Question 1

What is an inflatable penile implant?

Accepted Answer

An inflatable penile implant — also called an inflatable penile prosthesis or IPP — is a discreet, surgically placed device that restores the ability to have an erection on demand. The three-piece version has two cylinders inside the penis, a pump in the scrotum, and a fluid reservoir behind the abdominal wall. Squeezing the pump produces an erection; pressing the release valve returns it to flaccid.

Question 2

Is the AMS 700 the same as the Boston Scientific implant?

Accepted Answer

Yes. The AMS 700 is Boston Scientific's three-piece inflatable penile prosthesis. AMS (American Medical Systems) was acquired by Boston Scientific in 2015, and the AMS 700 product line continues as Boston Scientific's flagship inflatable implant.

Question 3

Who is a candidate for a three-piece inflatable penile implant?

Accepted Answer

Men with erectile dysfunction that has not responded to oral medication, injection therapy, vacuum devices, or shockwave therapy. Common patient profiles include post-prostatectomy ED, Peyronie's disease with significant curvature, and ED related to diabetes, vascular disease, or pelvic trauma.

Question 4

How is the surgery performed?

Accepted Answer

Under general anesthesia, through a single small scrotal incision. Dr. Gheiler developed this scrotal-only-incision technique, which places all three components of the AMS 700 (cylinders, pump, and reservoir) through that one incision. He does not perform the infrapubic approach. Patients go home the same afternoon.

Question 5

Will I have a visible scar?

Accepted Answer

Dr. Gheiler's scrotal-only incision is hidden in the natural folds of the scrotum, so the scar stays concealed and is minimally visible to the patient or a partner once healed. By contrast, the infrapubic approach used by some surgeons leaves a scar above the pubic bone.

Question 6

Why does Dr. Gheiler not use the infrapubic approach?

Accepted Answer

Three reasons. First, the infrapubic incision leaves a visible scar above the pubic bone. Second, the pump tends to sit in a more remote location and can migrate over time. Third, in thin patients, the tubing connecting the components can become visibly noticeable under the skin. The scrotal-only-incision technique Dr. Gheiler developed is designed to avoid all three of these issues.

Question 7

I had an implant placed somewhere else and it isn't right. Can Dr. Gheiler fix it?

Accepted Answer

Yes. Revision and complex implant cases are one of Dr. Gheiler's sub-specialties. Patients are referred to him from across the United States and internationally for failed, infected, malpositioned, or eroded implants, as well as for implants in patients with prior pelvic surgery, severe Peyronie's disease, or significant scar tissue. Request a confidential virtual consultation to send records for review.

Question 8

When can I have sex after an inflatable implant?

Accepted Answer

Five to six weeks after surgery, after Dr. Gheiler has confirmed proper healing and instructed the patient on using the device.

Question 9

Will my partner notice the implant?

Accepted Answer

When deflated, the implant is hidden inside the body and the pump sits discreetly in the scrotum, indistinguishable in appearance from normal anatomy. Most partners cannot tell a properly placed three-piece implant is present, even during intimacy.

Question 10

What is the difference between AMS 700 LGX, CX, and CXR?

Accepted Answer

The LGX cylinders expand in both length and girth (the most common primary choice). The CX expands in girth only. The CXR is a narrow-base version of the CX used in revision cases or anatomically smaller patients. Dr. Gheiler selects the variant at the time of the pre-op evaluation.

Question 11

Is a penile implant reversible?

Accepted Answer

The implant can be surgically removed, but doing so does not restore the patient's prior erectile function — the tissue inside the corpora cavernosa is reshaped by the cylinders. Patients should consider an inflatable implant a permanent solution.

Question 12

What if I've already had prostate cancer surgery?

Accepted Answer

Post-prostatectomy ED is one of the most common reasons men come to Dr. Gheiler for an implant. Once the prostatectomy site has healed and oncologic surveillance is stable, an inflatable implant is often the most effective option for restoring sexual function.

Question 13

Is Dr. Gheiler a Center of Excellence for penile implants?

Accepted Answer

Yes. Dr. Edward Gheiler is a Boston Scientific AMS 700 Inflatable Penile Prosthesis Center of Excellence and was among the first physicians in the world to earn the designation, in the program's first month (February 2024). He has also been a Castle Connolly Top Doctor since 2022.

Question 14

Will a penile implant make my penis shorter?

Accepted Answer

Not when it is sized correctly. A penile implant is fitted to the full length of your natural erectile chambers. Many men keep their length, and some regain length that erectile dysfunction had reduced over time. Precise sizing during surgery is what protects length. Individual results vary.

Question 15

Who makes the AMS 700 penile implant?

Accepted Answer

Boston Scientific. AMS 700 is the product family name for its three-piece inflatable penile prosthesis, the implant Dr. Gheiler uses in his Miami practice and teaches to other urologists in Boston Scientific physician-education programs.

Question 16

What is the difference between the AMS 700 CX and LGX?

Accepted Answer

The main difference is how the cylinders expand: the AMS 700 LGX is designed to expand in both length and girth when inflated, while the CX offers controlled expansion with strong rigidity and support. A third variant, the CXR, is a narrow-base version of the CX used in revision cases or anatomically smaller patients. All are inflatable implants in the same AMS 700 family, and the right choice depends on your anatomy, tissue quality, and priorities.

Question 17

What sizes does the AMS 700 come in?

Accepted Answer

The LGX cylinders come in 12, 15, 18, and 21 cm lengths, adjusted with rear tip extenders; the CX and CXR lines have their own size ranges. You do not choose a size from a catalog: your surgeon measures and sizes the device during surgery to fit your anatomy exactly.

Question 18

Can I have an MRI with an AMS 700?

Accepted Answer

Having an AMS 700 does not rule out an MRI of any body part. Tell the imaging center you have a penile prosthesis and which model when you book, and the technologist verifies the device against the manufacturer’s current labeling, the same workflow used for joint replacements.

Question 19

How long does the AMS 700 last?

Accepted Answer

It is a mechanical device, so it can eventually fail and need replacement, but most men go many years before needing one. When a replacement is needed, revision surgery is a routine part of Dr. Gheiler’s practice.

Question 20

Does insurance cover the AMS 700?

Accepted Answer

Medicare covers inflatable penile implant surgery when ED has a documented medical cause that has not responded to conservative treatment, and many commercial plans do as well, subject to each plan’s exclusions and prior authorization. Coverage is not guaranteed until verified: the practice checks your individual coverage and handles the authorization before anything is scheduled.

Question 21

What is a malleable penile implant?

Accepted Answer

A pair of bendable rods placed inside the erectile chambers. The penis is bent up for intercourse and bent down to conceal — no pump, no mechanism. It is the simplest type of penile prosthesis.

Question 22

Malleable vs. inflatable — what’s the difference?

Accepted Answer

An inflatable implant is flaccid until pumped up, giving the most natural look in both states. A malleable implant is always firm and positioned by hand, which makes it simpler to use. Most men choose inflatable; malleable suits men who want maximum simplicity or have limited hand dexterity.

Question 23

Who is a good candidate for a malleable implant?

Accepted Answer

Men who want the simplest device, men with limited hand dexterity (for example severe arthritis), and some complex revision cases. Dr. Gheiler offers both types and recommends what fits your anatomy and priorities.

Question 24

Can a malleable implant be switched to inflatable later?

Accepted Answer

In many cases, yes. Replacing one prosthesis type with another is a form of revision surgery, which Dr. Gheiler performs routinely.

Question 25

Will a penile implant make me shorter?

Accepted Answer

Usually the opposite. In Dr. Gheiler’s experience most men keep their length after a correctly sized inflatable implant, and the great majority end up longer than before over the years that follow. Only a small minority see any decrease. Individual results vary.

Question 26

Do I get my length back with an implant?

Accepted Answer

A correctly sized implant restores essentially your full natural (stretched) length at surgery, and for most men length continues to increase over the following years as the tissue accommodates the device.

Question 27

How much length can I expect to gain?

Accepted Answer

It varies from man to man. Many men gain roughly a centimeter or more over the long term, and some gain considerably more. Men who start on the shorter side often gain the most. These are general observations from Dr. Gheiler’s practice, not a guarantee.

Question 28

Do the length gains last?

Accepted Answer

Yes — in Dr. Gheiler’s experience the gains are sustained years out, across different implant devices, and hold up even in men with diabetes or a smoking history. Girth tends to improve modestly as well.

Question 29

Why does ED shorten the penis over time?

Accepted Answer

Long-standing ED reduces regular blood flow to the erectile tissue, and over time that tissue can lose some of its natural length. A properly sized inflatable implant gently holds the erectile chambers at their natural length again.

Question 30

My A1c is high — can I still have the surgery?

Accepted Answer

Sometimes it is safer to improve your blood-sugar control first, and sometimes surgery is reasonable as it is — it depends on your numbers and your situation. Dr. Gheiler reviews your recent A1c before surgery and tells you honestly whether tightening control first would lower your risk.

Question 31

Do diabetics have a higher infection risk with penile implants?

Accepted Answer

Yes. Published studies identify diabetes as a risk factor for penile implant infection. That does not mean diabetic men should avoid implants — it means the surgeon’s experience, technique, and infection-prevention protocol matter more. Dr. Gheiler operates on diabetic men routinely and tracks his outcomes closely.

Question 32

Can Peyronie’s disease be treated without surgery?

Accepted Answer

Yes. Xiaflex&reg; (collagenase) is an FDA-approved medication injected into the plaque over a series of treatment cycles to break down scar tissue and reduce curvature — a non-surgical option for men with a stable, palpable plaque and meaningful curvature whose erections are still adequate. Dr. Gheiler assesses whether you are a candidate.

Question 33

What is Xiaflex and who is a candidate?

Accepted Answer

Xiaflex (collagenase clostridium histolyticum) is the only FDA-approved drug for Peyronie’s disease. Good candidates generally have stable disease, a palpable plaque, and curvature that bothers them but still allows adequate erections. Dr. Gheiler examines the plaque and curvature and explains a realistic result before starting injections.

Question 34

Can a penile implant fix curvature from Peyronie’s disease?

Accepted Answer

Yes. When Peyronie’s occurs together with erectile dysfunction, a penile implant is — for appropriately selected patients — the most consistently effective option when other treatments have failed: it straightens the curvature and addresses the ED in a single operation. Dr. Gheiler corrects the curve at the time of implant placement and reviews the surgical risks with you beforehand.

Question 35

Who is a candidate for penile implant surgery?

Accepted Answer

Men with stable Peyronie’s disease and ED that no longer responds to pills or injections are typically good candidates. Dr. Gheiler assesses the degree of curvature and explains a realistic result before recommending surgery.

Question 36

Can Dr. Gheiler fix a penile implant done by another surgeon?

Accepted Answer

Yes. Dr. Gheiler performs revision and complex re-do penile implant surgery, including failed, infected, eroded, or unsatisfactory implants originally placed elsewhere. Patients are referred to him from across the U.S. and internationally.

Question 37

When is revision surgery needed?

Accepted Answer

Common reasons include mechanical failure, infection, erosion or migration of components, chronic pain or poor positioning, dissatisfaction with a prior result, or severe scarring that makes standard placement difficult.

Question 38

Is revision done as outpatient surgery?

Accepted Answer

Most revision procedures are outpatient. Dr. Gheiler reviews prior operative records, examines you, and explains what can and cannot be improved before any surgery is scheduled.

Question 39

What should I ask a penile implant surgeon before surgery?

Accepted Answer

Ask how many inflatable penile implants the surgeon places in a year and what share of the practice is implant surgery; whether the surgeon takes revision and referred cases; what the infection-prevention protocol is, step by step; which devices are offered and why one would be chosen over another; how the implant is sized and what to expect for length; where the operation is performed and who is on the team; and who manages a complication, at what hours. Ask for numbers rather than adjectives, and write the answers down so you can compare surgeons.

Question 40

Does a penile implant surgeon’s case volume matter?

Accepted Answer

Prosthetic urology is a volume specialty. A surgeon who performs implants regularly encounters scarring, unusual anatomy and intraoperative surprises often enough to have a practiced response to them, and has a fixed operative routine rather than one reconstructed from memory. Volume alone does not make a surgeon right for you, but it is the single question most likely to be answered vaguely, which is why it is worth asking directly.

Question 41

How can I verify a surgeon’s credentials myself?

Accepted Answer

Board certification can be checked with the American Board of Urology or through Certification Matters. Fellowship in the American College of Surgeons (FACS) is listed publicly. Manufacturer designations such as the Boston Scientific AMS 700 Center of Excellence are described on the manufacturer’s own website, including the criteria a physician has to meet. Whether a surgeon publishes or teaches in the field can be checked on PubMed and on the manufacturer’s physician-education pages. Network status is confirmed with your insurer, not with the office.

Question 42

What are the red flags when choosing an implant surgeon?

Accepted Answer

A guaranteed result — no surgeon can guarantee the outcome of an operation. Pressure to decide during the visit, or a price that expires. An all-inclusive price with no written breakdown of what it covers and what a complication would cost. Vague answers about surgical volume. No stated plan for who manages a complication. Before-and-after photos or reviews that cannot be tied to the surgeon who would actually be operating on you.

Question 43

Should the surgeon who places the implant also handle revisions?

Accepted Answer

Ask directly. A surgeon who performs revision and removal-and-replacement surgery has seen how implants fail, and is in a position to manage a problem rather than refer it elsewhere. If a surgeon does not do revision work, ask specifically where you would be sent and who would be responsible for your care if something went wrong.

Question 44

Does Medicare cover a penile implant?

Accepted Answer

Yes. Medicare covers penile implant surgery for documented erectile dysfunction that has not responded to more conservative treatment. Dr. Gheiler’s team documents medical necessity and manages the paperwork.

Question 45

What determines my out-of-pocket cost?

Accepted Answer

With insurance, it depends on your plan’s deductible, coinsurance, and out-of-pocket maximum — not on a single sticker price. The practice verifies your individual coverage before surgery so there are no surprises.

Question 46

When can I have sex after a penile implant?

Accepted Answer

Five to six weeks after surgery, after Dr. Gheiler has confirmed proper healing and instructed you on using the device.

Question 47

When do I learn to use the implant?

Accepted Answer

At a follow-up visit once healing is confirmed, Dr. Gheiler teaches you to inflate and deflate the device before clearing you for sexual activity.

Question 48

How much does a penile implant cost in Miami?

Accepted Answer

Medicare covers inflatable penile implant surgery when ED has a documented medical cause that has not responded to conservative treatment, and many commercial plans do as well, subject to each plan’s exclusions and prior authorization. Coverage is not guaranteed until verified: the practice checks your individual coverage before anything is scheduled. For self-pay pricing and financing, see the cost and insurance page.

Question 49

Where is the office located?

Accepted Answer

The office is at 2140 W. 68th St. #200, Hialeah, FL 33016, serving patients from Hialeah, Miami Lakes, and the greater Miami area. Call (305) 822-7227 to schedule a consultation.

Question 50

Will insurance cover a penile implant?

Accepted Answer

Often, yes. Medicare covers inflatable penile implant surgery when ED has a documented medical cause that has not responded to conservative treatment, and many commercial plans do as well, subject to each plan’s exclusions and prior authorization. Coverage is not guaranteed until verified: Happy Urology accepts most major plans, checks each patient’s individual benefits, and processes the prior-authorization paperwork before anything is scheduled. Self-pay arrangements and financing options are reviewed openly at consultation.

Question 51

Are penile implants worth it?

Accepted Answer

For men whose erectile dysfunction has not responded to oral medication, injection therapy, or vacuum devices, the three-piece inflatable prosthesis remains, in Dr. Gheiler’s experience, the most natural-feeling and most durable of the surgical options. Because the implant is a mechanical device, it works regardless of the cause of ED. Across published series, men who are properly selected and well-counseled before surgery report high satisfaction and meaningful improvement in quality of life. The implant can be surgically removed, but doing so does not restore prior erectile function, so consider it a permanent solution and decide with that in mind. Read what men say after penile implant surgery.

Question 52

Can a woman tell if a man has a penile implant?

Accepted Answer

In the great majority of cases, no. When deflated, the implant is hidden inside the body and the pump sits discreetly in the scrotum, indistinguishable in appearance from normal anatomy. Most partners cannot tell a properly placed three-piece implant is present, even during intimacy. The incision is concealed in the natural scrotal fold, and skin sensation does not change. What a partner usually notices is the result: an erection that is there when you both want it.

Question 53

Which implant brands does Dr. Gheiler use?

Accepted Answer

For inflatable implants, the Boston Scientific AMS 700 family (LGX, CX, and CXR), every one carrying the InhibiZone antibiotic surface; he selects the model and size during surgery to fit your anatomy. For men who want the simplest device, he also places malleable (semi-rigid) implants. Dr. Gheiler is a paid trainer and physician educator for Boston Scientific, the manufacturer of the AMS 700, and he is a Boston Scientific AMS 700 Center of Excellence. Read more about the AMS 700.

Question 54

Does a penile implant hurt?

Accepted Answer

There is real post-operative discomfort, managed with a plan that starts before the incision. In our published study, patients who received the pre-incision anesthetic block reported significantly lower pain scores in the first hours after surgery than patients without a block. Soreness then fades over the following days to weeks.

Question 55

How long does penile implant pain last?

Accepted Answer

The most uncomfortable window is the first days after surgery. Most men describe soreness rather than sharp pain by the end of the first week, and it continues to fade from there. Our week-by-week recovery guide covers what to expect at each stage.

Question 56

Does the block reduce the need for narcotics?

Accepted Answer

That is the goal of blocking pain before it starts. Patients still receive a pain-management plan for home, but a well-executed block covers the hardest window — the first hours — when narcotic demand is otherwise highest.

Question 57

How common is infection after penile implant surgery?

Accepted Answer

Infection is the most serious complication of implant surgery, which is why prevention gets this much engineering. Rates differ between first-time and revision surgery. We publish our own tracked rate, with full methodology and honest caveats, on our outcomes page rather than quoting numbers out of context.

Question 58

Why is there no cloth linen in the operating room?

Accepted Answer

Cloth linens shed lint, and airborne lint particles can carry bacteria onto a sterile field. Our implant cases use all-disposable synthetic plastic drapes instead, and outside linen stays out of the room.

Question 59

What is the no-touch technique?

Accepted Answer

A method of implant handling in which the device is never touched by gloves or skin that have contacted the patient’s skin surface. It minimizes the chance of transferring skin bacteria onto the prosthesis before it enters the body.

Question 60

What can I do at home to lower my own risk?

Accepted Answer

Follow the pre-surgical washing instructions exactly — antiseptic (Hibiclens) washes at home before surgery — and report any skin breakdown, rash, or urine symptoms before your date. Prevention is a partnership, and the at-home preparation genuinely matters.

Question 61

Does taking a blood thinner disqualify me from implant surgery?

Accepted Answer

Usually not. Many implant patients take anticoagulants or antiplatelet medication — the same vascular conditions that cause erectile dysfunction often come with them. What it requires is coordination: a peri-operative plan made with the doctor who prescribes your blood thinner.

Question 62

Will I have to stop my blood thinner before surgery?

Accepted Answer

That decision is never made by you alone, and never by the surgeon alone. Dr. Gheiler coordinates with your cardiologist or prescribing physician on whether, when, and how your medication is paused or bridged around surgery — based on why you take it and which medication it is.

Question 63

Why do blood thinners matter for this surgery in particular?

Accepted Answer

Bleeding into the space around a new implant — a hematoma — is something implant surgeons work hard to avoid, because pooled blood delays healing and raises infection risk. A proper anticoagulation plan protects you from clots and protects the implant from that complication at the same time.

Question 64

What should I bring to the consultation?

Accepted Answer

A complete medication list — including the blood thinner, its dose, and why you take it — plus the name of the doctor who manages it. That is everything needed to start building the peri-operative plan.

Penile Implant & Urology FAQ

Penile implants: the basics

Cost & insurance

Surgery day & recovery

Living with an implant

Erectile dysfunction

Prostate

Incontinence

Vasectomy

Practice & logistics

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