TOPIC: Wound closure - the bad and then the GOOD!

Thanks. It\'s back to 4.5 mseg and 5 base Girth...which is smaller than R1 at the MSEG. (It is swollen in the pic since I just had surgery). And, I have a huge dent now with 3 significant scars. There are still hard nodules that I decided to leave alone.

The last 18 months have been hell...the stress of this and constant surgeries and worsening has affected everything in my life. I have had no sex life. It\'s just amazing to me to see that pathology slide with 90% PMMA in my tissue. I can\'t believe this defective shit was injected in me, and I\'ll never be the same after so much tissue has been removed. My Dick really does not look remotely normal in Flaccid or Erect states. I don\'t really like posting pics all the time - but there is a huge C shaped dent where those stitches were taken out. It can\'t flatten out because he had to remove the PMMA tissue there.

The only possibility to get back to normal (even round 1 normal would be fine) is to spend thousands on Juvederm to smooth some of this out...but that seems very hit or miss.

I\'m wondering if at some point a small skin graft from your thigh maybe necessary to fill in the 2 Inch gap. To what success, i\'m not sure, but a 2 Inch wide wound with significant depression is noticeable for you and any future partner. When you have a larger allowance, I would consult a plastic surgeon. Right now as its healing it may be the right time to consider a skin graft. I don\'t want you to feel that you are part of some sewing circle where random suggestions are being afforded to you, take a short walk if it doesn\'t provide too much discomfort and clear your mind and set a plan.

My dad believes he doctored his notes given how inconsistent they are...and the bizarre \"obsession with biofilms\" comments (among others).

My Urologist cut everything out and buried monocryl and put vertical mattress nylon - it\'s in another thread. The whole thing was a giant mess...so it just all had to go. There was PMMA fibrosis all mixed in with it too. so I lost 2 square inches of penile skin (the wound was 7mm open & then had a scar band around it from attempts to suture it). If he never used silver nitrate, though, it would\'ve closed on its own, with a depressed scar (though the uro felt it wouldn\'t ever close). Either way, now I have a scar 1/2 way around my shaft and missing skin. Uro also wouldn\'t do PCR (this is in an academic hospital too), but he did a culture.

There was never really any pain at any point. It didn\'t smell or anything.

I think my uro did the \"if in doubt, cut it out\" approach... which was a little aggressive but it\'s all gone at least.

The Sutures look very good, but one side has 1\" more skin than the other - so there\'s a bulge where the skin is tucked in...not sure what\'s going to happen with that as it heals. Others have said it should smooth out.

A negative Healthgrades or yelp review will be the most damaging initially, but you can file a grievance with the state medical board concerning his unprofessional practice of medicine. It\'ll be easier to do the latter if you have a reliable attorney. This is an unfortunate mess. Whats the diameter of your opened wound? What was the opinion of your retired MD father? They have antibiotic biodegradable soy wound dressing, often with skin ulcers the wound is cleaned then packed with before mentioned dressing and either allowed to drain or sutured. Has any clinician suggested suturing the wound at this point? Are you in pain? Does the skin wound smell foul?

I thought this was interesting to mention...

My dad (a doctor for 40 years) read the notes I attached above from Dr. Bloom (the full version - not just my cuts I posted), and he said there are major problems with them:

1. He doesn\'t even mention applying the silver nitrate in the notes, yet he billed my insurance for it. Since the silver nitrate caused all the problems, he probably deleted it from his notes (but I have 50 photos of it which are GPS coded and time stamped by the iphone...so...what would that even accomplish?)

2. He added in all the psychiatric wording to make me look worse in the event of litigation, which is moronic considering I have a psychiatrist (who can invalidate everything) + proof why I went in there (Lemperle\'s email and a Dermatologist who knows I am not \"obsessed with biofilms\"). As far as my \"unhealthy obsession with the size and shape of my penis\" - well, you can judge. Regardless, I was in his office for 15 min. I have seen the same therapist for 1-2 years. I never brought up feelings of inadequacy due to penis size w/ my psychiatrist (who is gay and knows that gay men are size queens and it\'s an issue in the community). I\'ve had a lot of stress over the fact it has been fucked up since March...not the fact it\'s too small.

3. He said the wound was barely noticeable (again, probably doctored notes). My Urologist said nobody on earth could consider that \"barely noticeable unless they were blind\"

So, to add to the malpractice, now we have fraud and spoliation of evidence.

So, good - this way, once I get my derm, uro, and psych to sign off on answers to questions like \"did I have an obsession with biofilms\" - I\'ll be sending it to the state regulatory agencies for physicians and to attys.He also should be disciplined by my insurance company for billing for a procedure (the silver nitrate) that is not in his notes. Though, he did the procedure - he\'s trying to pretend he never did while getting paid for doing it.

Yes don\'t be afraid though. I did feel little internal knots after the monocryl Sutures dissolve but eventually they will soften completely 100% and you will forget you even had them. I abstained from sex during healing but everything is fine now. This suturing technique is very time consuming and tedious but it almost guarantees success because he is reattaching all of the dermis, not just the surface layer. The downside is it will take longer to heal, but is well worth the time and patience.

Your glan may bend to the side from the loss of skin, but this will correct itself over time as the skin stretches. Eventually it will be symmetrical again.

Godspeed.

Hoodle, they are taking a look in 1 week. He buried some monocryl Sutures that will dissolve over time (100% at 3 months). Then, he placed nylon Sutures on the wound, going in through all the deeper layers with the vertical mattress technique (he was giving the resident some rhyme to do the mattress Sutures... it was really kind of amusing to be awake during this) - so that thing should be CLOSED. I mean, it doesn\'t look so pretty but it is sealed like a nuclear arms vault. If it opens after this surgery, I have no idea what I would do. He said all the tissue there was just either PMMA fibrosis or necrotic - and it had to go or I\'d have an infection or I\'d have a hole in my penis permanently. That\'s interesting about bonehead. I will have to look up his posts. Celacyn is a great rx med for scars, but I can try silicone too. And I still have that bottle of DMSO - I haven\'t used it all this time because it can be runny and I\'ve had an open wound for 2 months. But I really wanted to use it on those remaining hard spots. I hope it can flatten this. I\'ll post a pic after saturday. I have to find out how circ scars are closed...cuz it\'s almost like I just had a mini Circumcision - I mean, they took skin out right there...and closed it right on that line. But, they closed it so it\'s like pinched up...which might not flatten so fast (hard to say). He\'s very honest with me. I asked and he just said he doesn\'t know how it will look.

One concern was that he took 1/2\" of skin off my right side but my left is the same...so will this feel weird Erect? He said it definitely won\'t bend because that comes from the tunica, but the skin might be pulling on the shaft...or I might have hair growing up the right side of the shaft which is no big deal. (I saw the excised tissue in the formalin and it was pretty gross...he also kept commenting \"this is everywhere - I can\'t even work on this - I can\'t get healthy tissue\"...which freaked me out - until finally he said - \"ok now we\'re getting it\").

Mustang, that pic was just a sample of how it was lifted. My own stitches are under all the dressings I can\'t touch till saturday. Thanks for letting me know about your Elist incision.

Bigben, it sounds like I\'ll probably follow a similar path to you since I also got dissolvable + non-dissolvable (nylon). Even after they dissolve, most people still feel ridges from the surrounding tissue. That\'s good to know it eventually went away. How did things go sexually with that kind of scar?

Side note - are the first few posts in this thread insane? I kind of lost my mind when I read his notes - on top of the crap he already did. I don\'t know why I posted all this here. I just was so pissed about all that. I can get a bit angry sometimes.

The scars on my penis have healed much better than other parts of my body. Erections seem to loosen the scar tissue and promote healthy healing. On the downside they do take quite a bit of time to heal. My scar on the circ area was visible and hard for 6-8mo (Dr Alter used internal stitches that dissolve over months). But by month 12 it was undetectable even to me. Hang in there.

It looks clean and well done. Good luck. I really think in time it will soften up and look fine.

MY incision from the best phaloplasty dr in the world, elist, took a couple of years to heal and soften up. Your will take a lot less so keep up your spirits...

How long do the Sutures have to remain in? As soon as they are out I\'d start using silicone gel sheets. They really do work. And as usual, I\'d also use DMSO, but not until the wound it completely healed. I think you need to do everything you can to ensure the scar tissue is as soft and pliable as possible. We have a member called Bonehead, who had Necrosis and had to have a flap technique based surgery on his shaft, which obviously meant lots of Sutures and scarring. But the last time I spoke to him, he said it actually healed really well. I think the penis does tend to scar well. When you consider that most circ scars are totally flat and soft, it makes sense the rest of the shaft would heal equally as well.

Thanks Hoddle... yeah, I find the psychiatric crap equally loathsome. As if a man wouldn\'t care about a big old hole on his Dick? My Urologist was so blown away by that comment (in dr. Bloom\'s notes)...because he\'s a REAL doctor who doesn\'t do this kind of crap. He\'s like - he thought you couldn\'t notice that? WHAT?

I just had everything cut out by one of the top urologists in the country this morning... I\'m hoping it\'s over for good. He sutured this thing like a freaking cardiac surgery.

Oh I dont mean everything - I mean, that section where the hole was. It was a mess. He cut out 1/2 Inch of skin vertically and 1-2\" of skin 1/2 way around my shaft like a circ scar. The PMMA / tissue clinging to it (the upper layer - Dartos fascia) was like chewed up gum, and it was creating a wound sinus tract that would have led to serious infections.

He put in vertical mattress Sutures, so now it looks like my skin will be permanently pinched upward...forever... but I don\'t know.

If I never got this stupid Nodule out I would have been fine!! But, it was really awkward and stuck out like a sharp pebble. So, now I have a big fat ridge going around my penis. I can\'t post a pic yet because it\'s covered in several layers of dressings.

He let me look before he closed...it is bandaged so pics will come later.

Man, you can\'t seem to catch a break! I hope things improve for you soon.

I despise the way the medical community so often try and excuse their poor work by intimating that the real issue is with the mental state of the patient.

Thanks Hans... yeah I am going back to the original doc who saw me from 2010-2013 for Peyronies and then fixed that. I think when things have gone bad over and over and over - then you\'re just stuck with the consequences for 6 months or so. I\'m not sure.

This guy was a total idiot who has been in practice 1 year (or less). If I never went there, I\'d basically have a closed wound, though it would have had a big scar - at least it would have closed. Having an open hole on my penis for 2.5 months is driving me crazy.

Oh, but according to doctor bloom, it\'s barely noticeable. yeah, im sure people would love to blow me with that on my penis.

All the best Restoration and sorry to hear.Hopefully with time there will be a solution.There must be a decent doctor out there somewhere that can help

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