TOPIC: Any experience with Texas Phalloplasty?

The staged PRP-FFT method seems to be safest non-permanent Girth solution, I know Dr. Giunta on the East Coast offers a similar procedure.

There was a brief progress report by someone who visited this center found at the old forum: phalloplasty.proboards.com/index.cgi?boa...n=display&thread=317
It\'s too bad he discontinued his updates, hope he returns!
It appears the place offers both PRP-FFT and Alloderm, though I\'m not as familiar with Dr. Capriotti.

@eq- Sorry if I ask you this Q. , please dont take it personal :-
Why did you mention Alloderm ???
As far as I remember you have mentioned before ( in the thread \"it\'s PMMA or nothing\") in your opinion Alloderm has a high risk in the short period (<180 days) ?? Are you not worried about the high risk any more.

eqstudent wrote: @hoddle10 ' thanks for your opinion. I don't believe I am operating on any 'gut feeling'. I am trying to do detailed analysis of the viable options as I see them. I do believe there are other viable options than Newplastic injections see my options here phalloboards.websitetoolbox.com/post/sho...401713&postcount=16I am not sure why you included FFT in the surgery category. IIMU that it is an injectable filler option much like Newplastic or Artefill. Am I mistaken? I have stated in the past that I see all the PE procedure options as investigational or experimental. There are no safe procedures, everyone needs to weigh the risks against their own personal situation.

I read your analysis before and it\'s largelly what I based my opinion on. I couldn\'t agree with many of your rankings and it seemed as if you\'d already made up your mind and your chart reflected what you wanted to be the case. For example, you have the scaffold as higher risk than any of the dermal matrix products, which doesn\'t make much sense. But in general my concern is that you are largelly basing your decision by evaluating the materials used and not the overall chance of success. I understand why, for example, you\'d see fat as a safer option than PMMA. However, my worry is that you are under estimating the devestating effects of an unsatisfactory procedure. Fat is a safer injectable than PMMA for sure, but the question I think you need to ask yourself, is which procedure is more likely to give you a better result and which is more likely to badly effect your life?

Basically what i\'m saying is that side effects such as granulomas etc aren\'t all you need to worry about. I can\'t begin to explain the mental devestation that happens to a guy when he see\'s his penis is deformed, be it by uneven, lumpy, soft fat or necrosis, or material rejection, or scarring or shortening. Results with all of these procedures are very unpredictable to say the least and the percentage of unhappy patients is something unheard of in any other plastic surgery procedure I\'ve come across. The reason I specifically singled you out is because in another thread you said you considered a 1.4% risk with an injectable too much, which immediately made me wonder if you were fully aware of just how frequently the surgical options go badly wrong.

FFT is definitely surgery. Liposuction on it\'s own is surgery. There was a member of MNS called Idbravheart who suffered necrosis as a result of FFT surgery. His photos are actually on Dr Solomons site, but they don\'t show the full extent of the damage.

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.
The fact is there are risks with ANY procedure. There are different types of risk. Personally I am convinced the risk of a deformed Dick is much greater with alloderm than PMMA.
The death of the Argentine beauty queen following a PMMA procedure is constantly cited. But what does that prove ?
Perhaps we should avoid the dentist since death can occur therehttp://www.telegraph.co.uk/news/1358962/Parents-sue-over-death-at-dentists.html
And whatever you do don\'t have a routine knee ophttp://www.dailymail.co.uk/news/article-1386050/Mia-Amber-Davis-Road-Trip-Actress-plus-size-model-dies-36.html
Surgery to Repair an achilles tendon can be lethalhttp://profootballtalk.nbcsports.com/2010/07/22/former-nfl-player-dies-after-routine-surgery/
The list of deaths from routine surgery is endless. Obviously we need to assess the risk before proceeding with any procedure, but let\'s at least take a balanced view.

hoddle10 wrote: 'I couldn\'t agree with many of your rankings and it seemed as if you\'d already made up your mind and your chart reflected what you wanted to be the case.

Incorrect. The chart was my way of presenting my current thinking. If you have been following the thread you should see that I have already changed cells based on opinions from Dd71, justabitmore, Skeptical One, and mikehok. I have presented detail on my thinking/analysis and asked for, welcome, and incorporated feedback.

hoddle10 wrote: 'For example, you have the scaffold as higher risk than any of the dermal matrix products, which doesn\'t make much sense.

I ranked scaffolds higher risk because it carries the same or slightly higher surgical risks as the allografts plus the scaffolds/tissue engineering piece is highly experimental with few actual successes while the allografts particularly Alloderm have 20+ years of successful procedures all over the body and is standard for burn replacement, breast reconstruction, gum replacement and hernia surgery amongst others.

hoddle10 wrote: 'Basically what i\'m saying is that side effects such as granulomas etc aren\'t all you need to worry about. I can\'t begin to explain the mental devestation that happens to a guy when he see\'s his penis is deformed, be it by uneven, lumpy, soft fat or necrosis, or material rejection, or scarring or shortening'

Since this seems to be about why I haven't chosen Newplastic (PMMA) I believe that most of the complications you cite have occurred in the face of PMMA patients just check realself or makemeheal sites. See also the independent studies I have cited.

hoddle10 wrote: 'The reason I specifically singled you out is because in another thread you said you considered a 1.4% risk with an injectable too much, which immediately made me wonder if you were fully aware of just how frequently the surgical options go badly wrong. '

Incorrect. In this thread the hypothetical 1.4% was referring to Alloderm surgery infection rates not injectables! phalloboards.websitetoolbox.com/post/sho...338552&postcount=113
I also posted this phalloboards.websitetoolbox.com/post?id=5385417 so I am well aware of the risks.

hoddle10 wrote: 'FFT is definitely surgery. Liposuction on it\'s own is surgery'

You are absolutely right. I completely forgot the lipo component. I will update FFT procedure risk to medium even though I believe lipo is a very low risk procedure and FFT is also a very low risk procedure. Thanks! I think this segment should be moved into the \"PMMA or nothing thread\".

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 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

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%

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.

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)

\"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.

@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!

eqstudent wrote:

hoddle10 wrote: 'I couldn\'t agree with many of your rankings and it seemed as if you\'d already made up your mind and your chart reflected what you wanted to be the case.

Incorrect. The chart was my way of presenting my current thinking. If you have been following the thread you should see that I have already changed cells based on opinions from Dd71, justabitmore, Skeptical One, and mikehok. I have presented detail on my thinking/analysis and asked for, welcome, and incorporated feedback.

hoddle10 wrote: 'For example, you have the scaffold as higher risk than any of the dermal matrix products, which doesn\'t make much sense.

I ranked scaffolds higher risk because it carries the same or slightly higher surgical risks as the allografts plus the scaffolds/tissue engineering piece is highly experimental with few actual successes while the allografts particularly Alloderm have 20+ years of successful procedures all over the body and is standard for burn replacement, breast reconstruction, gum replacement and hernia surgery amongst others.

hoddle10 wrote: 'Basically what i\'m saying is that side effects such as granulomas etc aren\'t all you need to worry about. I can\'t begin to explain the mental devestation that happens to a guy when he see\'s his penis is deformed, be it by uneven, lumpy, soft fat or necrosis, or material rejection, or scarring or shortening'

Since this seems to be about why I haven't chosen Newplastic (PMMA) I believe that most of the complications you cite have occurred in the face of PMMA patients just check realself or makemeheal sites. See also the independent studies I have cited.

hoddle10 wrote: 'The reason I specifically singled you out is because in another thread you said you considered a 1.4% risk with an injectable too much, which immediately made me wonder if you were fully aware of just how frequently the surgical options go badly wrong. '

Incorrect. In this thread the hypothetical 1.4% was referring to Alloderm surgery infection rates not injectables! phalloboards.websitetoolbox.com/post/sho...338552&postcount=113
I also posted this phalloboards.websitetoolbox.com/post?id=5385417 so I am well aware of the risks.

hoddle10 wrote: 'FFT is definitely surgery. Liposuction on it\'s own is surgery'

You are absolutely right. I completely forgot the lipo component. I will update FFT procedure risk to medium even though I believe lipo is a very low risk procedure and FFT is also a very low risk procedure. Thanks! I think this segment should be moved into the \"PMMA or nothing thread\".

Scaffolds are much safer than Alloderm as they aren\'t foreign bodies, but using your own cells. The scaffold itself will disolve within 6 months, whilst Alloderm may or may not reabsorb after 2+ years. Also alloderm is grafted, so can cause scarring and shortening and as a foreign body can be rejected encapsulated years later (as happened to the infamous Chad Hedman). In terms of surgical technique I can\'t see much difference. Alloderm has a much higher chance of getting infected and seeing as the matrix is semi permament it will require removal. The key difference between the two is that Alloderm offers far more consistent results, but as I\'ve pointed out, at a higher risk.

It\'s not your fault as the threads get so big, so we can\'t expect people to know what has been discussed before, but many of the studies you\'ve posted were already discussed at length, as were the posts on realself and makemeheal on the old board. The complications I\'ve pointed out that occur in PE surgery which, you\'ve compared with PMMA in the face, but this again has already been spoken about (again i understand that you wouldn\'t be aware of this.) You can\'t really compare facial injections of PMMA with penis surgery, but even if you did, complication rates would still be way lower.

Sorry I confused Alloderm and injectables for the 1.4% rate, but the general point I\'m making still remains. If a 1.4% infection rate is worrying you, then overall complication rates from these surgeries should cause you much more concern.

As for Texas Phalloplasty you know fat transfer surgery is very easy compared to most plastic surgery procedures and you also know that the demand for penis enlargement in the US is very high. Yet despite this demand and simplicity of procedure I think only 3 Dr\'s in the entire US do it! You have to ask yourself why this is. And why do they offer both Alloderm and FFT. Alloderm is much more expensive, involves more intensive surgery and yields only modest results. Yet they still offer it. It doesn\'t make sense they\'d offer a more expensive and riskier procedure if they truely believed in the quality of the results they are getting with FFT. I think there are some pretty obvious red flags here in the same way there was when Dr Elist came onto the scene.

mikehok wrote: 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...

Since you have made an issue with my posts I would like you to find and quote a single post I have made on this or the other site where I have \"played down the risks with other procedures\".