Archive for the ‘Phalloplasty surgeons’ Category

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.                                                     

 

 

 

Testicular Implants

Sunday, January 25th, 2009

 

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

Phalloplasty (Penile Augmentation), Penile Widening

Sunday, December 28th, 2008

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 for phalloplasty

Friday, October 17th, 2008

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

Phalloplasty, meaning

Tuesday, October 7th, 2008

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).                                                                         

 

 

Penile Enlargement, Vanity or Reasonable Cosmetic Decision

Sunday, October 5th, 2008

 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.

AlloDerm after dermal-fat grafts

Saturday, October 4th, 2008

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