TOPIC: Wound closure - the bad and then the GOOD!

Hoodle, they are taking a look in 1 week. He buried some monocryl Sutures that will dissolve over time (100% at 3 months). Then, he placed nylon Sutures on the wound, going in through all the deeper layers with the vertical mattress technique (he was giving the resident some rhyme to do the mattress Sutures... it was really kind of amusing to be awake during this) - so that thing should be CLOSED. I mean, it doesn't look so pretty but it is sealed like a nuclear arms vault. If it opens after this surgery, I have no idea what I would do. He said all the tissue there was just either PMMA fibrosis or necrotic - and it had to go or I'd have an infection or I'd have a hole in my penis permanently. That's interesting about bonehead. I will have to look up his posts. Celacyn is a great rx med for scars, but I can try silicone too. And I still have that bottle of DMSO - I haven't used it all this time because it can be runny and I've had an open wound for 2 months. But I really wanted to use it on those remaining hard spots. I hope it can flatten this. I'll post a pic after saturday. I have to find out how circ scars are closed...cuz it's almost like I just had a mini Circumcision - I mean, they took skin out right there...and closed it right on that line. But, they closed it so it's like pinched up...which might not flatten so fast (hard to say). He's very honest with me. I asked and he just said he doesn't know how it will look.

One concern was that he took 1/2" of skin off my right side but my left is the same...so will this feel weird Erect? He said it definitely won't bend because that comes from the tunica, but the skin might be pulling on the shaft...or I might have hair growing up the right side of the shaft which is no big deal. (I saw the excised tissue in the formalin and it was pretty gross...he also kept commenting "this is everywhere - I can't even work on this - I can't get healthy tissue"...which freaked me out - until finally he said - "ok now we're getting it").

Mustang, that pic was just a sample of how it was lifted. My own stitches are under all the dressings I can't touch till saturday. Thanks for letting me know about your Elist incision.

Bigben, it sounds like I'll probably follow a similar path to you since I also got dissolvable + non-dissolvable (nylon). Even after they dissolve, most people still feel ridges from the surrounding tissue. That's good to know it eventually went away. How did things go sexually with that kind of scar?

Side note - are the first few posts in this thread insane? I kind of lost my mind when I read his notes - on top of the crap he already did. I don't know why I posted all this here. I just was so pissed about all that. I can get a bit angry sometimes.

I thought this was interesting to mention...

My dad (a doctor for 40 years) read the notes I attached above from Dr. Bloom (the full version - not just my cuts I posted), and he said there are major problems with them:

1. He doesn't even mention applying the silver nitrate in the notes, yet he billed my insurance for it. Since the silver nitrate caused all the problems, he probably deleted it from his notes (but I have 50 photos of it which are GPS coded and time stamped by the iphone...so...what would that even accomplish?)

2. He added in all the psychiatric wording to make me look worse in the event of litigation, which is moronic considering I have a psychiatrist (who can invalidate everything) + proof why I went in there (Lemperle's email and a Dermatologist who knows I am not "obsessed with biofilms"). As far as my "unhealthy obsession with the size and shape of my penis" - well, you can judge. Regardless, I was in his office for 15 min. I have seen the same therapist for 1-2 years. I never brought up feelings of inadequacy due to penis size w/ my psychiatrist (who is gay and knows that gay men are size queens and it's an issue in the community). I've had a lot of stress over the fact it has been fucked up since March...not the fact it's too small.

3. He said the wound was barely noticeable (again, probably doctored notes). My Urologist said nobody on earth could consider that "barely noticeable unless they were blind"

So, to add to the malpractice, now we have fraud and spoliation of evidence.

So, good - this way, once I get my derm, uro, and psych to sign off on answers to questions like "did I have an obsession with biofilms" - I'll be sending it to the state regulatory agencies for physicians and to attys.He also should be disciplined by my insurance company for billing for a procedure (the silver nitrate) that is not in his notes. Though, he did the procedure - he's trying to pretend he never did while getting paid for doing it.

Man, you can't seem to catch a break! I hope things improve for you soon.

I despise the way the medical community so often try and excuse their poor work by intimating that the real issue is with the mental state of the patient.

Yeah I think it looks good... I wonder if they can put some surgical/skin glue on it when they take the stitches out. I am so scared of another wound separation. Steri strips are better for superficial wounds. At least I have some buried Sutures that will dissolve, though they loose strength fast.

I did some searching and found the american society of plastic surgeons president Dr. Rohich (sp?) did a study that Rutin + Grapeseed extract + vit c actually increased healing at a statistically significant percentage, so I will give this a try too.

All the best Restoration and sorry to hear.Hopefully with time there will be a solution.There must be a decent doctor out there somewhere that can help

Dr Alter told me he has excised PMMA from guys before (not sure if it was full penis or just nodules..) I would recommend emailing him pictures before the call if you schedule a phone consult so you get the most benefit from your time. He was upfront, honest, and surgically conservative, in all of my experience with him.

Regarding your comment, PMMA aside, penile Sutures are a little tricky because of the erections we get. So different doctors use different approaches. I don't know enough to say which technique is best though.

Resto, looking good man. Vitamin C as you know will improve your immune system so keep taking it..

You have positive energy from all the members here, so you will be fine dude

Hey Restoration that is a super clean suture. I would consider yourself through the crisis! Just put the bacitracin on until it heals and then switch to scar treatment which you probably won't need. It looks like it will blend with your Circumcision line perfectly.

My dad believes he doctored his notes given how inconsistent they are...and the bizarre "obsession with biofilms" comments (among others).

My Urologist cut everything out and buried monocryl and put vertical mattress nylon - it's in another thread. The whole thing was a giant mess...so it just all had to go. There was PMMA fibrosis all mixed in with it too. so I lost 2 square inches of penile skin (the wound was 7mm open & then had a scar band around it from attempts to suture it). If he never used silver nitrate, though, it would've closed on its own, with a depressed scar (though the uro felt it wouldn't ever close). Either way, now I have a scar 1/2 way around my shaft and missing skin. Uro also wouldn't do PCR (this is in an academic hospital too), but he did a culture.

There was never really any pain at any point. It didn't smell or anything.

I think my uro did the "if in doubt, cut it out" approach... which was a little aggressive but it's all gone at least.

The Sutures look very good, but one side has 1" more skin than the other - so there's a bulge where the skin is tucked in...not sure what's going to happen with that as it heals. Others have said it should smooth out.

The internal Sutures are not as strong as original, but they are still VERY strong otherise you would see blood in the morning after nocturnal erections. The ridge is very normal and looks fine. It will gradually soften over the months and full sensation will return. You have nothing to worry about. I am sorry if I caused any distress with my previous post. My intention was to show that even if you had a much more serious issue like Basque, there are options available. Clearly though, my memory was a little foggy and my post did not convey that message. I am very confident this will be your last surgery and you will be happy with the result. Be patient, time is on your side, and we are here to support you !

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It looks brilliant. Personally I'd start wearing silicone gel sheets, but I scar badly, so am particularly cautious.

Please don't spend money on a phone consult with Gary Alter. No more Dr's opinions (other than your surgeons) for at least 3 months. And by then you wont need anyone's opinion.

I'm wondering if at some point a small skin graft from your thigh maybe necessary to fill in the 2 Inch gap. To what success, i'm not sure, but a 2 Inch wide wound with significant depression is noticeable for you and any future partner. When you have a larger allowance, I would consult a plastic surgeon. Right now as its healing it may be the right time to consider a skin graft. I don't want you to feel that you are part of some sewing circle where random suggestions are being afforded to you, take a short walk if it doesn't provide too much discomfort and clear your mind and set a plan.

How long do the Sutures have to remain in? As soon as they are out I'd start using silicone gel sheets. They really do work. And as usual, I'd also use DMSO, but not until the wound it completely healed. I think you need to do everything you can to ensure the scar tissue is as soft and pliable as possible. We have a member called Bonehead, who had Necrosis and had to have a flap technique based surgery on his shaft, which obviously meant lots of Sutures and scarring. But the last time I spoke to him, he said it actually healed really well. I think the penis does tend to scar well. When you consider that most circ scars are totally flat and soft, it makes sense the rest of the shaft would heal equally as well.

It looks clean and well done. Good luck. I really think in time it will soften up and look fine.

MY incision from the best phaloplasty dr in the world, elist, took a couple of years to heal and soften up. Your will take a lot less so keep up your spirits...