Can Testicle Implants Be Placed Into A Scrotum That Has Had Silicone Injections In the Past?
Q: Dr. Eppley,I am male that has suffered from undescended testicles in the past. When I was a child, a surgery was performed. The result were very suboptimal. As a result of the surgery, my right ball is on the smallish side. My left testicle is less than 1cc in size and is stuck in scar tissue. The right testicle is between 3 and 4 cm in size.I had varicoceles reduction surgery years ago that did not help at all in terms of size. Adding insult to injury, my testicles have further shrunk since I started my HRT.
Several years ago I had a cosmetic surgeon inject my scrotum with 250 cc of a solution that has 1/3 of its volume in silicone oil. My body has produced close to 200cc in collagen (in addition to the 80cc of silicone). While I am happy with the size of my scrotum, I am very unhappy with my shape. I would like to research and consider the use of the testicular implants.
1- I anticipate that I would need to remove a good portion of the silicone/collagen I have prior to the implantation of new testicles – can you do this?
2- I suspect that that I will need one side-by-side and one wrap around implant (what do you think?) and
3- How big do the implants get? (dimensions and volume) – I definitely like the idea of a testicle size in excess of 80cc – maybe significantly more.
A: Thank you for your inquiry and sending your pictures. This is obviously a novel situation when it comes to testicle implants. (at least I have not seen it before) In answer to your questions:
1) I do not see that trying to excise the silicone/scar tissue conglomerate would be recommended. That will create a host of new problems including scarring, tissue contraction, decreased vascularity and potential loss of scrotal skin. What was probably not mentioned to you at the time of the injections was that it was a one way street. Once you get that mass of silicone and surrounding scar into the scrotum, you are not going to get it out without creating its own set of potential complications . In short while that theoretically will create more intrascrotal space, it will not improve the success of testicle implant placement or decrease their potential risk of complications. In fact trying to remove this scarred mass probably increases implant-related risks.
2) The real question is then can testicle implants be successfully placed into the scrotal tissues that now exist.That is a question that is hard to answer and would depend in my opinion on how soft or hard the scrotum now feels.
3) But what I am certain of is if testicle implants can be placed into the tissues, careful consideration needs to be given to their size. This is no longer a situation where putting in the maximum size now exists. This is a compromise situation now.
Dr. Barry Eppley