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Procedure guide · Intimate
A testicular implant is a silicone prosthesis placed in the scrotum to restore appearance after a testicle has been removed for cancer, torsion, trauma or an undescended testis, and as part of gender-affirming surgery. It takes 30 to 60 minutes, usually as a day case. It restores appearance only: it produces no testosterone and no sperm, and it does not affect fertility either way.
A testicular implant is a silicone prosthesis placed in the scrotum to restore the appearance and feel of a testicle that has been removed. It is most commonly offered after orchidectomy for testicular cancer, and also after torsion, trauma, severe infection, or where a testicle never descended. It is also used as part of gender-affirming scrotoplasty during metoidioplasty or phalloplasty, which is a different pathway with its own staging and assessment.
The first thing to establish, because men occasionally arrive believing otherwise, is that the implant restores appearance and nothing more. It produces no testosterone, no sperm and no hormones of any kind. A man who has lost one testicle usually produces normal testosterone from the remaining one and is often still fertile. A man who has lost both requires testosterone replacement whether or not he has implants, which is a separate discussion with a urologist or endocrinologist. Clinics do not generally misrepresent this, but it is worth stating plainly.
The timing decision is genuinely balanced rather than having a right answer. Having the implant placed at the same operation as the orchidectomy means one anaesthetic, no second scar, and no period of absence, which many men prefer. Against that, the decision is being made under the pressure of a new cancer diagnosis, and infection risk is higher where the original surgery was for infection or trauma rather than cancer. A delayed implant gives time to decide, is performed on healed tissue with lower infection risk, and costs a second operation. Neither choice is wrong, and men who declined at the time and later changed their minds should know that delayed implants are routine and often still funded.
Position is the commonest source of disappointment, and understanding why prevents most of it. A natural testicle hangs on a spermatic cord and moves, rising and falling with temperature and activity. An implant sits in a pocket created in the scrotum and is fixed in place to stop it migrating, so it does not hang, does not move much, and tends to sit higher than the remaining testicle. Surgeons place them as low as the scrotal skin allows and some asymmetry is usual rather than a sign of poor technique. Men who know to expect it adapt well; men who expected an exact match do not.
Feel is the second. Silicone prostheses are firmer and smoother than a natural testicle. Most men adapt within months and are satisfied, and a partner is likely to notice the difference. Men who mention it in advance rather than hoping it goes unnoticed generally find it a non-issue. Handling an implant at the consultation before deciding is worth asking for, and most urologists will have samples available.
Sizing is more limited than patients expect. Prostheses come in a small number of fixed sizes rather than being made to measure, so the surgeon chooses the closest match to the remaining testicle and a small mismatch is common. Some men prefer a slightly smaller implant because it sits more comfortably, particularly where scrotal skin has contracted in the years since the testicle was removed. Where contraction is considerable, a smaller implant or a staged approach with tissue expansion may be needed, which examination establishes.
Infection is the risk with the most serious consequence. It is uncommon, but antibiotics rarely clear an infection around a prosthesis and an infected implant almost always has to be removed, with a replacement considered only several months later once everything has healed. This is why the operation is avoided during any active infection anywhere in the body, why strict sterility in a proper theatre matters more than it might for a procedure of this size, and why increasing pain, spreading redness, fever or discharge should be reported the same day rather than waited out.
Most implants last indefinitely. Silicone prostheses have no expiry and are not routinely replaced, unlike breast implants, and most men keep the same implant for life. Removal, where it happens, is for infection, chronic discomfort or extrusion rather than for age, and a small number of men have the implant removed and decide not to replace it. A substantial proportion of men choose never to have one at all and are entirely satisfied with that, which is worth knowing if you are feeling pressed to decide quickly.
The material and lifespan of these devices are frequently confused with breast implants, which creates unnecessary anxiety. Testicular prostheses are usually a silicone shell filled with silicone gel or saline, sized as a solid unit, and they are not subject to the rupture expectations or replacement intervals discussed for breast implants. They have no expiry, they are not routinely exchanged, and most men keep the same implant for life. Removal, where it happens, is for infection, chronic discomfort or extrusion rather than because the device has aged, and a small number of men have one removed and decide not to replace it.
Cancer surveillance is worth addressing because men who have had testicular cancer are at slightly increased risk in the remaining testicle. The implant does not interfere with this, since there is no testicular tissue on that side to examine, and self-examination continues on the remaining side where any new cancer would develop. Checking monthly remains worthwhile. The implant itself should feel unchanged over time, so any new lump, change in firmness or discomfort around it is worth reporting, not because it would be cancer but because it may indicate a problem with the prosthesis.
Timing a delayed implant is constrained mainly by scrotal skin rather than by any deadline. Once the original wound has fully healed and any cancer treatment is complete, which usually means at least 6 months and often longer, there is no upper limit, and implants are placed years or decades after the original surgery. What changes with time is how much the scrotal skin on that side has contracted. Where contraction is substantial, a smaller implant or a staged approach using tissue expansion may be needed, which an examination establishes quickly. Men who declined at the time of orchidectomy and have since changed their minds should ask rather than assume the opportunity has gone.
Surgeons look for these points at the consultation.
A testicular implant suits adults who have lost a testicle to cancer, torsion, trauma, infection or an undescended testis and are troubled by the absence, men having an orchidectomy who want the prosthesis placed at the same operation, and men undergoing gender-affirming scrotoplasty.
Reasons a good surgeon will ask you to wait or choose something else.
A testicular implant is avoided during active infection anywhere, in the scrotum that has recently been infected, in poorly controlled diabetes, in current smoking that will not stop, in insufficient scrotal skin to cover an implant without tension, and where cancer treatment is ongoing and should be completed first.
Ask your surgeon which technique they recommend for you and why.
The prosthesis is placed during the same operation that removes the testicle, through the incision already being made.
The prosthesis is placed months or years after the testicle was removed, through a groin or upper scrotal incision.
Two prostheses placed where both testicles have been removed, or as part of gender-affirming scrotoplasty.
Choosing not to have a prosthesis, which a substantial proportion of men do and are satisfied with.
Step by step, from arrival to discharge.
The urologist assesses the remaining testicle and the available scrotal skin, and offers the available implant sizes to handle so a choice can be made before the day.
General anaesthesia is usual, sometimes local with sedation. Strict sterility matters more here than the size of the operation suggests, because infection means removal.
A pocket is created in the scrotum through a groin or upper scrotal incision, placed as low as the scrotal skin allows so the implant sits close to the natural position.
The prosthesis is placed and fixed to prevent it migrating upward. Fixation is why the implant does not move like a natural testicle, and why it tends to sit higher.
Layered closure with absorbable sutures, taking care that the skin covers the implant without tension, since tension risks extrusion.
Supportive underwear fitted before leaving, then home the same day with antibiotics where prescribed and clear instructions on what to report.
Frequencies follow published guidance; your personal risk depends on your health and the surgeon.
A testicular implant needs one thing understood before anything else: it restores appearance and nothing more. It produces no testosterone, no sperm and no hormones of any kind. A man who has lost one testicle usually produces normal testosterone from the remaining one and is often still fertile; a man who has lost both needs testosterone replacement whether or not he has implants. Clinics do not usually misrepresent this, but men occasionally arrive believing the prosthesis does something functional, and it does not.
The commonest disappointment is position rather than any complication. The implant is placed in a pocket in the scrotum and it does not hang on a cord the way a natural testicle does, so it tends to sit higher and to move less. Surgeons fix it in place to reduce this, and it still happens. Men who know to expect it generally adapt well; men who expected an exact match do not. Firmness is the second: silicone feels smoother and firmer than a natural testicle, which is noticeable to both the man and a partner.
Infection is the risk with the most serious consequence, because an infected implant almost always has to come out and cannot be replaced for months. It is uncommon, but it is the reason the operation is avoided during any active infection anywhere in the body, and the reason a delayed implant is often preferred where the testicle was removed because of infection or trauma rather than cancer.
Silicone prostheses feel firmer and smoother than a natural testicle. Most men adapt, but it is noticeable to them and to a partner.
The implant sits higher in the scrotum than the natural testicle, which is the commonest complaint after a testicular implant and is difficult to correct.
The implant looks or feels a different size from the remaining testicle, since sizes come in fixed increments rather than being made to measure.
An infected testicular implant almost always has to be removed, with a further operation months later to replace it if wanted.
Blood collecting around the implant after surgery, which sometimes needs draining and occasionally risks the implant.
Persistent aching or discomfort around the implant, which occasionally leads men to have it removed and not replaced.
The implant eroding toward or through the skin, usually where there was insufficient scrotal skin or where infection occurred, requiring removal.
Recovery after a testicular implant is short and usually uncomplicated. The scrotum swells and is sore for a week or two, supportive underwear worn continuously makes a substantial difference, and most men are back at desk work within a week. Simple painkillers are generally enough.
The implant feels high, firm and foreign for the first weeks, and this is the stage at which men most often worry that something is wrong. Swelling holds it upward, and the surrounding tissue has not yet formed the capsule that will hold it in its settled position. It drops as far as it is going to by around 6 to 8 weeks, and the position at 3 months is the position you have. Judging it earlier is not useful.
Report signs of infection rather than waiting: increasing pain after the first few days, spreading redness, fever or discharge. An implant infection caught early is occasionally salvageable and one left late is not, and the consequence of losing the implant is a further operation and a wait of several months before it can be replaced.
Days 1-3
The scrotum swells and is sore. Supportive underwear worn continuously, ice, and rest. Discomfort is usually well managed with simple painkillers.
Days 4-10
Bruising fades and swelling reduces. Flying is usually cleared at around day 5. Support continues day and night.
Weeks 2-4
Desk work at around a week. No lifting, cycling, sport or swimming. The implant still feels high and firm at this stage.
Weeks 6-8
Sexual activity usually resumes at around 6 weeks. Swelling has resolved and the implant has settled as far down as it is going to.
Months 3-6
The scar has faded, the capsule around the implant has matured, and the position and feel are settled. This is when the result should be judged.
A testicular implant feels high, firm and foreign for the first weeks, which is when men most often worry that something is wrong. Swelling holds it upward and the surrounding capsule has not yet formed. It drops as far as it is going to by around 6 to 8 weeks, and the position at 3 months is the position you keep.
It looks convincing in clothing and to casual inspection. It feels firmer and smoother than a natural testicle and sits higher and moves less, because it is fixed in a pocket rather than hanging on a cord. Most men adapt within months and are satisfied.
A small size mismatch is common, since prostheses come in fixed sizes rather than being made to measure. Handling the available sizes at the consultation before deciding is the best way to avoid a surprise.
Most implants last indefinitely and are never replaced. Removal, when it happens, is for infection, chronic discomfort or extrusion, and a small number of men have the implant removed and choose not to replace it.
A testicular implant is most often funded rather than paid for privately, because it follows the loss of a testicle to cancer, torsion or trauma and most health systems treat it as reconstructive. It is usually offered at the time of orchidectomy, and if you declined then and have since changed your mind, it is worth asking again rather than assuming the opportunity has passed. Delayed implants are routinely performed and often still funded.
Where it is paid for privately, the prices on this site come from verified clinic records rather than a published tariff. The cost covers the prosthesis itself, a general anaesthetic and a short day-case operation in a properly sterile theatre, which is the part least worth economising on given what infection costs.
The exposure that matters for anyone travelling is what happens if the implant becomes infected weeks after flying home. It almost always has to be removed, which means an operation locally, and a replacement cannot be considered for several months. Establishing who manages that, and at whose cost, belongs in the decision.
Why quotes for the same procedure differ, so you can compare packages fairly.
Options to weigh before deciding, surgical and non-surgical.
A substantial proportion of men choose not to have a prosthesis and are entirely satisfied. It avoids an implant, an infection risk and the possibility of removal.
Declining at the time of orchidectomy and having a delayed implant months or years afterwards, which is routine, often still funded, and made without the pressure of a new diagnosis.
Where both testicles have been lost, hormone replacement is what addresses the physiological loss. An implant does nothing for it and the two are separate decisions.
Where the scrotum itself is loose or asymmetric after a testicle has been removed, reshaping it sometimes suits better than filling it.
Where distress after losing a testicle is substantial, support alongside or instead of a prosthesis is offered by most cancer services and is frequently more useful.
Ask the same questions at every consultation so you can compare answers.
No. A testicular implant is a silicone prosthesis that restores appearance only. It produces no testosterone, no sperm and no hormones, and it has no function beyond filling the space.
A man with one remaining testicle usually produces normal testosterone and is often still fertile. A man who has lost both needs testosterone replacement regardless of whether he has implants, which is a separate discussion with an endocrinologist or urologist.
A testicular implant looks convincing in clothing and to casual inspection. It feels firmer and smoother than a natural testicle, and it sits higher and moves less because it is fixed in a pocket rather than hanging on a cord.
Most men adapt within months and are satisfied. Men who expected an exact match are the ones who are disappointed, which is why handling an implant at the consultation before deciding is worth asking for.
Placing a testicular implant at the same time is reasonable where the testicle is being removed for cancer, and it means one operation, one anaesthetic and no second scar. Many men prefer to avoid the period of absence entirely.
A delayed implant is often better where removal was for infection or trauma, because infection risk is higher, and it gives time to decide without the pressure of a new cancer diagnosis. Neither is wrong.
An infected testicular implant almost always has to be removed. Antibiotics rarely clear an infection around a prosthesis, and leaving it in risks a more serious problem. A replacement can usually be considered several months later once everything has healed.
Infection is uncommon but it is the reason the operation is avoided during any active infection anywhere, and the reason to report increasing pain, spreading redness, fever or discharge the same day rather than waiting.
A testicular implant sits higher because it is placed in a pocket in the scrotum and fixed to stop it moving, rather than hanging on a spermatic cord the way a natural testicle does. It also cannot respond to temperature by rising and falling.
It is the commonest complaint after this operation and it is difficult to correct once the capsule has formed. Surgeons place implants as low as the scrotal skin allows, and some asymmetry is usual rather than a sign of poor technique.
Testicular implants come in a small number of fixed sizes rather than being made to measure, so the surgeon chooses the closest match to the remaining testicle. A small mismatch is common.
Ask to see and handle the sizes at the consultation. Some men prefer a slightly smaller implant because it sits more comfortably, particularly where scrotal skin has contracted since the testicle was removed.
A testicular implant is frequently funded, because it follows the loss of a testicle to cancer, torsion or trauma, and most systems treat it as reconstructive rather than cosmetic. It is usually offered at the time of orchidectomy.
If you declined it then and have changed your mind, it is worth asking again rather than assuming the opportunity has passed. Delayed implants are routinely performed and often still funded.
A testicular implant lasts indefinitely in most men. Silicone prostheses have no expiry and are not routinely replaced, unlike breast implants, and most men keep the same implant for life.
Removal, when it happens, is usually for infection, chronic discomfort or extrusion rather than for age. A small number of men have the implant removed and choose not to replace it.
A testicular implant can be placed years later, and delayed implants are routinely performed. The pocket is created through a groin or upper scrotal incision, and the main limitation is whether enough scrotal skin remains on that side.
Where scrotal skin has contracted considerably over years, a smaller implant may be needed or a staged approach with tissue expansion. A urologist can tell you at examination which applies.
Neither. A testicular implant does not affect sperm production, testosterone, erections or orgasm, because it does nothing physiological at all. Sexual activity resumes at around 6 weeks once healing is complete.
A partner is likely to notice it feels firmer and sits higher than a natural testicle. Men who mention it in advance rather than hoping it goes unnoticed generally find it a non-issue.
Testicular implants are used in gender-affirming surgery, placed as part of scrotoplasty during metoidioplasty or phalloplasty, usually at a later stage once the scrotum has been constructed and healed.
That is a specialist pathway with its own assessment and multidisciplinary team rather than something to arrange through a cosmetic package, and the staging is planned around the wider surgical sequence.
Choose a urologist who places testicular implants regularly, in a proper theatre with strict sterility, since infection is the complication with the most serious consequence. This is not general cosmetic surgery.
Ask to handle the available sizes, ask how low they can place it given your scrotal skin, and ask their own infection and removal rates. A surgeon who warns you unprompted that it will sit higher is being straight with you.
Testicular implants and breast implants both use silicone, but the devices are different. Testicular prostheses are usually a silicone shell filled with silicone gel or saline, sized as a solid unit, and they are not subject to the rupture and replacement expectations of breast implants.
They have no expiry and are not routinely exchanged, and most men keep the same implant for life. Removal, when it happens, is for infection, discomfort or extrusion rather than because the device has aged.
A testicular implant does not interfere with checking, since there is no testicular tissue on that side to examine. Self-examination continues on the remaining side, which is where any new cancer would develop.
Men who have had testicular cancer are at slightly increased risk in the other testicle, so continuing to check the remaining side monthly matters. The implant itself should feel unchanged, and any change in it is worth reporting.
A testicular implant is no more noticeable than a natural testicle. It restores the visible contour of the scrotum, which is the point, and men report that the self-consciousness in changing rooms and swimwear is what the implant resolves.
On close handling it feels firmer and sits higher, which a partner is likely to notice. Mentioning it beforehand is generally less awkward than hoping it goes unremarked.
A testicular implant can be removed, usually as a straightforward day-case operation through the original scar, and a small number of men do choose this because of persistent discomfort or because it never felt right.
Removal leaves an empty scrotum on that side, as before the implant was placed. It is worth discussing with the surgeon rather than simply enduring discomfort, since chronic discomfort around an implant rarely improves by itself.
A delayed testicular implant waits until the original wound has fully healed and any cancer treatment is complete, which in practice usually means at least 6 months and often longer. There is no upper limit, and implants are placed years or decades later.
The main constraint is how much the scrotal skin has contracted in the meantime. Where contraction is substantial, a smaller implant or a staged approach with tissue expansion may be needed, which examination establishes.
European Association of Urology2024Clinical guideline
NHS2024Regulator
American Society of Plastic Surgeons2024Professional society
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