Your Questions
Your Questions
Q: Dr. Eppley, I have an odd question about testicle implants that I hope you will not think is too weird. I have had great loss of testicular size due to testosterone therapy. Is it possible to get two testicle implants and not disturb the small testicles that I have?
A: I think your question is whether you can add two testicle implants while keeping your existing small testicles. Provided there is adequate scrotal sac space, and there most likely is, the answer would be that you could. You would just have to be sure that you can get a testicle implant in the sac that is appreciably bigger than the existing smaller testicle. That way you could have two ‘dominant’ testicles and not just four smaller ones. (aka sac of marbles) The obvious assumption is that you are trying to have a more normal testicle size while keeping the simultaneous function of the existing testicles, small as they may be.
Testicle implants are placed through high scrotal incisions near the groin crease so the final resting place of the implant is not directly against the incisions. This is a procedure that is performed as an outpatient under general anesthesia.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I had a saline testicle implant placed last year and I hate it. It feels hard as a rock and very unnatural. I would like to replace it with a softer but larger silicone testicle implant. In addition I would like to make the opposite testicle larger. I have read that there is a way to do this by wrapping it with an implant. Is that true? I read it on the internet so you never know how accurate that information is.
A: Saline testicle implants feel very firm because they are an overfilled water sac which is under tension. Conversely silicone testicle implants are very soft and squishy because they are made of a low durometer solid silicone material. There is no question that silicone testicle implants feel a whole lot softer than saline ones. I will have to compare the largest silicone implant with that of saline to make sure it is bigger. But I would have confidence that it would be since the largest silicone testicle implant is up to 4.5cms in length with an oblong shape.
Capping the existing testicle is how it is made bigger. You take a large silicone implant, cut in in half and then remove the inside of the implant leaving only a thinner outer shell. Then you put the two halfs together over the existing testicle and put it back together like a clamshell. A space needs to be left between the two calfs so that the vascular pedicle and cord that goes to the testicle is not pinched off.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I am 38 years old and in good general health. However, I was born with very small testes. They seem to be normally functional. I had two children before my vasectomy. I have always been self-conscious about this and wanted to explore the possibility of silicone implants. Is that a procedure you would perform? Or is that something normally performed by a urologist?
A: Thank you for your inquiry. Testicular absence or small testicles can be cosmetically enhanced through the placement of testicular implants. This is done though a small incision on each side of the scrotum in a short 60 minute procedure for both sides. The only FDA-approved testicle implant in the U.S. is a saline-filled silicone elastomer shell implant available through the Coloplast company. (formerly Mentor) Other than the oval shape change, it is very much like a miniature breast implant. It comes in 5 different sizes based on dimensions and the volume of saline fill. It is a procedure that can be done by a plastic surgeon like myself or a urologist based on their experience with implants.
Dr. Barry Eppley
Indianapolis, Indiana
Q: Dr. Eppley, I have lost a testicle in my youth. I am 50 now and am tired of the embarrassment. My wife divorced me, said was tired of half of a man. Can you help?
A: Like many other body parts, implants are available for testicular replacement. An FDA-approved implant is available for testicular replacement/reconstruction and is a saline-filled implant, very much like a miniature saline breast implant. A testicular implant procedure is relatively routine and can last from 30 to 45 minutes, usually performed under IV sedation or general anesthesia as an outpatient operation. It has a quick recovery with minimal discomfort although there will be some scrotal swelling. It is important to know that testicular implants, like other medical implant devices, should not be considered lifetime devices. There is the chance, though minimal, that the body could have an adverse reaction to the implant, or that the implant may either rupture or leak (or both). Such events would require the implant to be removed Based on clinical studies of the saline-filled testicular implant, approximately 1 in 30 patients (3.3%) require resurgery within the first year to either remove or adjust the implant.
Dr. Barry Eppley
Indianapolis, Indiana