Getting surgery with an inexperienced surgeon

[DrBermant]

Well. My surgery is done. Just a couple hours post op right now. Not feeling much pain. She put in plugs. I'm going to go pick up my compression vest tomorrow.

One thing I'm scared about. My nipples seem to be collapsed/creased right now. Is this a normal occurrence right after surgery or is this rare?

I know it's way way way too soon to be worried, but I guess, since I got an inexperienced surgeon when it comes to gynecomastia, I'm quick to judge.

A crease is a fold of tissue surface tissue and is avoided during draping the skin during the sculpture. I prefer to finish my sculpture in the operating room such that it looks like what you see on my website. Creases should be minimized as part of the surgical plan or something discussed due to excessive skin issues such as tubular breast or major size reduction. Although tissues do evolve after surgery, just how much is not predictable. That is why it is better to have such issues addressed as part of the plan of surgical sculpture. You can see the types of minimal creasing I accept on the male mastopexy and tubular breast pages when my sculpture must deal with major amounts of excess skin.

Here is an example not on my site I posted here:

https://www.gynecomastia.org/smf/index.php?topic=8776.0

That minimal surface creasing is within the limitations of the best surgical technique I have been able to evolve.

Yet, the body does compensate over time. Major contour issues do change. However, that is the power of seeing what any doctor's methods are like and how their patients' tissue evolve after surgery.

Yep. It's just weird to see my nipple completely buried. I'm hopping the swelling goes down on the outer part and maybe that will fix it.

I always put my patients compression garments on at the time of surgery. Swelling is best prevented. Reduction of swelling afterwards is nowhere as effective. Each patient is also fitted for their garment before surgery, much less traumatic for the fitting and better as part of the basic education of each patient.

Good luck on your healing.

Hope this helps,

Michael Bermant, M.D.

for some reason, my compression garment wasn't ready, so I have to go without a compression garment for a day and a half.

Do you think, from my pictures, there's caving or is it just swelling?

Thanks for your imput as always, dr.

Sorry, different doctors have different methods and priorities. For elective surgery I prefer to have all of my "ducks in a row" and do not proceed without what I consider to be an essential component. That is why we fit, teach, and have the garment set aside the day before surgery. I could never achieve the results shown on my site if a compression garment is started well after surgery. Trauma surgery has different priorities and compromises are essential for life / limb saving measures.

The contour is just not nice, and can have many contributing components. If a doctor has such contours as part of how their tissues evolve, they should, in my opinion, help educate their patients about what tissues should look like and the chances of what the final contour will evolve. If this is normal for a doctor's methods but the tissues then compensate, it would be nice to have a series of pictures to demonstrate that so patients do not need to deal with the anxiety you now are expressing.

I have no clue what that will look like over time. Prevention is so much better than having to guess and stress out over unknown factors.

Hope this helps,

Michael Bermant, M.D.

[Pooz]

thanks. Guess I'll just have to wait for the swelling to go down.
Pretty frustrating that my compression garment wasn't ready..

[chopper]

I hope all is good in the end mate because it certainly looks like someone with no gynecomastia experience has operated on you from my untrained eye. I hope you can take your top off in your 1.5 yrs abroad

Good luck

[Pooz]

Honestly, my chest looks great now, just the nipples are all swollen/jacked up.

[kwl04]

I had very slight creasing at one point and it went away. 

[Pooz]

I had very slight creasing at one point and it went away. 

I'm not even sure if it's creasing. She said it's just swelling. The bottom half isn't swollen, while the top half is very swollen and that's why it looks jacked up.

I think my nipples will look a lot better once the swelling goes down.

[looseSHIRT]

Hope everything goes well mate!

[Pooz]

I'll be sure to keep you guys updated.

[morpheus11]

You just had surgery, so I wouldn't expect the final results until several months down the road.  Either way, you had your surgery done for free.  It doesn't look bad. The nipples look a bit swollen, but I'm sure that will go down.  In any case, it was free, and you don't have to worry about doubling up on shirts or being ashamed of your chest.

Congrats!

[Teenaged]

Thanks for telling us about your experience.  If you could keep posting pictures throughout the healing process that would be awesome. 

[thetodd]

Its worrying that you haven't been given a compression vest, its honestly the first time Ive ever seen it on this site!

They should of wrapped you up in bandages really at the very least, i hope it heals well. But honestly i would be complaining to the hospital its plain negligence

[Pooz]

Its worrying that you haven't been given a compression vest, its honestly the first time Ive ever seen it on this site!

They should of wrapped you up in bandages really at the very least, i hope it heals well. But honestly i would be complaining to the hospital its plain negligence

I got a compression vest a day and a half after the surgery. I'm wearing it now in fact. It's really f'n uncomfortable.

[Pooz]

Thanks for telling us about your experience.  If you could keep posting pictures throughout the healing process that would be awesome.  

No problem.

I'll be sure to post some updated photos soon.

here's a quick update. I suppose I got the surgery at the wrong time, but if I didn't get it at that time, then i wouldn't have been able to at all. The day of the surgery and a day after, I had to move and do a lot of lifting(50-60 pounds at times). I was also not getting any sleep because I was moving and leaving to go home. I'm not sure how much this will have an effect.

Something interesting is, I haven't had take any pain killers at all. Not even tylenol.

Anyways, I just flew home yesterday and my surgeon told me(when I picked up my compression vest) that I can remove the drains myself, so I don't have to fly back out. She gave me the tools and instructions(I'm going to call again to verify how to). Hopefully everything goes well so I can remove the drains on monday.

The swelling in my nipples have gone down a lot and they're starting to look more normal. I still have the tape on. I'm not sure If I'm allowed to remove it.

My chest looks great, btw.

I'm hoping after 2 weeks, I can go running and maybe play some sports. If not, that will be fine. That's a question I'll ask my surgeon when I call on thursday.

Overall, she's been very nice and enthusiastic. Although she might've been inexperienced with gyne surgery, she really seems to know what she's talking about.

That was just a quick update 3 days post op. Sorry if that's to much typing, but I think some people will find it interesting getting the perspective from someone who had surgery from an inexperienced ps.

Edit: If people are wondering why I have so many questions for my ps, it's because I was in a hurry when I went to get my compression vest. She was incredibly helpful and enthusiastic. I just had to get my compression vest and leave right away.

[Pooz]

You just had surgery, so I wouldn't expect the final results until several months down the road.  Either way, you had your surgery done for free.  It doesn't look bad. The nipples look a bit swollen, but I'm sure that will go down.  In any case, it was free, and you don't have to worry about doubling up on shirts or being ashamed of your chest.

Congrats!

Great point! I already know I can finally wear any t shirt I want without having to worry about my nipples showing. My chest looks great. Nipples are looking a little better already.

And like you said. Completely free!

Hopefully I don't run into any complications, because I would have to fly out to be looked at.

[Pooz]

1 week post op.
Nipples looking better.