muscle damage from gyno surgery?

[flatness13]

Do you know of any cases or could it happen where a surgeon causes nerve damage on the pec muscles? Like with poor use of the cannula? I don't know if that happened to me but I remember that my right pec felt painful and strange for months after surgery, and now it's more deflated than my left pec.

Could be that more tissue was removed from the right pec but I suspect that my muscles were damaged. My bench press is not as strong anymore since the surgery..

For instance this patient talks about muscle damage after his botched surgeries:
https://www.youtube.com/watch?v=GDdvrttfqsM

It has been worrying me and if it is the case I might be in bigger trouble than I thought.

[Dr. Elliot Jacobs]

I have never seen or heard about nerve damage to the pecs during gyne surgery -- but anything is possible.  Bear in mind, the nerve to the pec muscle enters from its undersurface, which is close to the ribs.  I can't see any surgeon going that deep.

On the other hand, could an inexperienced gyne surgeon accidentally go too deep so that he enters the muscle itself -- yes, that is possible.

It is impossible to comment on your situation -- only your surgeon would know what was done.

Dr Jacobs

[flatness13]

I have never seen or heard about nerve damage to the pecs during gyne surgery -- but anything is possible.  Bear in mind, the nerve to the pec muscle enters from its undersurface, which is close to the ribs.  I can't see any surgeon going that deep.

On the other hand, could an inexperienced gyne surgeon accidentally go too deep so that he enters the muscle itself -- yes, that is possible.

It is impossible to comment on your situation -- only your surgeon would know what was done.

Dr Jacobs

And if such a case happens(surgeon going deep enough to insert into the muscle) what is the side effect of this? Is it loss of function, strength etc? Does the muscle decrease in size after it's been damaged?

[Dr. Elliot Jacobs]

I cannot say -- this is only hypothetical.  I have never seen a case.

Dr Jacobs

[flatness13]

I cannot say -- this is only hypothetical.  I have never seen a case.

Dr Jacobs

True. I might have to get an MRI scan done on my chest one day to really get a good look and see if there's any damage on the tissue beyond the fat and glands.

I found a second case too.
http://liposuctionruinedmylife.com/
I know you doctors don't have the time to read this all but the patient shows MRI's which supposedly show damage to the muscles.

[Paa_Paw]

I don't have any comments that would help you directly. What I have to say is for anyone else contemplating surgery that might be following this topic. 
Cosmetic surgery is a specialty, Seek out a surgeon who is qualified and has a demonstrated interest in this type of surgery.  If cost and convenience are your main criteria for the selection of your surgeon, your results can be something that you might not like. 

[Dr. Cruise]

I have never had this issue in my practice nor do I know of anyone who has. As others have expressed, anything is possible, especially if the procedure is performed by someone who is not experienced with gynecomastia surgery.  It sounds as though you aren't really experiencing any significant issues, which is great news. Depending on how long ago your surgery was, the weakness when working out your chest, could be a result of the area still needing to heal. 

[flatness13]

I have never had this issue in my practice nor do I know of anyone who has. As others have expressed, anything is possible, especially if the procedure is performed by someone who is not experienced with gynecomastia surgery.  It sounds as though you aren't really experiencing any significant issues, which is great news. Depending on how long ago your surgery was, the weakness when working out your chest, could be a result of the area still needing to heal.

It has been 15 months. There could be other factors involved but I truly believe my chest has lost strength compared to pre-surgery. Well atleast my right pec, which happens to be the one that looks deflated now. It feels weaker and off, and more prone to injury.

Would you all be able to tell if something is wrong with the muscles if I showed an MRI scan here? Or do I need to go to another type of doctor for this..

Thanks

[Litlriki]

I have done revision surgery on someone in whom the muscle was injured during removal of the gynecomastia tissue, but this just involved removal of a chunk of pectoralis muscle, causing a "divot" on his chest.  The muscles that remain functioned normally, but there was a contour defect.  As pointed out, injury to the nerves that supply these muscles would be highly unusual, since they are deep to the muscle, and the muscle is left untouched in a normal gynecomastia procedure.  
Rick Silverman

[flatness13]

I have done revision surgery on someone in whom the muscle was injured during removal of the gynecomastia tissue, but this just involved removal of a chunk of pectoralis muscle, causing a "divot" on his chest.  The muscles that remain functioned normally, but there was a contour defect.  As pointed out, injury to the nerves that supply these muscles would be highly unusual, since they are deep to the muscle, and the muscle is left untouched in a normal gynecomastia procedure.  
Rick Silverman

But wouldn't this removal of a piece of the pectoralis muscle cause that side of the chest to become weaker, on top of the horrible problem of the way it looks?

It just sounds like a very severe complication to me. Can the muscle be fixed?

One last thing how did you come to find out that this patient suffered from this, was it obvious by looking or did you take x-rays etc.

[Litlriki]

I have done revision surgery on someone in whom the muscle was injured during removal of the gynecomastia tissue, but this just involved removal of a chunk of pectoralis muscle, causing a "divot" on his chest.  The muscles that remain functioned normally, but there was a contour defect.  As pointed out, injury to the nerves that supply these muscles would be highly unusual, since they are deep to the muscle, and the muscle is left untouched in a normal gynecomastia procedure.  
Rick Silverman

But wouldn't this removal of a piece of the pectoralis muscle cause that side of the chest to become weaker, on top of the horrible problem of the way it looks?

It just sounds like a very severe complication to me. Can the muscle be fixed?

One last thing how did you come to find out that this patient suffered from this, was it obvious by looking or did you take x-rays etc.

Based on history and the findings at the time of surgery, it was obvious that a small chunk of muscle was removed.  Such a small injury to a muscle, which healed afterwards, would not compromise function of the entire muscle unless it caused weakness leading to a muscle tear that more broadly impacts function. 

[flatness13]

Based on history and the findings at the time of surgery, it was obvious that a small chunk of muscle was removed.  Such a small injury to a muscle, which healed afterwards, would not compromise function of the entire muscle unless it caused weakness leading to a muscle tear that more broadly impacts function.

Removed? How do you think this could be possible, was it 'sucked out' during the lipo because the settings of the machine were too high? It sounds crazy to me, but the link I posted earlier in the thread is of a person who claims that a lot of his muscles were taken out in his botched surgery in that manner, which I am doubtful of.

[flatness13]

I have been looking into some options to fix the muscle loss.
-Implants. I'll be honest this is never gonna happen.
-Fat flaps/fat transfer. But is this gonna make it look worse since it's soft tissue on top of no muscle?
-synthol. Sounds dangerous to me but I'm just exploring everything here.

Any thoughts?

[Miguel Delgado MD]

This is a very unusual result after gynecomastia surgery. All of the surgery is performed above the muscle. Liposuction is often used as well and this is performed in the soft tissue as well. Liposuction canals can penetrate area but a well trained PS this would be rare.

[DrPensler]

To be clear correction of gynecomastia in experienced hands is safe and effective. The nerve to the pectoralis major muscle.The pectoralis major receives dual motor innervation by the medial pectoral nerve and the lateral pectoral nerve, also known as the lateral anterior thoracic nerve. One route of innervation of the pectoralis major originates in the C7, C8 and T1 nerve roots which merge out to form the lower trunk of the brachial plexus. The fibers continue in the anterior division of the lower trunk, become the medial cord, and exit the medial cord as the medial pectoral nerve.The nerve supply in under the muscle essentially. To damage the motor supply would require somehow placement of a cannula or some instrument below the muscle during surgery which should not occur. The only other way to damage the nerve would be to place an instrument in the neck or very high in the axilla which just does not make sense for the procedure.