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Background: Like many body areas augmentation of their sizes can be done. Most of the time in the body implant augmentations are done for muscular enhancement. (e.g., pectoral, bicep, tricep and calf implants) Other than the breast and hips, enlargement of the testicles are the only body implants not done to enlarge a muscle.

They are also exclusively a male augmentation method and are most commonly done for replacement of missing testicle. Thus the goal is to closely match to the size of opposite retained testicle. Such testicular replacements have been around for over twenty-five years and are typically viewed as a reconstruction technique for an asset or removed testicle.

But as a pure cosmetic procedure testicular enlargement refers to either increasing the size of one’s testicles. This can be done by either pushing aside very small testicle and placing a much larger implant nest to them or using en enveloping implant around the editing testicle. Both approaches have their roles in testicular enlargement and it depends on how small the existing testicles are as to which technique is used.

Case Study: This older male had a prior history of penile enlargement through fat injections, PMMA injections and a penile pump. He wanted very large testicles to be in a better size relationship to that of his penis. (improved penile-scrotal proportion) His current tesrticles were approximately 3.5 cms in size (longitudinal axis)

Under general anesthesia and through a midline scrota incision 6 cm ultra soft testicle implants were placed in front of his existing testicles. Six months he desired them to be bigger and 7 cm testicle implants were then able to be placed.

At one year he has a well healed scrotal incision (that could not even be seen) and two large and well tolerated testicle implants.

One conceptual approach to testicular enlargement is to keep the native small testicles in place and augment in front of them. This can work if the naive testicles are small enough and the implants are big enough. (should be close to a 2X size discrepancy) While this may seem unusual to have four testicles, extra large testicular implants can make the native testicles ‘disappear’ by comparison. Once one goes above a 6 cm implant, it becomes necessary to use a staged approach to expand scrotal capacity.

Case Highlights:

1) Testicular implants come in a variety of sizes as measured by their long axis.

2) Extra large testicular implants are any sizes bigger than 6 cms.

3) The stretch of the scrotal tissues allows very large testicular implants although extreme large sizes may require a staged approach.

Dr. Barry Eppley

Indianapolis, Indiana

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