NEOPAC

[moomoon]

hey guys
my first post! am wondering if anybody has seen this new treatment? neopac? in the trial stage right now. just says for women! do you think it might work 'filling-in' concavities for us poor souls who've had bad ops? had my op (on one side) over five years ago and have been thinking about saving up for more surgery. . .  think my concavity is so deep and creased that there is not much point though, not much any surgeon could do, etc. . . this neopac stuff sounds promising though. http://www.nydailynews.com/lifestyle/health/2009/11/13/2009-11-13_new_breastgrowing_technique_neopac_may_offer_alternative_to_implants.html. still v early. might be years and years away. maybe other non-invasive methods like this are being developed for female reconstructions . . . seems like a possible solution, though (really don't want to go under again considering my first.) so, neopac. any other guys who got concavity seen this? thoughts please.
best all

[Paa_Paw]

I don't think that I would call the surgical implantation of a devise along with the transplantation of tissue and microsurgery to connect a blood supply Non-invasive. It sounds like a rather involved procedure to me.

The initial premise would seem workable in a large way, as to replace a breast lost to cancer etc. In the case of filling in the concave deformity left by a botched male breast reduction it seems a bit like overdoing things.

The caveat to chose one's surgeon with great care initially would seem to be the wiser choice.

[DrBermant]

hey guys
my first post! am wondering if anybody has seen this new treatment? neopac? in the trial stage right now. just says for women! do you think it might work 'filling-in' concavities for us poor souls who've had bad ops? had my op (on one side) over five years ago and have been thinking about saving up for more surgery. . .  think my concavity is so deep and creased that there is not much point though, not much any surgeon could do, etc. . . this neopac stuff sounds promising though. http://www.nydailynews.com/lifestyle/health/2009/11/13/2009-11-13_new_breastgrowing_technique_neopac_may_offer_alternative_to_implants.html. still v early. might be years and years away. maybe other non-invasive methods like this are being developed for female reconstructions . . . seems like a possible solution, though (really don't want to go under again considering my first.) so, neopac. any other guys who got concavity seen this? thoughts please.
best all

Vascularized fat transfers by microvascular surgery is not new, we were performing such breast reconstructions 25 years ago. One of my mentors, Bill Shaw pioneered the techniques.  The problem is where the fat comes from, the donor site.  Places on the body where fat can be harvested with an attached blood supply for a female breast are the buttocks and the layer of fat in the belly omentum. The scars and defects for a female breast are such that the donor site deformity would be worse than the Crater Deformity on the chest. While the amount of fat needed for a male crater would be less, the buttocks muscle needed to support the flap would make a terrible bulge. For the belly, the injury inside the abdomen carries its own complications. When remote donor site of vascularized fat become available, perhaps with tissue engineering, this would be an ideal tool. We were dreaming of it back then. Nothing has evolved yet to give us such a resource. For now I have my Vascularized Fat Flaps which will work for a subset of the population that have not had their local resources destroyed by over aggressive removal.


Fat grafts need to get a new blood supply. Some of the fat graft dies in the transfer process which makes the remaining fat firm and dense like gland. I have yet to see a decent documentation of a successful crater deformity managed this way on a male chest. By decent documentation I mean, exam of actual patient, movies of motion, or at least pictures showing pectoral muscles flexed and arms over head. Filling with something firm that looks OK at rest is fine for a hype website advertisement or a paper in a journal. But that does not make a chest look good in a swimming pool, playing basketball or volleyball shirtless!

Dreamers and hope spring eternally. Someday such options may happen. I saw a demonstration of future potential technology of turning back on  cells to regrow and tissue frameworks made in the lab (but these were not vascularized).  25 years later, we are still not there yet.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

[Paa_Paw]

Thanks to Dr. Bermant for a very enlightening response.

While I have compassion for those who have had surgeries that left them with deformities such as mentioned here, I believe our efforts should be directed at informing people prior to surgery. These deformities can be prevented simply by using great care in selection of your surgeon.

Out of desperation and often influenced by price, some men submit themselves to the care of surgeons who are not properly qualified.

This is not an area where it is wise to scrimp on price or be lazy about checking the qualifications of the Dr..

[DrBermant]

Thanks to Dr. Bermant for a very enlightening response.

While I have compassion for those who have had surgeries that left them with deformities such as mentioned here, I believe our efforts should be directed at informing people prior to surgery. These deformities can be prevented simply by using great care in selection of your surgeon.

Out of desperation and often influenced by price, some men submit themselves to the care of surgeons who are not properly qualified.

This is not an area where it is wise to scrimp on price or be lazy about checking the qualifications of the Dr..

Paa Paw, you are right on target. Prevention is so much better than needing revision surgery! Asking a surgeon you are considering if they have ever had a crater deformity is reasonable. I have yet to make my own other than for cancer excisions to date.

Dreaming of better reconstructions methods is the playground of the creative mind. That is what made the scifi short story by Kornbluth "The Little Black Bag" one of my early inspirations back in 1970. Robert Silverberg (Ed)'s "The Science Fiction Hall of Fame: Volume One, 1929-1964" (1970, anthology). Hunting for better and easier to use medical technology that artists could then build upon and expand what medicine could offer has been my passion from the start.  However, the story also carries the warning that when the unskilled try to take on such magic, disasters occur if the magic is not what it is hyped up to do.  I often wonder what would Da Vinci be able to go to starting from today's technology!

Bringing us back to Paw Paw's point, just because you admire a Da Vinci painting in a museum, does not mean you can just go off to a local artist and get one painted.  Verify through many examples what a specific surgical sculpture achieves.

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery