TOPIC: Any experience with Texas Phalloplasty?

\"I agree with Hoddle. Seems to me that sparticus/eq concentrate their attacks on PMMA and play down the risks with other procedures. I don\'t know why.\"

When have I ever played down the risks to any procedure? Can you please post a quote? I\'ve been very consistent from the start stating that NO procedure provides an adequate safety profile. The only exception would be FFT, which generally has poor aesthetic results and is impractical for most due to top ups.

hi guys just thought i\'d chime in to clarify some bits and bobs

eqstudent wrote: One important note, the scaffold material (PLGA, ePTFE, ') is more likely to cause a foreign body reaction than Alloderm,

in my understanding this foreign body reaction is what causes new tissue and blood pathways to grow within any matrix

eqstudent wrote: remember Alloderm is an Acellular dermal matrix.

again in my understanding this is a good thing when compared to implanting someone elses unprepared cellular tissue which could be rejected but irrelevant as a negative when compared with other acellular matrixes such as prepared pig dermis or synthetic scaffolds
When compared to synthetic (also obviously acellular) scaffolds such as PLGA I believe it is at a disadvantage for the following reason
According to my understanding and experience, the PLGA scaffold dissolves completely with only the new tissue remaining. (Unfortunately there is little to no gain and no guarantee of consistent tissue creation). With the alloderm or any other material that is not guaranteed to completely absorb there are dangers. Not only can the graft contract in unusual ways, as Hoddle has mentioned, it is grafted to the fascias and can cause limitations in Erection length and twisted appearances not to mention blood flow issues.The major danger however is if new vessels are not grown through the graft quickly, which is more difficult with thicker or multiple sheets, and the graft does not either \"take\" (ie become cellulariesed) or completely dissolve, the body is left with this acellular material that is now prone to harbouring infections. The body has less chance of fighting the infection because of the very fact that the graft is acellular and porous

eqstudent wrote: Also the task of combining one's cells with the scaffold material and ensuring survival and growth is daunting.

Daunting, yes, but applies to alloderm too.

eqstudent wrote: I am very confident that if you ask 100 surgeons today on the safety of Alloderm vs. Scaffolds all 100 would pick Alloderm. Now in 7 to 10 years that may change.

Not sure if this is useful...better to ask 100 urologists. Also find out how many doctors have had to take out alloderm grafts. Urologist Dr Gary Alter can give some good advice regarding this.

eqstudent wrote: As the CMO of the firm where I work said about the emerging scaffolding opportunity 'let them continue to experiment on people in Eastern Europe and the Far East where no one seems to care'.

Your CMO sounds unethical at best and it also seems that the company you work for are not going to win any awards for pioneering efforts or breakthroughs any time soon . Perovic and his team were world renowned. At least in the UK all the top urologists I had consulted respected the work that the Serbian team did. Also I doubt any doctor anywhere really cares about us the way we are supposed to care for ourselves. There is limited sympathy when things go wrong especially with penis surgery whether in serbia, uk, thailand, us or mexico
Even though the surgery didn\'t work in terms of gains, I am glad I was left with nothing rather than a dodgy alloderm graft years later. Being Circumcised is a major drag too but that would have happened with any surgery regardless.

I would not recommend either procedure and in hindsight would never recommend anyone taking a scalpel near their penis unless absolutely required.
However, even though no urologists are going to appreciate anyone inserting PMMA in their penis, my interest is still piqued and I enjoy reading the studies that you gopher out so keep it up please. More information both negative and positive regarding the procedure is better and thanks to all.

(disclaimer: just an average joe with no medical background yada yada, read as opinion only)

eqstudent wrote: @hoddle10 we will agree to disagree on Scaffolds vs. Alloderm. One important note, the scaffold material (PLGA, ePTFE, ') is more likely to cause a foreign body reaction than Alloderm, remember Alloderm is an Acellular dermal matrix. Also the task of combining one's cells with the scaffold material and ensuring survival and growth is daunting. I am very confident that if you ask 100 surgeons today on the safety of Alloderm vs. Scaffolds all 100 would pick Alloderm. Now in 7 to 10 years that may change. As the CMO of the firm where I work said about the emerging scaffolding opportunity 'let them continue to experiment on people in Eastern Europe and the Far East where no one seems to care'.I am very aware of most of the discussions that took place on the old board so let's leave it at that.I am extremely concerned about the overall complication rate of all these procedures. If you have any links or data on said rates I would very much appreciate you pointing me towards them.I hear you on the FFT. Your extreme caution is noted, heard, and very much appreciated. If there only 3 doctors in the US who doing it that is 3 more than are doing PMMA in the penis!

I know you want to agree to disagree, but I do want add some more as what you\'ve posted is key to the point I\'m trying to make. We are talking about the safety of the products regarding PE and not in general use. I\'m sure if your CMO were aware of what type of surgery the two products were being used in, he\'d have a different opinion and the same would be true of the hypothetical 100 surgeons. The penis is a dynamic organ and therefore having a less pliable material grafted onto it can cause real problems, such as shortening and curvature. Obviously this wont happen with the scaffold material. You also have to worry about long term encapsulation, which again wont happen with the scaffold. And of course if Alloderm gets infected and needs removing you are in real trouble. The makers of Alloderm specifically point out that they don\'t recommend its use for penis enlargement. The scaffold is specifically made for penis enlargement and in theory is far more suitbale. I don\'t recommend the scaffold, as results are inconsistent to say the least and the main surgeons doing it have caused their fair share of problems, but in terms of your safety criteria, the scaffold itself is definitely superior to Alloderm. Sorry for harping on after you\'d requested we take it no further, but I really want to stress the point that it isn\'t a case of simply comparing the materials themselves, but their application in penis enlargement surgery.

londonlad wrote: 'Even though the surgery didn\'t work in terms of gains, I am glad I was left with nothing rather than a dodgy alloderm graft years later'

I am truly sorry your scaffold procedure did not work out. However having said that, for the slightly lower surgical procedure risk (IMO) with Alloderm you would not end up with a 'dodgy graft years later'. You will know within the first 90 to 180 days if there is a problem. Most (non penis) Alloderm studies show infection/rejection rates to be very low on the order of < 2%

@hoddle10 until I get hard facts on the safety on any of these products in a penis I am comfortable with extrapolating usage from other systems. As I posted in another thread Hernia Repair is an even more demanding solution where Alloderm is used. www.ncbi.nlm.nih.gov/pubmed/18209948

eqstudent wrote: @hoddle10 until I get hard facts on the safety on any of these products in a penis I am comfortable with extrapolating usage from other systems. As I posted in another thread Hernia Repair is an even more demanding solution where Alloderm is used. www.ncbi.nlm.nih.gov/pubmed/18209948

You wont get reliable facts in my opinion. I could show you studies published in highly respected medical journals about the safety and efficiency of scaffold surgery, that quite a few members on here can tell you are utter nonsense.

The only way you can truely get trustworthy information on any of these procedures is to follow them for years, as I and some others have. I\'ve been part of the online PE surgical community since 1997 and can tell you that reallity nearly always contradicts what we read in studies. There really is no big conspiracy theory in which plastic surgeons and urologists are trying to prevent PE surgery going mainstream. The reason these procedures are carried out by so few is pretty straight forward - they all have terrible track records. I\'ve followed guys online for years and can totally understand why so few Dr\'s are interested in performing these relatively simple, but very profitable procedures.

hoddle10 wrote: ...You wont get reliable facts in my opinion. I could show you studies published in highly respected medical journals about the safety and efficiency of scaffold surgery, that quite a few members on here can tell you are utter nonsense...

Would love to see that data!

hoddle10 wrote: ...The only way you can truely get trustworthy information on any of these procedures is to follow them for years, as I and some others have. I\'ve been part of the online PE surgical community since 1997 and can tell you that reallity nearly always contradicts what we read in studies...

Then post the data you and others have accumulated over the last 14 years. In your opinion, what are the complication and satisfaction rates for the following procedures: FFT, Alloderm/Belladerm, Dermal Grafts, Elist Implant, PLGA Scaffolds, Other?

I can\'t post data as sites have constantly been closed down. There were originally just general health messageboards, then the old PEforums (now defunct), the yahoo group (now defunct) and at least 3 versions of MNS that are all now defunct. Everytime these boards get closed down we lose important data. This is what the work EP is currently doing by recording PMMA data is so important. I said on the old site that those who have had PMMA are currently taking part in the biggest and only truely trustorthy study of a penis enlargement technique. What the medical community has to say, should be secondary to what we actually observe.


You really don\'t need to be suspicious about the my inabilty to produce data to support my concerns with PE techniques (all old timers will agree with me anyway), as the contradictions and lack of conformity within the industry itself should tell you something isn\'t right. It\'s really not my desire to ensure you remain unhappy with the size of your penis.

In my opinion, based on cases I\'ve followed pre the actual surgery (ignoring those who only joined the forum and told of their woes after they had surgery), I\'d say short term success (under 2 years) of these procedures is about 75%. Long term I\'d say this drops to below 50%. I\'m not including the Elist Implant in this.

I think Mikehok might have a link for the scaffold report. If not try Sava Perovic\'s website.

eqstudent wrote:

londonlad wrote: 'Even though the surgery didn\'t work in terms of gains, I am glad I was left with nothing rather than a dodgy alloderm graft years later'

I am truly sorry your scaffold procedure did not work out. However having said that, for the slightly lower surgical procedure risk (IMO) with Alloderm you would not end up with a 'dodgy graft years later'. You will know within the first 90 to 180 days if there is a problem. Most (non penis) Alloderm studies show infection/rejection rates to be very low on the order of < 2%

thanks for your concern. I don\'t know if it is a slightly lower risk surgery really? the methods vary but alloderm can be inserted after complete degloving or by stuffing it from the base or the circ scar or both so on which method is your opinion based on? Plus to my knowledge only urologists do/did the scaffold not plastic surgeons which is the case with many of the alloderm surgeons.

Also these guys seem to have found a study talking about how 8% of patients requiring alloderm mesh explants. I can\'t find the study but maybe you can ask them for it since it interests you in particular and will be of benefit to all of us

www.hernia-patchlawsuit.com/failure/mesh-explant/

and this study says that almost half of alloderm patients experienced diastasis and if it was in me I\'d consider it a \"dodgy\" graft

www.ncbi.nlm.nih.gov/pubmed/16924395

I\'m pretty sure I\'ve ruled out alloderm because the gains are modest at best and risks get dodgier with subsequent surgeries not to mention all the real horror stories that managed to get shown on the various boards over the last few years. However, if you are seriously considering this surgery you could consider Dr Reed as he can give you good advice being pro-alloderm but bear in mind he is conservative and will not stack sheets and will make you wait a hell of a time before he decides if you are suitable for a second round


Can\'t read this one but sounds interesting
www.ncbi.nlm.nih.gov/pubmed/17255646

This one gives information about the popular surgery types
books.google.co.uk/books?id=GahMzaKgMKAC...omplications&f=false


Lastly to show how much of this data gathering by the actual professionals is so damn unhelpful this report shows 100% satisfaction and no-complication rate with silicon liquid injections, and also a much more positive outlook on plga than any of us actually had in the real world (where is bonehead??)

www.eu-acme.org/europeanurology/upload_articles/Gruenwald.pdf

keep it coming

@londonlad ' Hernia Repair is the new hotbed for Alloderm usage and is very controversial, Breast Reconstruction is the other but less contentious. journals.lww.com/plasreconsurg/Abstract/.../pubmed/18847657What will make your head spin is that Alloderm has gained popularity as a hernia repair option because Alloderm does very well, and much better than tissue repair or artificial meshes, in contaminated (infected) wounds at resisting infections! www.ncbi.nlm.nih.gov/pubmed/17071174 Agreed on the gains. Current state of the art for Alloderm penis girth increase is 0.75\" max. If you want more than that I would look elsewhere!

eqstudent wrote: @londonlad ' Hernia Repair is the new hotbed for Alloderm usage and is very controversial, Breast Reconstruction is the other but less contentious. journals.lww.com/plasreconsurg/Abstract/.../pubmed/18847657What will make your head spin is that Alloderm has gained popularity as a hernia repair option because Alloderm does very well, and much better than tissue repair or artificial meshes, in contaminated (infected) wounds at resisting infections! www.ncbi.nlm.nih.gov/pubmed/17071174 Agreed on the gains. Current state of the art for Alloderm penis girth increase is 0.75\" max. If you want more than that I would look elsewhere!

noted, just shows that in the end your decision might have to be based on emotion and trust in the doctor rather than true evidence if past papers is all we are going by.

that 0.75\" gain (if that ) is in flaccid, not always erect by the way

EQ
Where was the information you saw supporting .75 Girth gain from alloderm? When you say .75 are you implying this gain is from stacked sheets and not a single sheet? Most personal reports I have seen indicate around .3-.5. I honestly have not actively looked for any supporting studies as I assumed there were none, so my only source is personal reports.

@sparticus I have no independent study supporting my 0.75' erect girth increase. That number came from initial consultations with 2 PE doctors as to a 'reasonable non-guaranteed' expectation, in addition to anecdotal info from the prior board including soma who documented his progress on this board. phalloboards.websitetoolbox.com/post?id=5398214

hoddle10 wrote: ...In my opinion, based on cases I\'ve followed pre the actual surgery (ignoring those who only joined the forum and told of their woes after they had surgery), I\'d say short term success (under 2 years) of these procedures is about 75%. Long term I\'d say this drops to below 50%. I\'m not including the Elist Implant in this.

I am very comfortable in using those numbers, based on your 14 years' experience in this field, in lieu of established studies. I would suggest you create a sticky post with this info so that newbies such as myself can see what they are really up against before they undertake these elective surgeries!