, 2009

 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

Limited Traction following penile lengthening procedure

Wednesday, October 14th, 2009

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

Penile Augmentation, long shopping list

Friday, August 28th, 2009

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

 

 

AlloDerm for Penile Widening

Wednesday, May 27th, 2009

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

 

 

Peyronie’s, Simultaneous insertion of penile implant and modeling

Sunday, May 10th, 2009

Looking back at 9 patients who had Peyronie’s and underwent installation of an inflatable penile implant and simultaneous modeling to correct penile curvature, that is to say, bending of the inflated or erect penis in the opposite direction to correct for angulation, the incidence of mechanical malfunction that followed was 33.3%. Admittedly a small group for a study, but in the control group, the incidence of mechanical malfunction was 4.3%, after a mean followup of about 19.6 months. Reported by Dr. Christopher DiBlasio and group from Memphis, TN. at the April 2009 AUA meeting.

Harold M. Reed, M.D.
Penile Implant and Phalloplasty Surgeon

Silicone Disasters and Aesthetic Revision

Sunday, February 15th, 2009
 Please see our web-site  http://www.penisdoctor.com/silicone.htm        

Silicone injection to the male genitalia as well as other parts of the body for enhancement is often done by non-medical personnel or doctors operating in foreign countries. The fees seems affordable, but the results are often disastrous. Silicone like injectable fat chooses paths of least resistance. Once inserted, silicone takes a random walk and the ultimate result is often unpredictable.

We have seen many transsexual females with butts that look like car tires. Way too much material is often unfortunately a feature of silicone practitioners and the results are very grotesque.

Here are some examples including one case of a female breast representative of so many we have seen, with hard lumpy contours.

Lastly although we are removing silicone as frequently as a few cases a month, there are surgical pitfalls. Silicone destroys normal healthy vascularity, so there is a propensity for poor wound healing, including separation and infection. Inevitably some silicone must be left within few milliliters of the skin as removing all of that will certainly result in skin necrosis. Silicone often will track into the lymphatic system. Tissue bulking secondary to ligneous edema may result in periodic swelling depending upon degree of physical activity.

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

 

Status post Dermal-Fat Graft and Liposuctioned Fat Transfer

Sunday, February 15th, 2009

QUESTIONS:i have dermal grafts and fat transfer,but the dermal graft is almost gone and the fat transfer is very insignificant, due to very low body fat.i would like to have the fat takin from my buttock area moved to my penise. how much would that be?  thank you…  Benson

Good morning Benson,

Thank you for your interest in what we do.

This is a story we are all to familiar with.  I could talk for almost 30 minutes about liposuctioned fat survival and the need for dermal fat grafts to secure excellent vascularization to survive.  (Been there, done that)  Most likely you not only have atrophy of the graft but perhaps a fibrous tether as well with some loss of penile length.

We are always responsive to patient requests, but we do make recommendations based upon 35 years of medical experience and common sense.

Please consider initiating a consultation with our office, could start out on the phone, as you do not want to continue to revisit your penis with one surgical procedure on top of another.

Our one time charge for consultation fee is 250.  If you do start with a phone consult there is no further consult fee once you come to our office, or any additional charge for followup questions.

Have a restful Sunday,

Harold M. Reed, M.D.

Phalloplasty Surgeon
305-865-2000

At 06:44 PM 2/14/2009, you wrote:

_________________________________________________

SURGERY:Penile Enlargement
OTHER_SURG:

Testicular Enhancement

Sunday, January 25th, 2009
I have a few questions regarding testicular enhancement. I believe my 
testicles are healthy but have lost mass due to testosterone 
replacement therapy. Additionally, they have never really dangled to 
my satisfaction. With this in mind ….
 
•Does the implant procedure itself eventually cause the scrotum to 
stretch and therefore not draw up as radically?
•How much down time after surgery?
•How detectable is it that there is something additional in the ball 
sac?
•What is the price range for such surgery and is it outpatient?

 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.

4. How detectable is it that there is something additional in the ball 
sac?
For someone who is intimate with you, only perhaps.  For sheer appearance even up close, probably impossible to tell.
5. What is the price range for such surgery and is it outpatient?
Yes, the procedure is outpatient and our fees are published on our web-site http://penisdoctor.com/testicular.htm  Also look for photographic examples there.
All the best,
Harold M. Reed, M.D.                                                     

 

 

 

Adult Circumcision, how tight can it be?

Sunday, January 25th, 2009

Many patients ask for “high and tight.”  Actually we try to discourage the extremes of high and tight, because when there is lifting of the pubic skin or as we say triangulation of the penile-pubic junction when erect, this is way too tight, and for sure the doctor is not off the hook because after some deliberation by the patient he’ll realize that the doctor made it too tight.  We say shiny tight.  Not good.  There is no more pleasure that can be derived from a shiny tight penis than a penis with somewhat mobile penile skin, but in no way comes close to covering the glans. 

Of course no patient wants it that loose it covers the glans in any part.  For that reason, we have hand held mirrors in the operating room and tell patients to be sure they are happy with the laxity or degree of tightness before we close.  We can also put the penis on the stretch to simulate an erection.

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