You hear it all the time on this board, but it's absolutely true!! Do your home work and take your time in choosing your surgeon. There are lots of great options out there - but look for someone who specializes in this.
Long story, short(er)
I had pretty severe gyne since a teenager - at least a B cup. I just got by layering, wearing tight t-shirts and never took my shirt off in public. At 40 I just got tired of it and decided to do something.
I did some cursory research and went for a consult with a well regarded PS. He felt confident he could get it resolved, but when I asked him about how many of these he did a year, he dismissively said 'too many to count.' I knew several people who had seen him, but they were all women getting breast implants, lifts, mommy makeovers, etc. I didn't seek a PS who specialized in this.
The surgery seemed to go well. Standard excision, drains, vest for a few weeks, etc. I had tried to set very realistic expectations, especially in the initial recovery - but I immediately had concerns with how much mass was still there...especially on one side. The surgeon felt that everything looked 'fantastic' and I was right on track.
I tried to put it out of my head for a few months. But after 6 months, my initial concerns were still there. Don't get me wrong, it is MUCH better than it was before. When I'm in a 'glass half full' mood, I can pull out my before pics and feel better.
But there is still a lot of mass there, especially on the lower half under the nipple. Enough that it's on my mind as much as the original gyne...even though it's not nearly as prominent.
Before my 6 month follow up, I got a consult with another PS who specializes in gynecomastia procedures. The patient coordinator gave me a short 2 page paper this doctor wrote about the procedure and my heart just sunk. He talked about utilizing a procedure that combines lipo and excision and going through the armpit. The result being no drains and a much cleaner result.
The examination confirmed my fears. There was still a significant amount of tissue. I believe Dr. Jacobs mentions the 'pinch' test and there is still a good 2 inch pinch. He was very balanced in his approach. There are always risks to a revision, including my skin not being elastic enough to tighten up, leaving some drooping.
And I also needed to consider there was notable improvement and was it worth the additional risk.
The patient coordinator met with afterward to share the estimate. It was the EXACT amount I paid for the original procedure. I wanted to throw up. I am convinced my results would have been totally different if I went to this doctor first.
So later this week I have the follow up with the original surgeon. I'm going to wait and see what his evaluation is. I'd almost feel better if he at least acknowledged that there is a significant amount of tissue left and opened the door to a revision. But I have a feeling he's going to say 'things are great' and send me on my way.
If he does, I'll politely express my concern about the results and inquire about a revision.
But at this point, I'd be torn to do it. I would imagine a revision surgery from the original doctor would be significantly less. But if it's something that I have to push for, I wonder if the results are going to be any better than what I have now.
Like a lot of people, this took me awhile to save for. The idea of turning around and spending the same amount would be hard to stomach. But at this point, I want to finish the job.
If you are considering this surgery, be extremely picky about who does it. Find someone who specializes in it and ask all the questions you have. There are a lot of board certified PS surgeons out there, but that doesn't necessarily make them an expert with this type of procedure. For most people you have one shot to get it right...make sure you use it wisely.