What do the implants do?
They add shape and fullness to the scrotum.
They do not produce testosterone or sperm and do not restore fertility.
Gender-affirming surgery
Testicular Implant Placement
Testicular implant placement adds prostheses to an existing or surgically created scrotum to create fullness and the appearance of testicles.
Can they be placed after gender-affirming surgery?
Yes, when the scrotal tissue and healing allow.
Placement may be part of a planned reconstruction or a later stage after scrotoplasty. A surgeon must assess the available space and tissue.
Will they feel like natural testicles?
Their feel and movement may differ.
Discuss firmness, size, position, and how noticeable the implants may be when sitting, exercising, or having sex.
01 · Overview
Understanding testicular implants
Testicular implants are prostheses placed inside the scrotum. They can replace the appearance of an absent testicle or add fullness to a surgically created scrotum. They are not transplanted testicles and do not provide reproductive or hormonal function. [1]
In gender-affirming care, implant placement is distinct from scrotoplasty, which creates a scrotum. It is also different from a penile implant used for rigidity after some types of phalloplasty. These procedures may be discussed together, but each has its own purpose and risks. [2]
Your surgeon will discuss the number and size of implants, the available tissue, and the timing of placement. Prior surgery, scars, and any ongoing wound or urinary concerns may affect the plan. Choosing not to have implants is also a valid option.
- Purpose
- Scrotal shape and fullness
- Function
- Appearance only; no hormone or sperm production
- Timing
- Individualized, sometimes staged
- Long-term care
- Implants may need revision or removal
Does implant placement create a scrotum?
No. Scrotoplasty creates the tissue pouch; implants add fullness within it. If you need both, ask whether they should be performed together or in separate stages.
Does placement change hormone treatment?
The implants do not make hormones. Any hormone changes relate to your overall care and whether hormone-producing organs have been removed—not to the prostheses themselves. Discuss medications with your prescribing clinician and surgical team.
02 · Concerns & Goals
What you may want to address
You may want a fuller scrotum, a different balance, or an appearance that feels more aligned with your gender. Your priorities help guide the discussion.
Limited fullness
You may want more volume in an existing or reconstructed scrotum. The tissue must have enough room to hold an implant without excessive tension.
Uneven appearance
Differences in tissue, scars, or implant position can affect symmetry. Perfect matching is not always possible.
Gender alignment
Scrotal fullness may be meaningful to your sense of comfort or identity. You do not need implants to validate your gender.
Comfort and feel
Firmness, visibility, and movement matter alongside appearance. Let your surgeon know which daily activities and sensations concern you.
03 · Options
How the approaches differ
These are planning choices rather than interchangeable techniques. Your surgeon can explain which are appropriate for your anatomy and reconstruction.
Placement in an existing scrotum
Adds a prosthesis where scrotal tissue is already present.
How it worksThe surgeon creates a pocket and inserts an implant through an incision.
May suitPeople with adequate healthy tissue who want to replace missing fullness.
Main tradeoffScarring, tissue tightness, or prior surgery may limit size and positioning.
Placement during scrotoplasty
Combines scrotal creation and implant placement in selected cases.
How it worksImplants are placed as part of the reconstruction if the tissue and surgical plan allow.
May suitPeople whose surgeon considers combined placement appropriate.
Main tradeoffHealing tissue must accommodate the implants; not every reconstruction can safely support this approach.
Staged placement after scrotoplasty
Allows the reconstructed scrotum to heal before implants are added.
How it worksA later operation places implants after the surgeon reassesses tissue healing and space.
May suitPeople whose reconstruction or wound history favors separate stages.
Main tradeoffRequires another procedure and recovery period.
Revision or replacement
Addresses an existing implant's size, position, or complications.
How it worksThe surgeon may reposition, exchange, or remove a prosthesis, depending on the concern.
May suitPeople with an unsatisfactory or troublesome existing implant.
Main tradeoffScar tissue can make revision more complex, and immediate replacement may not be safe if infection is present.
Ask which implant is proposed, what it contains, and whether its size and firmness fit your tissue and goals. Testicular prostheses provide appearance rather than biological function. [1].
Can I choose the size?
You can discuss your preference, but tissue capacity and safe wound closure set limits. An implant that is too large can put pressure on the skin and incision.
Will I need one implant or two?
That depends on your anatomy, existing testicles or implants, reconstruction, and goals. Placement does not automatically require removal of a healthy testicle.
04 · Results
What may improve and what may remain
Shape and fullness
Implants can add volume, but the surrounding tissue shapes the result.
- Size and position are limited by tissue thickness, scarring, and available space.
- Some asymmetry or visible implant edges may remain.
Feel and function
A prosthesis is not a functioning testicle.
- It may feel firmer or move differently from a natural testicle.
- It does not produce sperm or testosterone, create an erection, or guarantee changes in sexual satisfaction.
Long-term expectations
The result may change, and further surgery may be needed.
- Implants can shift, become uncomfortable, or develop other complications.
- There is no guarantee that an implant will remain suitable for life.
Review appearance, feel, and possible future removal or replacement before choosing a prosthesis. [1]
05 · Recovery
Planning your recovery
Recovery at a glance
- Stay after surgery
- Determined by Your Surgeon
- Initial recovery at home
- Varies by Individual
- Return to desk work
- Varies by Procedure and Work Activity
- Light daily activities
- Based on Individual Recovery
- Strenuous exercise
- Based on Surgeon Clearance
Returning to work does not mean fully healed. Follow your surgeon’s instructions; strenuous activity requires clearance.
Recovery depends on whether placement is performed alone or alongside reconstruction. Your surgical team's instructions take priority; returning to work does not mean the tissue is fully healed.
Step 1 · Day of surgery
Treatment day
The team monitors your recovery from anesthesia and checks the surgical area. Whether you go home that day depends on the overall procedure and your condition.
Step 2 · First several days
Early healing
Soreness, swelling, and bruising may occur. Follow your team's plan for medications, wound care, clothing, and activity.
Step 3 · Following weeks
Gradual return
Activity increases as the incision heals and discomfort improves. Combined scrotoplasty or other genital surgery may require a longer recovery.
Step 4 · Weeks to months
Settling and follow-up
Swelling and tissue changes can affect early appearance. Follow-up visits assess wound healing, implant position, and persistent discomfort.
Planning everyday activities
ActivityGeneral planning contextWhat affects the plan
Desk workPlanning context: May resume before full healingWhat affects it: Sitting tolerance, pain medication, commuting, and combined procedures affect timing.
DrivingPlanning context: Requires safe movement and alertnessWhat affects it: You should be able to brake and turn comfortably and be free of medication-related impairment; ask your team when this is safe.
Exercise and cyclingPlanning context: Need individualized clearanceWhat affects it: Lifting, straining, and saddle pressure can stress healing tissue.
Sexual activityPlanning context: Wait for procedure-specific guidanceWhat affects it: Friction and pressure can affect the incision; restrictions may be longer after combined reconstruction.
Do not massage, pull, or reposition an implant unless your surgeon specifically instructs you to do so.
Before your procedure
- Review prior genital operations, implants, scars, and wound-healing problems with your surgeon.
- Share your medication, supplement, allergy, and hormone-treatment history.
- Discuss nicotine use and the team's requirements for stopping before and after surgery.
- Ask which implant, incision, and staging plan are proposed.
- Arrange transportation and any help needed during early recovery.
- Get individualized instructions for fasting, medications, wound care, and follow-up.
Can I use compresses for swelling?
Ask your surgical team whether compresses are appropriate and exactly how to use them.
What if an implant seems higher than expected?
Swelling and tissue tightness can affect early position, but a change should be reviewed by your surgeon. Do not try to force the implant into another position.
06 · Safety
Risks and what your clinician assesses
Temporary soreness, bruising, swelling, and changes in sensation can occur. Symptoms should generally improve rather than become increasingly painful, red, or swollen.
Infection
Infection may require antibiotics, drainage, or implant removal. Replacement may need to wait until the tissue has healed.
Wound opening or implant exposure
The incision or skin may break down, allowing the implant to become exposed or push through. Further surgery may be necessary.
Bleeding or fluid collection
Blood or fluid can collect around the implant and may need treatment or drainage.
Position or appearance concerns
An implant may sit too high, shift, or look uneven. Size or firmness may not meet your expectations.
Persistent pain or device problems
Ongoing discomfort, scar tightening, altered sensation, or implant damage may lead to revision or removal.
Anesthesia and general surgical risks
Anesthesia reactions, blood clots, and other complications are possible. Your health and the extent of surgery influence these risks.
Discuss these risks and your individual health history with your surgeon. [1]
What your clinician assesses
- Scrotal tissue thickness, blood supply, space, and scars
- Prior reconstruction, implant history, and any active infection
- Health conditions, nicotine use, medications, and anesthesia risks
- Goals for fullness, comfort, size, and willingness to consider future surgery
07 · Costs
What makes up the Total Procedure & Care Cost
Compare written estimates for the same planned scope: implant placement alone, placement with scrotoplasty, or revision. Confirm the number of implants and any additional procedures before comparing totals.
Surgeon
Surgical care
The surgeon's services and the planned implant procedure.
Ask your surgeonAsk whether the implant devices, combined procedures, and potential revision care are included.
Facility
Anesthesia and facility
Anesthesia services and use of the surgical facility.
Ask your surgeonAsk about separate bills, planned outpatient care, and charges if an overnight stay is needed.
Supplies
Supplies and follow-up
Dressings, prescribed supplies, medications, and postoperative visits.
Ask your surgeonConfirm which items and visits are included and how unexpected treatment is billed.
TRC
Patient Services
Any separately listed coordination or administrative services.
Ask TRCAsk whether these services apply, what they include, and whether they are optional.
Your written estimate should explain the services included, any separate charges, and payment terms.
08 · Questions
Common questions
Is this the same as a penile implant?
No. Testicular implants add scrotal fullness. A penile implant provides rigidity in selected circumstances and is a different operation.
Can I have implants without phalloplasty?
Potentially. Phalloplasty is not automatically required, but you need an existing or surgically created scrotum with suitable tissue. Your surgeon can assess the options.
Will implants affect fertility?
The implants do not produce sperm or restore fertility. The effects of any accompanying surgery depend on which reproductive organs are involved. Discuss fertility preservation before procedures that could affect it.
Will insurance cover placement?
Coverage depends on your plan, benefits, documentation, and authorization requirements. Ask about coverage for both the procedure and implant devices, and request an estimate of your responsibility.
0 consultation questions in your plan
View in My TRC workspaceMy Aesthetic Plan
Prepare for your consultation
Bring these to help your consultation:
- Confirm the implant choice, number, and timing with the surgeon.
- Obtain a personalized recovery plan and urgent-contact information.
- Review the written estimate and any insurance authorization requirements.
View My Aesthetic Plan
Choices stay in this visit until saving to your account completes. Nothing is sent to a clinician.
Sources
- [1]Cleveland Clinic — Testicular ImplantsPurpose and nonfunctioning nature of testicular prostheses; implant selection, placement, recovery, complications, and warning symptoms.
- [2]American Society of Plastic Surgeons — Gender Affirmation SurgeryGender-affirming genital surgery context and the distinction between reconstructive procedures such as scrotoplasty and phalloplasty.
Photographs are illustrative scenes, not patients, staff, facilities or outcomes. This information does not replace a personal assessment by your treating clinician.