doctors?

[tetsiga]

 I weighed 315 pounds and now i weigh 152 pounds  only area on my body with skin issues is my breast its not gynecomastia but it is extra skin,  i went and seen two doctors
Dr. Marc Robert Polecritti, D.O.
julianplasticsurgery.com
 also
Dr. Suliman M.D
suliman.com/

the problem is the first and second doctors have two different opinons on what they want to do, they both want to cut out the nipple and lift it, but than suliman wants to cut the skin out and pull it togather and put nipple threw scar(does not want to use drain tubes, and wants to use ace bandage type compression, polecritti wants to cut and pull skin down so scar will be under the pectorial muscle (wants to use drain tubes and use compression vest)

i have read up on the doctors a little bit but if you guys can give me a little advice about this and the doctors i would apreciate it

[Dr. Elliot Jacobs]

In situations such as yours, with massive weight loss, there is usually very droopy, lax skin with nipples that are very low.  Oftentimes there is still a little residual breast tissue as well.

These are not the usual gyne cases.  In your case, there will be a need to remove skin, elevate the nipples to an appropriate position and perhaps remove any remaining gyne tissue as well.  It is a long and complicated operation.

Every surgeon will approach it differently, depending on his examination of you and his prior experience and training.  There is no absolutely correct way to approach it.  In going to several surgeons, you now have options for treatment.  Deciding is difficult.  Perhaps you can return to each and discuss their approach in more detail.  Question the pros and cons of each approach and ask about possible complications as well.  The use of drains (or not) is very individual and really should not be a major factor in your decision, however.

Good luck!

Dr Jacobs

[DrBermant]

Congratulations on the weight loss. You will need to look for actual examples of Male Mastopexy Skin Reduction Chest Lift to understand what a surgeon's techniques are like. With a loose skin component, make sure you examine videos or at least bending over views to see just how well the loose skin was managed. Loose skin is not well documented by a few standing up photos. That is why I evolved a separate set of Standard Pictures for this contour deformity. The skin needs to come out from some access point resulting in scars. This is surgery that has its own skills. Just because a surgeon can perform a female breast lift, does not mean that their male chest sculpture looks as good.

Hope this helps,

Michael Bermant, M.D.

[tetsiga]

well the only issue that i was concerned about was the scarring issue suliman wants  to put the scar across my chest, and poli wants to put it under my pec muscle

[Dr. Elliot Jacobs]

You are going to have a permanent scar either way -- be prepared for that.  It will be a trade-off of a scar for a better, trimmer and tighter shape.

Either method may work.  Part of your decision may be how you tend to heal.  If you have had any prior surgery, accidental cuts, etc on your body, you can get some idea of how your body heals.  Scars also improve significantly over time -- and for younger patients, the time may be 1-2 years or more before it settles down.  Be prepared for that.

Dr Jacobs

[Litlriki]

I'd also like to congratulate you on your weight loss.  As plastic surgeons, we are seeing more and more patients like yourself who have managed to get to a healthy weight after being heavy, only to discover that they are unhappy with the way their body looks due to the resulting loose skin.  Unfortunately, surgery is typically the only way to get improvement, and all surgery leaves scars.

With regard to the surgeons you visited, hopefully, you were able to see some photos of what you might expect from each surgeon's approach.  My preference is placement of the scar under the pectoralis muscle, since this is a more natural line than a line across the chest at nipple level, but it presents challenges, just as any approach does.  As Dr. Jacobs pointed out, the scars will fade over time, but it's important that you have an idea of what sort of results you might expect.

Good luck.

Rick Silverman

[DrBermant]

well the only issue that i was concerned about was the scarring issue suliman wants  to put the scar across my chest, and poli wants to put it under my pec muscle

Scars are more than the incision site on the skin. Scars can exist throughout the surgical sculpture. This is why, if you concerned about scars, you want to see the results with muscles flexing, arms up overhead, bending over to see the compromises of skin left behind, and preferably videos of the chest. To compare results look for documentation of what any one technique that doctor has achieved. This is surgery that you want to better understand what you are getting into before having it done. If a surgeon has done this problem enough, then there should be examples of just what their patients look like and move after surgery.

Hope this helps,

Michael Bermant, M.D.

[DrPensler]

 good job re the weight loss ,do you have a photo?