How Large Can Wraparound Testicle Implants Go?

Q: Dr. Eppley, I’m curious about your testicular implant surgeries. I have used metal testicle stretchers (1-10 lbs at a time), and have done saline infusions into my scrotum (up to 2.5L of 5% dextrose saline) and have learned about your surgeries recently. I know of people that inject silicone into their scrotum, but the danger and permanence of silicone injection in that area has turned me away. Hearing about your work with silicone implants, that can ‘wrap’ around the existing testicles has piqued my curiosity, so I figured I’d reach out with some questions. On the page you describe the implant process, you mention the largest implants you’ve done have been 7cm in length. Doing some rudimentary measurements, one of my testicles is about 2 inches, and the other is about 1.5. Pulling my scrotal skin outwards, and measuring from the base of my scrotum the measurement is a bit over 8inches, and pulling apart the skin to the sides reads a bit over 7 inches. I was curious whether you considered doing larger testicular implants, and whether with large amount of ‘space’ I have what size I might be able to accommodate. I’m also curious about how many of these types of procedures (or similar) you’ve done. I know there’s not really such thing as a ‘safe’ surgery, but I was also curious what the risks of something like this may be. 

Thanks for taking the time to read this, and for any information you may have for me, 

A: In answer to your testicle implant questions:

1) Whether you can safely handle an implant size greater than 7 cms I can not say. It may be so. But external measurements by stretching scrotal skin do not really tell what the displacement effects may be with an internally spaced volume, particularly when there are two implants. But with your history of stretching and saline infusions it may be possible. In this situations/requests I have to be prepared for what happens if the size chosen (let’s say 8 cms) does not fit in surgery. Thus a backup smaller implant size must be available.

2) When it comes to specifically wrap around testicle implants the only complications I have ever seen in when the testicle slips out of the implant after surgery. (which has occurred twice and occurs early before encapsulation occurs) What I have learned from that experience is to place a suture between the closed end of the implant up through the bottom end of the testicular capsule and used that pull it into the implant and then tie it down. That will prevent that potential displacement issue.

Dr. Barry Eppley

Indianapolis, Indiana