Author Topic: Slight pain and discomfort 2 years post-op  (Read 3312 times)

Offline godspeed

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Well im 2 years post-op and till this day im having minor pain and discomfort in my left breast.  That breast also has a huge indentaion due to the Dr. being way to aggresive with the lipo and or gland removal.  My question is what would cause this slight pain and discomfort this far out?

Iv also wondered for the longest time that why do indentations happen so often.  For example when a bodybuilder gets down to such a low body fat he has basically no fat in his chest.  So if a Dr removes all the fat and gland why are some left with this indentation?  What type of options do i have in repairing this and is this pain and discomfort permanent?

DrBermant

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Well im 2 years post-op and till this day im having minor pain and discomfort in my left breast.  That breast also has a huge indentaion due to the Dr. being way to aggresive with the lipo and or gland removal.  My question is what would cause this slight pain and discomfort this far out?

Iv also wondered for the longest time that why do indentations happen so often.  For example when a bodybuilder gets down to such a low body fat he has basically no fat in his chest.  So if a Dr removes all the fat and gland why are some left with this indentation?  What type of options do i have in repairing this and is this pain and discomfort permanent?

Standard Revision Gynecomastia Surgery Pictures or even better yet, Standard After Gynecomastia Surgery Movies are excellent ways to demonstrate your concerns to others. They are especially revealing for Crater Deformity Defects from bad gynecomastia surgery.

The normal male chest has some fat between the skin and coverings of the muscle as seen in this Anatomy of Gynecomastia.  When all tissue is removed, the surrounding natural layer of fat then becomes an elevation. Plastic Surgery cannot reduce the global body fat around the entire body.  However, I have seen crater deformity defects that have improved with massive reduction of general body fat as in bodybuilders. In this situation, the crater wall of fat thins and becomes less noticeable when at rest. Unfortunately, the skin is still usually stuck to the muscle and it does not move well at all. It is usually this adhesion that shows up as a deformity.  That is why the movies or photos of arms up or flexing muscles are so revealing of this problem and the success, partial success, or failure of a particular technique.

Surgery can injure nerves. Some surgery so aggressive to remove all the fat can also severely permanent injure the nerves. Nerves can also be stuck to scarred tissues. Both injured and entrapped nerves can result in discomfort, especially on animation or stimulation.  A less common cause of discomfort that I have seen is gland recurrence. Gland growing from stimulation can become uncomfortable.  That can often be managed by stabilizing the problem.

It is interesting to speculate why such injuries happen. I have seen many such crater deformities from around the world and trying to understand what led that surgeon to that result boggles the mind. Some of the deformities I have been able to reconstruct with an extended version of my Fat Flap Technique. However, options are limited by local available resources. Some have been so extensively damaged, that I know of no reasonable reconstructive option. I am currently updating my site to show some of the many successful crater defect reconstructions I have achieved.

It would be awesome if filling operations like dermal fillers or fat grafting would work for such defects. Dermal fillers do not feel like fat, but firm like gland of gynecomastia and do not move like fat. Grafts unlike flaps do not bring their own blood supply and depend on tissue they are transferred into for survival. When fat is transferred into muscle, there is a better chance to get a blood supply. When it is transferred into scar, less blood vessels attach, more of the fat dies becomes firm and looks weird on animation. Although I have seen several unhappy patients who had other doctors try such grafting, I have yet to see one that has moved naturally. I also have not yet seen a happy patient with good before after reconstruction documentation such as animation. Filling a depression with firm material that does not move well can look great for a journal article or website, but how it moves when playing basketball or swimming is what counts. 

My advice is to carefully investigate real results in motion before agreeing to any such attempt.

Hope this helps,

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


 

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