DO I NEED A REVISION???? NEED OPINIONS

[WANTGYNEGONE]

Hello everyone, I am 5'10'' and 160lbs and have had gynecomastia since puberty and weight loss nor working out ever got rid of my gyne. When I went for my consultation, the surgeon siad that my case was medium. It was not bad and wasn't good. He showed me a computer generated image of what my chest should look like after surgery, which looked completely flat. I had my gynecomastia surgery on April 2, 2009. The surgeon performed gland excision and liposuction in both breasts. A total of 1100cc of tumescent solution were infiltrated and 450cc of adipose tissue were aspirated and 200cc of glandular tissue was cut. It has now been 3 1/2 months since my surgery and in my opinion, the only thing that looks different is my nipples are no longer puffy and my breasts are not as pointy, due to the glandular tissue being removed. But there seems to be no difference in the amount of fat or breast tissue that makes up the whole breast. It almost seems as if no liposuction was done because it looks and feels the same as before the surgery. Will my chest actually fet flatter. I will post pics in next post.

[DrBermant]

Hello everyone, I am 5'10'' and 160lbs and have had gynecomastia since puberty and weight loss nor working out ever got rid of my gyne. When I went for my consultation, the surgeon siad that my case was medium. It was not bad and wasn't good. He showed me a computer generated image of what my chest should look like after surgery, which looked completely flat. I had my gynecomastia surgery on April 2, 2009. The surgeon performed gland excision and liposuction in both breasts. A total of 1100cc of tumescent solution were infiltrated and 450cc of adipose tissue were aspirated and 200cc of glandular tissue was cut. It has now been 3 1/2 months since my surgery and in my opinion, the only thing that looks different is my nipples are no longer puffy and my breasts are not as pointy, due to the glandular tissue being removed. But there seems to be no difference in the amount of fat or breast tissue that makes up the whole breast. It almost seems as if no liposuction was done because it looks and feels the same as before the surgery. Will my chest actually fet flatter. I will post pics in next post.

How tissues evolve after surgery depend on many factors.  Options for Revision Gynecomastia Surgery depend on what was the original problem, what was done, how the patient healed, and many other factors best explored during a consultation where the details can be better explored.  I evolved Standard After Gynecomastia Surgery Pictures for those patients who prefer to start with our Preliminary Remote Discussion to minimize travel. 

Hope this helps,

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

[Dr. Elliot Jacobs]

At 3 1/2 months, you should be starting to see the final results, although there may still be some very firm areas.  I would recommend waiting for virtually complete healing, which usually is at about six months, and then doing an assessment of the results.  One good way to assess completeness of removal is to do a pinch test.  This is a pinch of skin and underlying fat.  Start at the collarbone and work downwards to the fold beneath the breasts.  The pinch should be thin and uniform in thickness.  If there are areas of thicker pinch, then removal of tissue may not have been complete.

An honest and candid discussion with your surgeon should then be held.

Would recommend you post some pre and post op photos.

Dr Jacobs

[WANTGYNEGONE]

Pre-Op right side and 3 1/2 months Post-Op Right Side and Left Side Pre-Op and Left Side 3 1/2 months Post-Op

[WANTGYNEGONE]

This is the extra tissue or fat that I have left at 3 1/2 months. The surgeon says it is extra skin but it feels like tissue or fat to me. He also says that he thinks it looks great and my skin will tighten over the next 9 months and he says there is still some swelling. I need some opinions. Do you think I need a revision and when should I ask the doc for one? Or do you think my chest will tighten up over time?

[WANTGYNEGONE]

Thanks for your opinion. I hinted to the doc the last time I was there that I was a little surprised at how much fat was left and his reply was, "Are you kidding me? Have you looked in the mirror lately?! You look great!"    I will wait until 6 months and then tell him that I am not happy with the results, that is if my chest don't get any better. I have been working out every other day so hopefully that will help. Can any of the doctors give me their opinion about what I should do about my situation please? How should I approach my doc when he insists things will get better? How long should I wait before I know that my chest is not going to get any flatter? When should I mention to him that I want a revision?

[Curiousone89]

I've seen the pictures, and honestly, I'm sorry to say (I really am, usually I'm super optimistic on these forums) that not much has changed at all. As one of the previous doctors have stated clearly - 3.5 months is enough to see what the final results look like. Did it look like that during your first week also?

I would seriously reccomend going back to the doctor, and he gives you the whole "It looks great." Tell him you seen another PS (A little white lie ;p) that it really does not look like what you showed me on the computer.

HOWEVER [BIG However here]

How much activity have you been doing after the surgery, I understand that if you gain weight it shouldn't go back to whatever after the surgery blah blah, but I'm really anxious to know. If they seem like they got bigger by swell and not fat, then I may be wrong.

Start working out rigorously, like right now, keep taking it up another level -- Wear a stage two garment if you have to, get some pecs on you, look good, if gyne is still on you, then seriously go back and see him.

[moobydo]

Your post-op pictures do look better than before, but I guess the question is, always, is this good enough?

How long did you wear a compression vest after surgery? Also, when did you resume upper body exercise? 

Please do keep us informed about your progress and decision on revision surgery.  I am exactly 3 weeks post-op and the change from pre-op conditions is not as much as I'd have liked, so naturally I'm asking the same questions: how much of what is left is just swelling that will eventually reduce, how much is tissue that was never taken out, how much is loose skin, etc.  I guess that there are a few others who are asking the same questions.

Good luck!

[WANTGYNEGONE]

Thanks for your response moobydo. I wore my compression vest for 4 weeks 24 hours a day except for when i showered. I am now 4 months post op and i still wear it to bed. I started doing light cardio 1 week post op and I started light weight training about 1 month post op. I am currently running 3 miles per day and weight training every other day. I saw my regular general medicine doctor today and he told me he thinks that there is only about 15 to 20% fat remaining, if that. He did a few tests and had me flex my chest muscles and pointed out that whatever is left is a mixture of muscle, pec, and skin with a very thin layer of fat which he said I needed. He told me in his opinion he thought getting a revision was not necessary and would be a waist of time because most of what is left is not fat. In his eyes I look normal. Hopefully as time goes by and i hit the weights things will begin to tighten up and look better.

[WANTGYNEGONE]

The doctor that I went to who gave me his opinion on the matter was NOT the surgeon who did the surgery. It was a completely different doctor from a different hospital so he has nothing to gain from giving me a line of bs. It was just his professional opinion. I will wait and see how the weight training goes and if my chest does not get better then I will go for the revision. I am only at 4 months post-op. I have time yet.

[WANTGYNEGONE]

Can any Doctors out there please give me your opinion.