eqstudent

I wanted to begin to compile some data of the effectiveness of Alloderm PE.  Since Dr.Whitehead listed his complication experience on his site I decided to use his data to begin to get a sense of complication rates.  I got over 1000 but less than 2000 for the number of cases after speaking to a consultant.  I will use 1000 as the number but will update if I get more details.

Adverse Effect                                         Number of Cases (1000 total)

Loss of upward angle                              2

Scarring, loss of length                           0 (with use of a stretching device)

Absorption loss of thickness                  1 (partial with some loss)

Contracture /Separation                         3

Failure to take                                           0

Skin incision separation                           10* (a few temporary is the exact quote)

Loss of penile skin                                     NA* (quote is this rarely occurs)

Bleeding                                                      1 (collection of blood under skin, easily managed)

Fibrosis of superficial vein                        NA* (rarely occurs and usually resolves by itself)

Infection                                                       7 (3 lost the graft, 1 partial lost, 3 did not lose graft)

Ecchymosis                                                  NA* (rarely occurs and usually resolves by itself)

Nerve injury                                                0

Edema (Temporary)                                   NA* (occasionally seen in patients)

Seroma                                                         0

Erectile Dysfunction                                   0

Summary

Complication rate of all adverse effects: (24/1000) or 2.4% (*includes a swag of 10 for incision separation).

Total Infections: (7/1000) or 0.7%,

Infection caused Lost Graft: (4/1000) or 0.4%

Total Grafts Lost: (8/1000) or 0.8% (including partial loss or contracture or separation)

My Take

I was extremely surprised by the low rate of adverse effects.  I had expected something 10 times higher.  These results lead me to question both the number of cases and or the accuracy of the adverse effects reported.

For comparison a study of the most controversial current usage of Alloderm, in Abdominal Hernia Repair, shows a (14/70) or 20% complication rate with 1 rejection (1.5%), 2 infections (2.9%), and 14 recurrences.

http://www.ncbi.nlm.nih.gov/pubmed/18209948

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ripple

Hi EQ, with all due respect, can you really trust statistics provided by a doctor on his own website about the procedure he performs? I’m not necessarily saying he was dishonest, but PE doctors have been known to stretch the truth about their results.  Ask Dr. Rosenthal, for instance, and he’ll claim almost no complications at all when there have been at least two members from the old forum with horror stories (in fairness he’s had some successful ones as well.) 

 

From what I can tell, there have been many successful enhancements with Alloderm but more than a few botched ones as well.  I don’t know if using Whitehead’s own “data” is really a good starting point  to accurately gauge the product’s effectiveness or complication rate.

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Skeptical One
eqstudent wrote:
Scarring, loss of length                           0 (with use of a stretching device)




I'm not sure how he obtained these numbers when it can take many months before a patient post-op can fully realize gains.  "With use of a stretching device," also suggests that there could have been a loss of length WITHOUT the use of a device, but he fails to mention those stats.

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eqstudent

@ripple - agree and I stated some concerns in my post. The positive about Whitehead is that unlike most of the PE doctors he has very distinguished and prestigious current academic standing at universities and teaching hospitals.  I am hoping that he produces a study before he is gone.

Do you have any better starting data you would suggest?

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hoddle10

Dr Whiteheads Alloderm surgery can't be compared to what it is today. Whitehead used a single sheet of Alloderm. Today they either stich two sheets together and wrap or layer. Whitehead refused to do this as the chance of all the complications mentioned in other threads were too high. The trouble was by using just one sheet of Alloderm the gains were very poor (about 0.3" in erect girth). To get around this he started epxerimenting by making incisions in the actual tunica and this lead to some terrible complications.

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ripple
@EQ  to be perfectly honest, I don't, and I respect what you're trying to do.  I am always just a bit skeptical when it comes to the claims of PE docs.
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eqstudent
Skeptical One wrote:
..I'm not sure how he obtained these numbers when it can take many months before a patient post-op can fully realize gains.
If these are numbers over all his procedures why is this an issue.  It may not include 2011 numbers but all indications are he no longer practices so recent cases should not be a concern.
 
Skeptical One wrote:
... "With use of a stretching device," also suggests that there could have been a loss of length WITHOUT the use of a device, but he fails to mention those stats.
This is a great question.  All procedures change over time.  If the question is how many complications were found before he required a stretching device?
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eqstudent
hoddle10 wrote:
Dr Whiteheads Alloderm surgery can't be compared to what it is today. Whitehead used a single sheet of Alloderm...

The info from his site contradicts your statement.

With the Allograft Dermal Matrix Graft (Alloderm ®) technique we are adding multiple layers of Allograft Dermal Matrix Graft (Alloderm ®) under the penile skin on top of the erectile chambers to give thickness by "stacking" or "folding" the grafts. I do not use strips of Allograft Dermal Matrix Graft (Alloderm ®), but create a conjoined graft. There are no contour defects and appearance and feel are normal. A penile stretching device is suggested after the widening procedure to combat Allograft Dermal Matrix Graft (Alloderm ®) contraction that might occur.”

http://www.drwhitehead.com/pw.html

 

 

Maybe he evolved his procedure over time?

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eqstudent
ripple wrote:
@EQ  to be perfectly honest, I don't, and I respect what you're trying to do.  I am always just a bit skeptical when it comes to the claims of PE docs.
I'm with you.  I am going to try and gather as much data as I can and see where it leads.
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Skeptical One
His stats for length loss/scar formation post-op are not listed independently of traction therapy.  In other words, there is no telling if length loss is common initially after a surgery.  I consider this gap in the information a problem personally.  Not saying he was intentionally misleading, since the stats themselves are likely accurate.

If length loss is a possibility, I'd like to know how much of a risk it is, since not everyone can commit to the post-op stretching regimen required to ensure a regaining of length.  Granted, he no longer practices, but his past statistics are still clearly relevant to today's use of Alloderm for penis enlargement.

Length loss has been reported from at least one former member off the top of my head (however, it was Alloderm with a separate doctor).

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hoddle10
eqstudent wrote:
hoddle10 wrote:
Dr Whiteheads Alloderm surgery can't be compared to what it is today. Whitehead used a single sheet of Alloderm...

The info from his site contradicts your statement.

With the Allograft Dermal Matrix Graft (Alloderm ®) technique we are adding multiple layers of Allograft Dermal Matrix Graft (Alloderm ®) under the penile skin on top of the erectile chambers to give thickness by "stacking" or "folding" the grafts. I do not use strips of Allograft Dermal Matrix Graft (Alloderm ®), but create a conjoined graft. There are no contour defects and appearance and feel are normal. A penile stretching device is suggested after the widening procedure to combat Allograft Dermal Matrix Graft (Alloderm ®) contraction that might occur.”

http://www.drwhitehead.com/pw.html

 

 

Maybe he evolved his procedure over time?

He hasn't done the procedure since about 2004. He's now in the referral business from what I understand and the guys he sends people to use multiple layers. But when Whitehead was in practice he used a single layer, which is why he starting experimenting with surgery on the actual tunica. And even if he did change his technique towards the end of his career it wouldn't have been for the large majority of his 1000 (very dubious) follow up patients.


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Skeptical One
I'm not doubting Dr. Whitehead's professionalism or prestige, but I can tell you that other "popular" phalloplasty surgeons like Dr. Giunta and Dr. Elist are adamant about the dangers and ineffectiveness of Alloderm.  These doctors have also claimed to see numerous botched Alloderm procedures.

Even though virtually every device and filler used for phalloplasty is rarely, if ever, approved for actual penile use, few have submitted outright disclaimers from their respective companies:


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Skeptical One
I should note that I'm not exactly saying Dr. Giunta or Dr. Elist are anymore trustworthy on the matter, but this is all food-for-thought.

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ripple
Funny how every pe doctor is against every procedure except his own.
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Skeptical One
ripple wrote:
Funny how every pe doctor is against every procedure except his own.

Pretty much 

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