Background: Testicle implants are available in saline filled and solid silicone types. The solid type of implant would generally be considered superior as it can never fail or deflate over the patient’s lifetime. But despite this advantage, it still has to be the right implant size, shape and feel for an optimal aesthetiuc outcome. In addition the pocket and location of the implant should be as close as possible to the opposite side. (even though natural testicles do not hang symmetrically)
While silicone implants do exist for testicle implants, they are not all the same and are produced by different manufacturers. Beyond the size limitations of some scrotal implants, the softness of them is also a very important feature. The lowest possible durometer or silicone elastomer cross-linking should be done to ensure they have the greatest compressibility while still being a cohesive structure.
Case Study: This 50 year-old male had a history of testicular cancer with a solid silicone implant placed after testicle removal and radiation therapy. While the implant was clearly better than no replacement at all, its size was inadequate. Also its smaller size and higher position inside the scrotum allowed it to fall back between the legs…an uncomfortable and annoying issue that constantly required repositioning.
Under general anesthesia, a midline scrotal incision was used as a scar was already in this location. The existing implant was removed and a capsulotomy performed to lower the implant pocket in the scrotum A permanent implant stores was also removed from the prior surgery. The new implant replacement’s size and shape could be seen compared to the removed implant. The softness of the new implant could be seen to be greater than the previous implant.
His immediate result at the end of the operation could be seen to have improved scrotal symmetry. It is presumed that the larger implant with a lower pocket will prevent posterior migration between the legs when erect.
Highlights:
- The best silicone testicle implant is one that has adequate size, shape and a very soft feel.
- Malpositioning of a testicle implant requires a capsulotomy and pocket adjustment.
- A midline scrotal incision is the best approach for repositioning the implant pocket.
Dr. Barry Eppley
Indianapolis, Indiana