What Size Testicles Implants Do I Need To Treat My Penile-Scrotal Disproportion?

Q: Dr. Eppley, I have attached pictures of my penius both erect and flaccid.  I suppose this sort of surgery is always for aesthetic reasons, but I feel the need to justify anyway. :-)In the flaccid picture I just feel that the scrotum is smaller than it “should” be proportionally.  I realize this is because I have an above average flaccid length that varies but with the suprapubic area retracted (as I am hoping it will be post lipectomy) the flaccid length is in the neighborhood of 6 or 7 inches. The skin tightening will draw the scrotum up more and I would prefer the scrotum to hang down at or even past the length of it flaccid.  That just seems like the traditional shape in my head.

The “problem” is exacerbated when I become erect as I believe they become very much dwarfed by the rest of my shaft both in girth and length. If I am not explaining myself well, please feel free to ask questions if it will get more useful information.

The last picture is sort of a goal picture.  It is of me a day or some after having infused about 750ml of 0.9% Sterile Saline IV Fluid.  (I take every precaution imaginable.)

A:This is classic aesthetic penile-scrotal disproportion. When it comes to testicle implant size selection using a side by side or displacement technique here are the concepts to know:

1) It is not an exact science. Until one is in surgery there is no way to know what will ‘fit’ or what the maximum implant size the scrotum can handle. There are no preoperative measurements/tests that will answer that question.

2) But since every testicle implant over 5cms in size must be made custom we do have to pock a size since it is one custom design per patiebnt.

3) A good rule to follow is that for adequate displacement of your natural testicles the implant should be at least 70% that of your natural testicle size. (100% is even better)

4) If any custom testicle size that is chosen does not fit in surgery I can manually reduce them so that they will. (would like to obviously avoid)

5) ) Many custom testicle implant size selections are a battle between myself (who is worried about having them fit and the creation of potential problems ) and the patient who wants the maximum size possible. (who is understandably only focused on the their benefits)

6) Your goal picture sh0w very low hanging testicle, which may or may not occur from large testicle implants, but most certainly will not in the early after surgery phase. That requires time and scrotal skin relaxation….and may well require ‘ball stretching’ postop as well.

Dr. Barry Eppley

World-Renowned Plastic Surgeon