6 Years After Surgery. -- Questioning Outcome Quality

[Peregrine]

Hello Folks,

Six years ago, I underwent gynecomastia reduction surgery performed by an American Board of Plastic Surgery (ABPS) certified surgeon in the U.S. Midwest. I was sixteen at the time of the surgery, and, by that point, I had developed substantial breast which had a manifestly feminine shape. Even when wearing several layers of clothing (a come tactic, I now know), there was still clear and abnormal bulging in the area around my chest.

The surgery resulted with the removal of a significant amount glandular tissue, and, initially, I was very pleased with the outcome of the surgery. Though it was clear there was cratering and excess skin immediately after the surgery (which my surgeon acknowledged, but was not too concerned about), the large reduction in mass on chest considerably increases my body-image and self-confidence. I would post the photos taken before the operation, but I believe they are buried deep within a file cabinet somewhere in my mother's house.

Recent photos are shown below to illustrate the current state of my upper-body (I apologize for the absolutely terrible quality of the photos.) While the poorly shaped features of my chest do no show through most clothing, I remain very uncomfortable about taking my shirt off around even my family. However, for many years, I have been content to simply avoid shirtless activities. Now that I am in the process of coming out of a long-term relationship, though, I am becoming increasingly bothered by the misshapen nature of my chest.

My question to you is then: Based on your experiences, how would you recommend I proceed?

I realize I could consult the same surgeon for a revision, but I now live in a different region of the U.S., so this would present some logistical difficulties. Also, I would really like to get the opinions of other plastic surgeons on the outcome of the initial surgery. Of course, I also realize that additional surgical intervention could potentially just make things worse.

-P.S. Has anyone else had a similar issue with the shape of his chest several years after surgery? Before doing my research, I thought my results were typical, but, looking over some of the pre-op/post-op comparisons posted here, that does not appear to be the case whatsoever.

Thanks!

Images:

[McGilli]

Hi I just want to ask you something...

Are your nipples attached to your pec muscles?

Like if you do a push up - do they droop down, or are they still attached and the surrounding skin droops around it?

[Peregrine]

Hi McGilli,

The skin surrounding the areola clearly sags down when I am in the push-up position, making the crater even prominent. It's not clear whether this issue is due to excess skin or poor attachment of the skin to the underlying tissue.

As for the nipples themselves, it's hard to say. They do droop slightly, but not by much. Oddly enough, the nipple on the less deformed side (to the right in these pictures) sags more than the other, so if either are improperly attached to the underlying tissue, it's that one.

[UNIGYNO]

So u didn't go to a plastic surgeon? Also did u wear a compression vest? Or any kind of compression after surgery? ... U need a revision.. I hope u get it worked out bud

[Peregrine]

Hi UNIGYNO,

(1) My surgeon did, in fact, specialize in plastic surgery (ABPS => American Board of Plastic Surgery); I'll edit my initial post to make that clear.   

(2) I did wear a compression vest continuously for a few weeks after the surgery.

[UNIGYNO]

Where in the Midwest? Wha was doctors name?

[Peregrine]

The surgery was performed in Iowa, but I am not comfortable releasing the name of the surgeon.

At the time, the surgeon had over 20 years of experience, and he had previously performed male breast reduction surgeries. Since it's been over five years since I last talked to the surgeon, I am not sure what approach he would take now, so it wouldn't seem appropriate to post information that could be potentially harmful to his practice. 

[UNIGYNO]

Well I'm in the same area couessie message me maybe so I can see if I know the doctor? Is it in eastern Iowa? Quad city area or more in the middle like demoines? U should go see a doctor to see about getting that fixed I know if I was me I would def. find a way to get that taken care of life's short don't forget that

[Peregrine]

UNIGYNO,

I've PM'd you with more precise information about the location of the doctor; I'd prefer not to get more specific than that.

[xelnaga13]

I would not get revision with your original surgeon. At this point you need to see someone uber qualified in gyne and gyne revision surgery. If I found myself in your shoes I would be on the next flight to see Dr. Jacobs and at the very least get his input on how to proceed.

I would also encourage you to share the name of the doctor with anyone who pm's you to inquire.

[Dr. Elliot Jacobs]

You appear to be young and your photos do not show evidence that you have been very much overweight.  IF that is true, then your skin should have sufficient elasticity so that, with proper revision surgery, you would not need skin removal -- indeed the skin might tighten on its own.

You undoubtedly have  crater deformities.  These might be able to be treated with fat flaps from the surrounding areas.  There might also be some excess tissue in the surrounding areas as well, which could be suctioned a bit.

Overall, IMHO, you might benefit from revisional surgery.  Obviously, you should consult with an experienced gyne surgeon for a hands-on physical examination, for that is the best way to assess if anything can be done.

Good luck!

Dr Jacobs

[Peregrine]

Hi Dr. Jacobs,

Thank you for your response.

Though it's not clear due the poor quality of the initial pictures I posted, there may be some skin elasticity issues. I've attached higher quality close-up shots of each side of my chest. There was a period during middle school when I was fairly overweight, which I suspect is the cause of the stretch marks you can see here (I have them on other parts of my body as well). Also, I am 22 years old; I don't now why I didn't mention that explicitly in the original post.

I'll be relocating to the Silicon Valley area later this year for graduate school, and it looks like there are several experienced gyne surgeons within reasonable driving distance. Once I get established there, I'll make certain to consult one of those doctors.

[Dr. Elliot Jacobs]

Yes, the stretch marks show in these close up photos - and your prior overweight condition has probably affected your skin's elasticity.  Yet, you are still young so your skin should still retain some elasticity.  The craters can probably be fixed -- but you need a really experienced gyne surgeon for this.. Be careful and do your homework.

Dr Jacobs

[ladiesman69]

Maybe this is stupid and won't work... but have you ever considered working out and building some muscle? It seems like your pecs really aren't developed at all. I imagine if you built them up that would solve a lot of your problems.

[Dr. Elliot Jacobs]

Sorry, ladiesman69 -- no matter how much muscle is developed, it will absolutely not cure this problem.

Dr Jacobs