I’m Dr. Sébastien Beley, urological surgeon and andrologist based in Paris. Today, I’d like to share with you an important subject that is often a source of questions among patients concerned by severe erectile dysfunction: the size of the penile implant during prosthesis surgery. Many wonder whether they can choose the size of their implant, or whether this is a decision for the surgeon alone. In this article, I’ll explain how implant size is determined, the medical criteria involved, and what you can expect from this procedure in terms of final length.
Introduction: understanding the importance of penile implant size
Penile implants are often considered as a last resort when other treatments for erectile dysfunction have failed or are unsuitable. This surgical procedure restores the ability to achieve an erection sufficient for satisfactory sexual activity. Naturally, the question of implant size is crucial for patients, as it affects body image, self-confidence and quality of sexual life.
It’s understandable that you might wonder: who actually decides the size of the implant? Is it you, as the patient, who gets to choose? Or is it the
How is the size of the penile implant determined?
The answer to these questions depends above all on precise anatomical and surgical criteria. Implant size is not a subjective choice that can be decided in advance by the patient or even arbitrarily by the surgeon. It is determined by measurement of the corpora cavernosa during the operation, known as in situ surgical measurement.
Corpus cavernosum measurement: the fundamental principle
During surgery, after making the necessary incision, the surgeon precisely measures the length of the corpora cavernosa, the two main erectile structures of the penis. These cavernous bodies are incised to allow insertion of the implant cylinders. The measurement is taken at their maximum possible extension, i.e. the length that the penis can reach in its current tissue state.
This measurement is therefore intra-operative and reflects the anatomical reality of the penis at the time of surgery. It’s important to understand that it won’t necessarily be the same length you had before the onset of erectile dysfunction or other previous treatments.
Why can the initial penis size differ from the surgical measurement?
Several factors explain why the length measured during the operation may be less than the size you had before:
- Prolonged erectile dysfunction : When erections no longer occur or are insufficient for several months or years, the tissues of the corpora cavernosa can lose their elasticity and volume, reducing the functional length of the penis.
- Lapeyronie’s disease: This pathology, characterized by the formation of fibrous plaques in the corpora cavernosa, can lead to curvature and reduced length.
- Consequences of oncological treatments: After prostate cancer surgery or radiotherapy, anatomical changes and fibrosis can reduce penis size.
In short, the actual length of the corpora cavernosa at the time of surgery is often shorter than the size you had before these problems.
The surgeon’s role in implant sizing
The surgeon plays an essential role in the measurement and final choice of the size of the implanted cylinders, but he does not decide arbitrarily. He bases his decision exclusively on the patient’s anatomy and the possibility of preserving tissue flexibility.
The “size gain” augmentation technique
When the tissues allow it, the surgeon can try a technique called waist augmentation. This involves inserting cylinders slightly longer than the original measurement, with the aim of recovering some of the lost penile length. However, this technique requires that the tissues are still sufficiently supple and elastic to accommodate these longer cylinders.
This process is not instantaneous. After surgery, a progressive rehabilitation program is put in place, which involves
Limits and realities of length gain
It’s important to remain realistic: the augmentation technique does not guarantee a complete return to the original length of the penis prior to illness or treatment. Its main aim is to improve available length and limit the sensation of loss. Tissue quality, the duration of erectile dysfunction prior to surgery, and the rigor of the post-operative rehabilitation protocol are key factors in the success of this approach.
What you need to know before surgery
Before committing to penile implantation, it’s essential to have a clear and honest discussion with your surgeon about the expectations and limitations of the procedure.
The final size depends on your anatomy
The final implant size does not depend solely on your personal wishes, or even exclusively on the surgeon’s choice. It depends above all on your anatomy and the state of your tissues at the time of the operation.
Preventing loss of length
If you’re experiencing erectile dysfunction, it’s advisable not to delay seeking advice and considering appropriate treatment. Indeed, the longer the dysfunction lasts, the more the tissues retract and the greater the loss of length. Early treatment can often limit the damage.
The role of post-operative care
Follow-up after implant placement is crucial. Progressive inflation of the cylinders, as explained above, is an essential step in optimizing the final size and functionality of the implant. This protocol requires rigor and patience, but it often pays off.
Frequently asked questions about penile implant size
Can I choose a longer implant than my corpora cavernosa will allow?
No, implant size is limited by the measured length of the corpora cavernosa and the flexibility of the tissue. Choosing an implant that is too long could lead to pain, complications and even malfunctioning of the prosthesis.
Does a penile implant always shorten the penis?
Not necessarily, but some reduction in length is common after prolonged erectile dysfunction. Surgery can help recover some of this length, especially with a good rehabilitation protocol.
What can I do if I’m disappointed with the size after surgery?
It’s important to discuss this promptly with your surgeon. Sometimes, adjustments or complementary techniques can be considered. But above all, a clear dialogue beforehand helps to manage expectations and prevent disappointment.
Conclusion: the size of your implant depends above all on your body
In conclusion, the size of the penile implant you receive during surgery is not an arbitrary choice or a mere whim. It is determined by the precise measurement of the corpora cavernosa during the operation, which reflects the anatomical reality of your penis at the time of surgery.
Neither you nor your surgeon can choose a size beyond what your anatomy allows. However, with advanced surgical techniques and a rigorous post-operative rehabilitation protocol, it is possible to recover some of the lost length.
The key to optimizing results is to consult early, have realistic expectations, and scrupulously follow post-operative recommendations. Don’t hesitate to discuss any concerns you may have openly with your surgeon before the procedure.
If you’d like to learn more about male sexual health, erectile dysfunction , Peyronie’s disease , or other related topics, I encourage you to follow my content regularly. Knowledge and information are your best allies in taking care of your sexual health.
Finally, don’t forget that every patient is unique, and that surgery is personalized to offer you the best possible results based on your situation.
