Background: Testicle implants are most commonly used when a testicle has been removed. (testicular replacement) But there are patients who desire larger testicles even with having an existing pair. (testicular enhancement) In these cases the decision is whether implant are made to wrap around the existing testicles (bivalved implant design) or to simply place implants and push aside the existing testicles. This is feasible if the existing testicles are small enough. Otherwise encasing most of the existing testicle with an implant wrap should be done.
Regardless of the technique used for testicular enhancement, there are limits to the implant size that can be placed given the stretch of the scrotal sac. In my experience large testicle implants of a size up to 5.5/6.0cms (length of ovoid shape) is the usual limit that can be placed or that men want. But some men want live larger sizes and, with a custom design process, extra large testicle implants be made.
Case Study: This middle-aged man had a history of prior testicle implant surgery of a custom 6.0cm size placed six months previously. While he was very pleased with this size increase and it gave better penile-scrotal proportion, he wanted to go up just one size more.
Under general anesthesia and through an existing midline scrotal incision, his indwelling custom implants were removed. Capsulotomies were performed to stretch out the scrotum and new custom 7.0cm testicle impacts placed with not wound closure tension.
Like all implants throughout the face and body, extra large implants almost always require a prior implant history. A soft tissue stretch with relaxation must first be created to accommodate the extraordinary implant size. This is as true in testicle implants as it is in breast implants for example.
Highlights:
1) Testicle implants can be placed in scrotums that have existing small testicles
2) The largest standard testicle implants are in the range of 5.5 to 6cms in size.
3) Extra large testicle implants (7cms) can be implanted if there has been a prior implant in place to provide soft tissue scrotal expansion.
Dr. Barry Eppley
Indianapolis, Indiana