A penile implant is a medical device surgically placed entirely inside the body to treat severe erectile dysfunction (ED) that has not responded to other treatments. The purpose of the implant is to allow a man to achieve and maintain an erection suitable for sexual activity. These prostheses restore function by replacing the natural erectile tissue, not by enhancing size. The entire device is fully concealed beneath the skin and is generally undetectable to an untrained observer.
The Two Main Types of Implants
The two primary categories of penile implants are the malleable (semi-rigid) type and the inflatable (hydraulic) system. The difference lies in their structural components and the mechanism used to achieve rigidity. Both types consist of a pair of rods or cylinders placed inside the corpora cavernosa, the two natural chambers in the penis.
Malleable implants are the simpler design, composed of two bendable rods that are always semi-rigid. These rods are typically constructed from silicone with an inner metal core, allowing them to be manually bent into position for intercourse or concealed beneath clothing. Since they have no moving parts, the surgery is generally less complex and recovery time can be shorter compared to the inflatable type.
The inflatable implant, which is the most common choice, mimics a more natural erection and flaccid state by using fluid transfer. This system involves cylinders placed in the penis, a pump, and a fluid reservoir, all interconnected by tubing. When activated, fluid moves into the cylinders, causing the penis to become firm; when deactivated, the fluid returns to the reservoir. The ability to control the rigidity and return to a soft, flaccid state is the primary advantage over the constantly semi-rigid malleable implant.
Components of the Inflatable Implant System
The most common inflatable device is the three-piece system, comprised of three distinct components hidden within the body. These parts work together by shifting sterile saline fluid to create a controlled, on-demand erection. The internal nature of all components ensures the device remains invisible from the outside.
The cylinders reside within the penis shaft, placed side-by-side inside the corpora cavernosa. These hollow, balloon-like tubes are made of silicone and inflate with fluid to create rigidity when activated. Modern cylinders are designed to expand in girth and length to maximize the fill of the erectile chambers.
The pump is the only externally tangible part of the system and is the mechanism used for activation. It is a small, usually spherical device implanted discreetly within the scrotum, often positioned near the testicles. Squeezing the pump bulb transfers fluid from the reservoir into the cylinders. A small deflation button on the pump is pressed to return the fluid and make the penis soft.
The reservoir is a small, balloon-like sac that holds the sterile saline solution when the penis is flaccid. This component is placed deep within the patient’s lower abdomen or pelvis. The reservoir is neither visible nor palpable from the exterior, serving its function entirely out of sight.
External Appearance After Implantation
After implantation of either type of prosthesis, the external appearance of the penis remains largely natural, which is a major factor in patient satisfaction. When flaccid, the penis with an inflatable implant appears soft and hangs naturally, with the device being completely concealed. The exception is the small pump, which is usually palpable (felt) within the scrotum.
In the flaccid state, the malleable implant results in a penis that is constantly semi-rigid, meaning it cannot hang completely soft. While it can be bent downward for concealment under clothing, it maintains a consistent level of firmness. For both implant types, the cylinders prevent the penis from fully retracting, which can sometimes make the flaccid penis appear longer than before surgery.
When the inflatable device is activated, the penis achieves an erection that is firm, straight, and sufficiently rigid for intercourse. The erection feels firm, but the head of the penis, the glans, does not engorge naturally with blood, unlike a physiological erection. The external appearance of the erect penis with a malleable implant is also firm, but the lack of true inflation may feel less natural.
The surgical incision required for implantation is usually small, often located at the junction of the penis and the scrotum, or entirely within the scrotum. These incision sites are well-hidden and heal into a small, inconspicuous scar. The overall external appearance and feel of the penis is designed to be as close to a natural, functional penis as possible.