Is there such a thing as a surgeon's volume being *too* high?

[Asdefxx]

I was planning to go with one of the superstar surgeons this forum raves about, but I figured I should give my local surgeon a chance first.

I ask him how many of these surgeries he does every year, and lo and behold he tells me he's #2 in the country for AMS (which is my preferred brand, I don't want a Titan). He also works directly with AMS and was telling me about these cool developments I should expect in the future, like to control or even schedule my future implant through a phone app 3 years from now. Which sounds amazing, but not amazing enough to postpone this amazing surgery.

Anyways, this is equivalent to like 150 to 200 surgeries a year. Obviously we want our surgeons to have 40+ (though I've seen some say 25+), but is there such a thing as too much? Or would you consider it to be a small positive, like 150-200 is even a a bit better than a mere 40?

[GoodWood]

I’m curious about your surgeon saying they are “#2 for AMS”. Who is the surgeon? How many did they say they have done in their career and how many do they do a year.

The big names in penile implant do thousands of implants during their career. It’s their primary surgical procedure and they have full surgical schedules several days a week. So to be #2 would be a big number.

You don’t HAVE to have a “superstar” to get a good result. This forum is filled with men who have great implants done by surgeons that only do a handful of implants a year. As long as everything goes according to plan and there is nothing unexpected a third year surgical resident could do a fine job.

The value of having a high volume surgeon is they have a better chance of avoiding complications and have more experience dealing with unexpected or difficult situations. I’m not saying they NEVER have surgical complications or unsatisfactory results, just that they have fewer of them. They also have more experience sizing correctly. Not too small so you lose a lot of size. Not too large where you can have erosion or chronic pain.

An often overlooked benefit to using a high volume surgeon is the entire team of people around that surgeon are more experienced in the implant process. The physician assistants and nurse practitioners, the surgical techs, scrub nurses, circulating nurse, the staff that process the surgical instruments for sterility, even the office staff that process the insurance claims. All of them have a higher likelihood of doing their job correctly and knowing how to avoid or correct problems.

Lots of things go into the decision of which surgeon to use. Location, insurance coverage, price, which product they use, personality, experience. Each of us weighs the importance of those things differently as we come to our decision.

Have consultations with the surgeons available to you and then make your decision.

[Old Guy]

The negatives I see is availability. If the surgeon is doing 50+ a month good luck getting scheduled anytime soon. I also think of them rushing to get through the day of 5-10 implants. Sure don't want to be # 10 for the day!

[Asdefxx]

I’m curious about your surgeon saying they are “#2 for AMS”. Who is the surgeon? How many did they say they have done in their career and how many do they do a year.

It's Dr. Rusilko in Pittsburgh, and it's 150 to 200 surgeries a year.

They also have more experience sizing correctly. Not too small so you lose a lot of size. Not too large where you can have erosion or chronic pain.

Yeah that was one answer of his that concerned me. Not actually of his, but his physician assistant. He made it sound like men who do this *will* lose half an inch, but as we know from browsing this forum that's just not true. I made a mistake not asking the surgeon himself more about it. But I'm also less concerned about size than other men, since I'm already at 6" or 6.5", still would be a fantastic tradeoff even if I had to lose half in exchange for at-will erections.

[Gt1956]

I highly doubt that he is #2 in using AMS. My dr claims around 200 to 250 a year. He only does AMS & I've seen him in some AMS online advertisements. In his private practice he only operates on mondays. If a holiday falls on monday then no surgeries of any kind. He does do a few implants at the local VA hospital. I'm sure they are included in his total.

Here is where it gets confusing. The malpractice premiums are based upon more than just implants. There are some procedures that his insurance lumps in with IPP's. So long story short. His true IPP rate is lower than what his insurance charges him for.

His assistant (female) is very chatty. I was talking to her during a follow up. She quoted the number of the last few weeks implants. It was clearly on the path of hitting 200 that year.

So I don't see how he can be #2 in the USA. Especially since he seems a bit unknown to at least me.

I use the smell test on claims of excellence. Drs have a tendency to brag. I get the ego part. Personally, I wouldn't place any value in his claim. Will he let you talk to any past patients??

Just remember that there is at least one dr in the middle of nowhere USA that has a similar surgery rate. There is a small chance that considering that Titans have gotten more popular that the number of high volume AMS drs has fallen a bit. But on that Titan vs AMS debate. Just remember. To a degree drs will implant whatever is popular at that point in time.

[whatevery]

To a degree drs will implant whatever is popular at that point in time.

They do have preferences though. I don't think I came across a doctor who would implant Coloplast but wouldn't implant AMS but I did meet a few that would implant AMS but not Coloplast which I always found strange. They all work for a hospital though so I wonder if they are under some sort of contractual obligations. I also came across a doctor that would implant CX but nothing else. Odd.

[Rider1400]

A point to consider is I went with a very high volume surgeon but he’s high volume because his practice is men’s sexual health. He does implants girth enhancements and several other procedures focused on the penis. His specialty is implants. Yes he is a urologist but I wouldn’t go see him for prostate cancer or BPH. So why would I go to a urologist that does it all but not a specialist in implants to have an implant done.
And by the way I drew the short straw and have ran into major infection problems and I’m now doing 3 months explanted and will have my 4th surgery in 6 months in mid September, hopefully my last.But yes I still trust my Dr. if I can’t trust him there’s nowhere else to go that could handle it any better than he is doing. For sure nobody any more qualified than he is.

[ElbowRoom]

IMO it all depends on the surgeon.

My surgeon is Dr. Hakky and I could not be happier. He does 250ish implants per year, so very high volume. When I was in recovery he gave me a cell phone number that I could text with any issues. I used it a few times, and always got a response direct from him (not a screener or assistant) within an hour or two, even on the weekends. When I had complications he got me in to his office to diagnose it within a day, even once on a Saturday. Just wonderful post-op care.

The only way I could see high volume being an issue is if the surgeon takes on more patients than he’s willing to devote good care to, or if he uses his practice as an “implant mill” and just treats you like just another dick to increase his bottom line. Luckily, most of the well-known, high volume surgeons don’t seem to do this. I haven’t heard of this kind of behavior from any of the names that are commonly tossed around on this forum.

[easymoney]

I used one of the leading implant surgeons in the country for all 3 of my surgeries. My outcome has not been good and he is among the highest volume implanters in the country. In the end when you do surgery you are at the mercy of the gods including the penis gods.

[wfr1952]

And by the way I drew the short straw and have ran into major infection problems and I’m now doing 3 months explanted and will have my 4th surgery in 6 months in mid September, hopefully my last.But yes I still trust my Dr. if I can’t trust him there’s nowhere else to go that could handle it any better than he is doing. For sure nobody any more qualified than he is.

Rider, I am curious about the infection and how it went for you. Could you elaborate on what the course of the infection was like, symptoms duration of symptoms before you knew something was wrong? How long after the surgery did the problem develop?

I am seeing the doc in a month.