Need your advice friends, What's your take on my case?

[Ali19]

Hi guys, haven't posted in awhile but I'm getting my 2nd surgery soon and need your guy's input.

I've had gyne since puberty (when I was 11 years old, I remember my chest hurting for weeks and going to the doctor).

I had my first surgery in 2012, consisted of only excision, unfortunately this is the only photo I can pull up from before the surgery, I definitely had hard lumps in both breasts.



My surgery went well and these were my photos 3 days after the surgery.





I was very pleased as the results looked great, however 5 weeks post when the healing process was almost over my nipples were once against puffy, as you can in the picture below (I understand some of you may say hey that looks pretty good and not puffy at all) but yes they were pretty bad, of course major improvement from what they were before the surgery but I still wasn't happy as the chest was still puffy and still would be stared at in the public.

5 weeks post op without nipples erect.



6 weeks post Op with nipples erect



See the difference? I would be so happy if my nipples always looked like the latter picture, but as soon as the erect nipples faded I was back to puffy nipples, I went back to the doctor but he said
I'm still healing and to wait it out at least 6-12 months and see where we're at as the scar tissue post-op will fade away by then and my nipples should be back to normal.

So I waited 6-8 months, here are my pictures from that time frame post op.





Things were back to step 1 at this point, I'm exaggerating a little as before the surgery every shirt I wore my nipples would stick out, and my chest was rock hard as their was a lump, after post op the right shirts and undershirts do hide my puffiness to a degree and the hard lumps on both chests are no longer there.

I went back to the doctor, he had a look at my chests, and he said he can feel absolutely no lumps under my breast as both my breasts were super soft if that's the best way to put it, but obviously you could still feel the puffy nipples.

He recommended I lose weight and things should improve, I was a little overweight at the time, so I took his advice and did my job, even though one of the doctors from this site who I also showed these pictures to mentioned weight loss will not fix this and surgery would need to be done, but I still followed my own doctor's advice on the weight loss as it could only do good and we'll take things from there.

Now 3 years later (I know I should of committed to the weight loss earlier but hey I finally did it), my nipples are worse than they've ever been post op and this is with my weight loss.







It may look like in the pictures I haven't lost all that much weight, but I have, I'm sitting at 150 pounds right now at 5'9, the doctor checked my BMI which is also normal.

I went back to my doctor and we're in works on doing a 2nd surgery, I still have no hard lumps under my breast, all the scar tissue is gone, he realized that I'm sitting at the right weight, but he is hesitant on doing the 2nd surgery, he say he's done many gyno cases and I'm the first one he's going to be performing it on for the 2nd time, he says he's planning on taking a little bit more out and planning on doing both lipo and excision this time.

He is also is not guaranteeing perfect results for me and says I may be one of those guys whose breasts may never look perfect no matter how much work gets done on it.

FYI guys - when my nipples are erect (out of the shower, or cold climate) they do look pretty good and the puffiness is not there, but of course that's only 10% of the time in a day or two's span.

[Dr. Elliot Jacobs]

It appears that you still have residual tissue on your chest, albeit much better than your original pre-op condition.

This may be tissue that was not initially removed or it may be scar tissue or a combination of both.  Bottom line -- you should be able to get a better result -- but be aware, secondary surgery is always more difficult and less predictable.

Speak to your surgeon about realistic expectations for additional surgery.

Dr Jacobs

[Ali19]

Thanks for the reply doctor.
I forgot to mention I did smoke marijuana about 2-3 months after my surgery, the pictures you see 5-6 weeks post op, I did not smoke weed during that time.
Do you think smoking weed 2-3 months after the surgery hurt the final results? Of course as you can see my nipple were puffy 5 weeks post op when I didn't smoke weed and to this day the chest still looks the same, do you think if I didn't smoke it after the 2-3 months I would of healed better or would the puffiness not be there? How much affect did it have on the final results?

[Dr. Elliot Jacobs]

My gut feeling is that smoking weed would not have had the effect that you are seeing.

Dr Jacobs

[Ali19]

My gut feeling is that smoking weed would not have had the effect that you are seeing.

Dr Jacobs

Why do the 99% of doctors say to stop smoking weed after Gyne surgery than?

[Dr. Elliot Jacobs]

It's all a matter of degree.  Understand, patients like to push the limit -- therefore doctors draw red lines in the sand.  Obviously, 1 or 2 joints a week is not going to affect anything.  Three to four a day might have some effect.  Bottom line is that we doctors really don't know either way because there has been no scientific research done on this because it has been totally illegal for so long.

Perhaps in the near future, better scientific data will be available and we will be able to answer your question more definitively.

Until then, just be smart!  Less is better.

Dr Jacobs

[Ali19]

Appreciate the advice doc.

I don't want to keep pushing questions at you but I'd keep moving back and forth until I do, do you think I need excision along with Lipo?

What frustrates me is why didn't my doctor do lipo in my first surgery? now with my 2nd surgery he clearly stated he'll be doing both excision and lipo, it really is mind boggling.

[Ali19]

You gave some good advice doctor and I appreciate that, but what's up with you ignoring me now?