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Background:  In aesthetic testicle implant enhancements custom implants are almost always needed. As the largest standard testicle implant is 5.0cms, any size larger requires a custom implant design. These custom implants are made of an ultrasoft solid testicle implant material whose softness is based on the durometer (cross-linking) of the material during manufacture. 

But as custom implants become bigger, despite being made of a low durometer, they do become a bit more firm. This is a sheer function of the amount of material in the implant. Even an ultrasoft silicone material becomes less soft the more material there is. At what size implant does this become a potential issue. In my experience this becomes relevant in the 6.5cm or greater implant size.

Overcoming solid silicone implant firmness can be done in two ways. The obvious one is make it like a breast implant, create a bag with liquid silicone inside. (which is absolutely what we don’t want to do) Or develop an implant design on the outside has the desired size but has less material on the inside.                                                                                               

Case Study: This male had a prior history of custom 6.0cm implants two years previously and now desired to have larger implants. In ‘graduating’ to 7.0cm implants I wanted to make sure that they remained very soft. To do so a new implant design concept was done. 

Under general anesthesia his existing testicle implants were removed and compared in size to the new implant replacements.

What was new unique in the new custom testicle implant replacements was the hole on one end. This hole led into a small inner chamber at its center.With less volume inside the implant it maintained a very soft feel despite the increase in implant size.

The external hole leading into the inner chamber also had one other benefit…the ability to place antibiotics by liquid or powder form into the implant. (antibiotic impregnation)

The new implant replacements fit into the existing implant pockets without undue tightness…due to the prior tissue expansion provided by the first set of implants.

Softness of a testicle implant is one of its important features. One of the advantages of a solid implant is that it can be made of a low durometer/soft silicone material. But as the amount of material becomes much larger dude to implant size  no matter how soft it is manufactured it becomes firmer. One implant design to improve the softness of very large testicle implants is to decrease the amount of material internally with a hollow chamber. This location of less material allows the sidewalls to collapse more easily giving it a softer feel.

Case Highlights:

1) An initial custom testicle implant can be replaced with a larger custom testicle implant secondarily.

2) As ultrasoft solid testicle implant as it becomes bigger starts to become more firm due to the increase in material volume. This can be averted by the design of an internal chamber in the implant.

3) The internal chamber of the implant also serves as a reservoir for antibiotics. 

Dr. Barry Eppley

World-Renowned Plastic Surgeon

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