Archive for the ‘Phalloplasty surgeons’ Category

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

Penile silicone disaster patient seeks a better way

Saturday, July 3rd, 2010

Hi Dr. Reed,

I found this email address on www.penisdoctor.com, I am hoping to arrange a consultation regarding a variety of things!

First of all, a few years ago I received silicone injections - 60cc in my scrotum and 10/20cc in my penis.I love the sensation of having a foreskin ( from the silicone in my penis shaft, I was circumcised as a kid), I love the size and the way it feels, however, I am dissatisfied with its appearance. My penis shaft is lumpy, there is a small area that looks inflamed, it looks inflated when flaccid rather than dangling down like a normal penis,

Therefore I am looking to reverse the silicone procedure, and would like to review other augmentation methods.

I am not sure if I am able to have everything done at once or whether it would have to be done in stages, so please provide me a breakdown of costs, and what you would do for the following:

1. removal of silicone
2. foreskin restoration (do you do this surgery?)
3 penile lengthening and augmentation
           (there seems to be lots of techniques in AlloDerm, scaffolding, fat transfer etc - what’s the difference in using each of these )
4. glanular enhancement
5. penis lengthening
            (is there a way to disguise/minimise the scars)
6. testicular enlargement

I have part-time work in adult entertainment, which I love to do. Therefore I want to go as long, and wide (within sensible limitations) as possible.

Ideally I would love to have something close to the porn star Max Delong as seen here (forgive me for the pornographic nature of the content)
http://monstercockland.com/files/2047.jpg
http://pacificsunwholesale.com/photos/DVDs/549/cover2hires.jpg

Also I am pleasantly impressed with one of your after-pictures of one of your patients
http://www.penisdoctor.com/images/larrybuff2.jpg
(exmple #2: 2/1 from page http://www.penisdoctor.com/photo-penis-enlargement.htm#1)

Also, are there any techniques (frequent penis pumping, jez extender, or exercises) that you recommend would compliment the surgery?

I’ve noticed that I have seen any ‘new’ advances in cosmetic surgery to the penis - are there any new techniques that I should consider waiting for?

Many thanks,

Ted

July 3, 2010

Good morning Ted,

Thank you for your interest in what we do.  The attached may provide some helpful background information.

To best advise you, you would need to be seen at the office.

If you wish to take photos and talk over the phone, our consultation fee is 250 (a one time charge).

We perform all of the procedures mentioned on your wish list.

Have a happy and safe July 4th holiday weekend,

Harold M. Reed, M.D.
1111 Kane Concourse, # 311
Bay Harbor Islands, Florida 33154-2041
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

Reconstruction of new penis

Sunday, January 17th, 2010

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

 

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

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.