Author Topic: Which PS's care about chest-in-motion Post Surgery?  (Read 2060 times)

Offline Keep_It_Moving

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I'm wondering if some supporting doctors could chime in on this topic and describe how they best off-set crater deformities when the arms are raised, chest flexed, etc...I'm still learning about this whole Gynecomastia thing- please excuse my unawareness.

Thank you to those who respond....

Best!
K.I.M.

Edited: Changed post, I didn't communicate my question very well.

« Last Edit: February 24, 2014, 09:32:18 PM by Keep_It_Moving »

Offline DrPensler

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Every plastic surgeon cares about the appearance with and without motion.I think you have incorrectly characterized Dr. Delgago's feelings. The issue is standardized evaluation of the post operative result which can only occur when comparing similar pre and postoperative photos.

Let me tell you a quick story so you can view this in a less personal perspective.I performed a secondary rhinoplasty on a patient who three months after surgery said " I love the result when I look straight ahead in the mirror,however when I put lipstick on and have my lips contract to form something like a kiss it scrunches my nose and I hate the way things look." After a bit more discussion I explained I can make your nose the way you like it when you contract your lips however it will change the appearance when your face is at rest and you are looking straight in the mirror.I then asked her which of the two she would prefer,she answered both .I replied you cannot have both I can only fix it one way in the operating room.

Back to you, we optimize the appearance at rest because there are different distortions of the soft tissue with various muscle contractions. Some if not most of these distortion are present before surgery.Other "distortions" occur in every surgery case and maximize at about one month after surgery,then slowly resolve with time.The time course of the resolution is highly variable from weeks to over a year.
« Last Edit: September 19, 2013, 12:51:45 PM by DrPensler »
Jay M. Pensler,M.D.
680 North Lake Shore Drive
suite 1125
Chicago,Illinois 60611
(312) 642-7777
http://www.gynecomastiachicago.com

Offline Keep_It_Moving

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Every plastic surgeon cares about the appearance with and without motion.I think you have incorrectly characterized Dr. Delgago's feelings. The issue is standardized evaluation of the post operative result which can only occur when comparing similar pre and postoperative photos.

Let me tell you a quick story so you can view this in a less personal perspective.I performed a secondary rhinoplasty on a patient who three months after surgery said " I love the result when I look straight ahead in the mirror,however when I put lipstick on and have my lips contract to form something like a kiss it scrunches my nose and I hate the way things look." After a bit more discussion I explained I can make your nose the way you like it when you contract your lips however it will change the appearance when your face is at rest and you are looking straight in the mirror.I then asked her which of the two she would prefer,she answered both .I replied you cannot have both I can only fix it one way in the operating room.

Back to you, we optimize the appearance at rest because there are different distortions of the soft tissue with various muscle contractions. Some it not most of these distortion are present before surgery.Other "distortions" occur in every surgery case and maximize at about one month after surgery,then slowly resolve with time.The time course of the resolution is highly variable from weeks to over a year.

Dr. Pensler,

Thank you for your response, I have a better understanding now. My apologies if this came across harmful in anyway, this has never been my intention nor will it ever.

Edited: Due to negligence on my part.
« Last Edit: September 23, 2013, 11:04:57 PM by Keep_It_Moving »

Offline Litlriki

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Dr. Pensler has given the best explanation of that issue that I've ever read. Bravo!

RS
Dr. Silverman, M.D.
Cosmetic and Reconstructive Plastic Surgery
29 Crafts Street
Suite 370
Newton, MA 02458
617-965-9500
800-785-7860
www.ricksilverman.com
www.gynecomastia-boston.com
rick@ricksilverman.com

Certified by the American Board of Plastic Surgery

Offline Keep_It_Moving

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Dr. Pensler has given the best explanation of that issue that I've ever read. Bravo!

RS


I agree, it is a great explanation.
Thank you both for responding.


 

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