Testicle Implants


Scrotoplasty is the construction of a testicle implant laden scrotal sac, also known as testicle implants. This procedure can be combined with a Simple Meta or done as a separate procedure. Scrotoplasty can also be performed in conjunction with the Ring Meta (RM) although not yet performed at the original procedure. Patients are asked to wait 3 months after RM to have the implants placed due to potential strain on the original incisions of the Ring Meta and urethral extension. The second procedure also allows Dr. Bowers to repair any potential leak or fistula when the testicles are placed.


Scrotoplasty is performed while under general anesthetic normally. The original incisions of the Simple Meta allow the implants to be placed through a single incision hidden in the midline between the testicles (as it is in natal males!). If performed as separate procedure, two small nick incisions along each labia minora are continued in to the deep space beneath the labia majora. The space in the labia minora is mostly fatty and leaves ample space for manual expansion (not requiring tissue expanders). The implant is soaked in antibiotic solution and placed. The layers are sewn back over with dissolvable suture and the procedure completed.

The implants are made of solid, medical grade silicone and are imported from Brazil. Hence: Brazil nuts. They range in size from 1 to 4 (small-medium-large-extra large). Also called huevos. Dr. Bowers has examples of each and will show and discuss size options with patients prior to surgery so that a joint decision is made in choosing size-appropriate testicles. Most patients choose medium or large implants.

Postoperative course

Patients typically do well with scrotoplasty although can experience expulsion due to the body rejecting the implants as foreign bodies. This rejection, were it to occur, would happen within the first 3 weeks although Dr. Bowers has taken care of clients of Dr. Biber and others who have experienced rejection of the implants years after insertion. This is an unlikely scenario however, decidedly rare. While some surgeons advocate prior tissue expanders to allow the skin to stretch while the implant is adjusting to its new location, Dr. Bowers’ experience favors a one-stage procedure with ample stretching of the skin that eliminates the immediacy and cost of tissue expanders.