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Testicle implants have two roles in improving the appearance of the scrotal sac, replacement and enhancement. Replacement is the historic use of testicle implants and is used when a testicle has been lost either through removal form traumatic or pathologic reasons or for one that has  never developed or descended. Conversely testicular enhancement is when the testicles are intact, albeit small usually through atrophy, and the patient desires to make them appear bigger. In essence testicular implant replacement is reconstructive in intent while testicular enhancement has an aesthetic objective.

One other feature that separates testicular replacement from testicular enhancement is implant size and availability. Since replacement uses the opposite indwelling testicle as the size goal the normal implant sizes that are available off-the-shelf can be used  which ranged from 2.5 to 5.0cms in length. Testicular enhancement can not use standard implant sizes as, whether it is a wrap around or a side by side technique, larger sizes are needed than what off-the-shelf options can provide. Thus testicular enhancement implants must be custom made on an individual case basis.

Once testicular implants become bigger it is hard for patients to judge what size implant they prefer. While there are numerous methods to try and make that determination one method is to visualize it compared to something known with a similar oblong shape. Eggs would be one commonly known item to use for comparison. The analogy I make is that most chicken eggs are around 5.5cms, a duck egg is at 6.5cms and a goose egg is 7.5cms. This matches up well with custom testicle implants of such designed sizes.

This is an easy analogy for me since I live in a farm with such birds and see these egg types all the time. Most men however may only have such familiarity with a chicken egg  but probably have rarely if ever seen a duck or goose egg to appreciate their size differences. But familiarity with a chicken egg is a good starting reference point since it allows one to say that size is adequate or it definitely needs to be bigger.

Dr. Barry Eppley

World-Renowned Plastic Surgeon

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