Q: What are the pros and cons of testicular implants?

Pros They can replace missing testes, correct cosmetic concerns like asymmetry, or fill out a new scrotum as part of gender confirmation surgery. Research shows increases in patient satisfaction and psychological health. The procedure is safe, with few risks and side effects. Cons If it’s not covered by medical insurance, testicle implant surgery can be costly. Testicular implants don’t have the functionality of a natural testicle. As with any surgical procedure, there's a risk of infection or other side effects like extrusion, in which the implant presses against the skin.

Question 1

What are testicle implants?

Accepted Answer

Testicular implants, aka testicular prostheses, synthetically replace one or both testes. Inserted inside the scrotum (the sac that holds the testicles), they don’t retain any of the functionality of real testes. The procedure is done primarily for cosmetic reasons.

Testicular implants can address concerns like asymmetrical or irregularly shaped or sized testicles, which can help boost self-esteem.

The surgery may also be performed after a man’s testes have been surgically removed during orchiectomy (to treat testicular cancer, for example), in cases where they are absent due to a birth defect or physical trauma (such as severe torsion, or twisting), or to treat advanced prostate cancer. It doesn't help with erectile dysfunction, which is better addressed with a penile implant.

For transgender men, testicle implants can be inserted after scrotoplasty, a gender confirmation procedure that creates a scrotum from labial tissue.

A company called Coloplast manufactures testicular implants under the brand name Torosa. This saline-filled testicular prosthesis, encapsulated in a silicone elastomer shell, is currently the only FDA-approved option on the market. (Most silicone gel-filled options have been discontinued by the FDA.)

These saline sacs are designed to look and feel as close to a normal testicle as possible. They come in a variety of different sizes, so your doctor can find the ideal implant to match your scrotum and proportions, giving it the most natural appearance possible.

Question 2

What are the pros and cons of testicular implants?

Accepted Answer

Pros

They can replace missing testes, correct cosmetic concerns like asymmetry, or fill out a new scrotum as part of gender confirmation surgery.
Research shows increases in patient satisfaction and psychological health.
The procedure is safe, with few risks and side effects.

Cons

If it’s not covered by medical insurance, testicle implant surgery can be costly.
Testicular implants don’t have the functionality of a natural testicle.
As with any surgical procedure, there's a risk of infection or other side effects like extrusion, in which the implant presses against the skin.

Question 3

How much does it cost to get a testicular implant?

Accepted Answer

Most testicular implant surgeries are covered by insurance in the case of loss of a testicle after cancer surgery.

Question 4

Who makes a good candidate for testicular implant surgery?

Accepted Answer

Good candidates for testicular implant surgery include men who are unhappy with the absence of a testicle (or both), hoping to address their cosmetic appearance, or undergoing gender confirmation surgery.

Prime candidates are nonsmokers in good health. Before giving you the green light for testicular implant surgery, your doctor should perform a routine physical and run a few common tests, including blood and urine analyses.

Question 5

How is a prosthetic testicle attached?

Accepted Answer

Testicular implant surgery is usually performed by a urologist, with the patient under general anesthesia—meaning that you will be in a sleep-like state during the procedure.

It’s a relatively quick procedure, often taking less than 45 minutes.

The implants, which come in a range of sizes from extra small to extra large, are placed through a small scrotal incision in an outpatient procedure, according to Carmel, Indiana–based plastic surgeon Dr. Barry Eppley. Your surgeon will make a small incision, either in the scrotum or the lower groin area, create a pocket for the implantation, and place the prosthetic testicle.

If the procedure is replacing an existing testicle, they’ll carefully remove your natural testicle through the incision in the lower groin, closing the previously attached blood vessels and vas deferens with tiny sutures and removing the spermatic cord.

Then they’ll insert the new implant in the scrotal pocket and close the incision.

Question 6

What should you expect during recovery?

Accepted Answer

You’ll need one to two days of downtime after surgery. Your surgeon will likely recommend that you leave your surgical dressings on for the first 24 hours.

They'll provide instructions on how to keep the incision clean and avoid infection. They will also prescribe pain medication to help keep you comfortable during the first few days.

You can expect to have a follow-up appointment within the first week, to ensure you're healing well.

“Recovery is fairly rapid, with scrotal swelling for a few weeks,” explains Dr. Eppley in a RealSelf Q&A.

You may be able to resume normal physical activity around 10 days after the procedure, depending on your doctor’s recommendations, but the scrotal area will remain swollen and sensitive to the touch for a few weeks.

Refrain from vigorous exercise and sexual activity until you feel fully healed.

Question 7

Are testicular implants safe?

Accepted Answer

Studies have shown that they are generally safe and well-tolerated by healthy patients. Other research has documented improvements in patient satisfaction and overall psychological health after testicular implant surgery.

Another recent study concluded that testicular implant surgery has a low complication rate.

These implants have been around, in various versions, since the 1940s. Early iterations were made of metal, rubber, plastic, glass, lucite, and silicone. The first silicone rubber-shell, liquid-silicone-filled testicular implant was introduced in the U.S. in 1973.

In 1993, the FDA mandated that all implants cease to be produced until companies could fully document their safety. This action was in response to silicone implants of all types (including breast implants) leaking liquid silicone into surrounding tissue. Since then, testicular implant safety has improved.

Before proceeding with testicular implant surgery, discuss your overall goals and any past or current health issues with your surgeon, to ensure you’re a good candidate.

TESTICULAR IMPLANT

Rebecca Dancer

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Rebecca Dancer

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