Testicle implants have been used for decades in various forms. It is the only known surgical method to replace the lost volume and shape occupied by a natural testicle. Originally they were composed of solid silicone but that material was removed from commercial availability as a result of the silicone breast implant issues in the early 1990s. They were subsequently replaced by saline-filled implants, a dubious choice for the scrotum, but was the only implant material available at the time.
Newer custom testicle implant devices are now available on an individual patient basis. They are much softer than that of saline implants and have no risk of implant deflation. Because they are done on a custom basis the size options are much greater and better size matches to the opposite side now exist.
In almost all cases of testicle implant replacement that I am asked to performed, due to size and feel issues with the indwelling implant, a saline testicle implant is encountered. But in a most recent case of a twenty-five year old implant replacement, an old silicone implant was encountered. It was smaller than the opposite side and was very highly positioned. It also had a mesh patch on one of its ends presumably to encourage tissue adherence/fixation…wbich it clearly had done with an adverse aesthetic effect. (highly positioned and a feeling of intermittent tugging) Its custom replacement was 25% larger, made of a much softer solid silicone material and a new pocket was made much lower in the scrotal sac.
Their is a long history in testicle implants of wanting to fix the implant into position. This is a curious implant technique as it can be the cause of a high implant position and some level of chronic discomfort. This harkens back to the early of breast implants when various methods were used to fix the implant to the chest well. Like a breast implant, a testicle implant should be allowed to float freely and let it seek its own natural low position in the scrotal sac.
Dr. Barry Eppley