Uhh oh... I think the surgeon took off too much.

[revolver]

I had Unilateral gynecomastia and went in for surgery (incision and ultrasonic liposuction) 3 days ago. Yesterday was my 2-day post op where we removed bandages and to my surprise... it doesn't look right at all! Will it get better as time goes on? Is my left chest supposed to be this flat compared to my right?

I can't stand how it looks right now! I went in because I had gynecomastia glandular tissue on the left chest and after getting it removed.... the plastic surgeon made it look like I have gynecomastia on my right chest now!

Of course, I don't want any glandular tissue. But if you look at my right chest, the pectoral muscles look much larger than on the left chest where I got the procedure done. Will this be fixed over time? Or am I really screwed?

http://img175.imageshack.us/gal.php?g=dsci0004h.jpg

[revolver]

http://img175.imageshack.us/i/dsci0004h.jpg/
http://img97.imageshack.us/i/dsci0007qx.jpg/
http://img441.imageshack.us/i/dsci0005m.jpg/

^^Those are photos of it now: Here's a photo of how my chest was pre-op: http://img576.imageshack.us/img576/2758/dsci0002.jpg



What should I do??

[balalayka]

You are right, this seems a bit unbalanced. I don't think what's making the other side big is your pectoral muscle, it's probably a bit of excess fat. After everything completely heals you might want to start considering your options. I think  a bit of lipo to the other side will fix it.

[revolver]

The surgeon should know better than to do liposuction though if it would have taken off that much. The last thing I want to do is spend more money to get this problem fixed....

[mrmandudehat]

no dude, you shouldnt have to worry about the cost.  since it's the surgeon's fault, he will HAVE  to fix it for free.  or you can just start working out.  the problem will fix itself in a couple of weeks.    The left will become larger from your pectoral muscle getting bigger, while the right will reduce in size from loss of fat.

[revolver]

It's only 3-days post-op, so it's hard for me to judge what I should do.

Do you think it will get better within the next few weeks? If not, what should I do?

[balalayka]

mrmandudehat, revolver is already quite lean. I don't think he can lose much more fat. The problem with working out is that the muscles are going to push the fat further away on one side and the other side will just have muscle, so the asymmetry will remain.
It is the doctor's responsibility of course to fix this problem. I say you hold off and wait for the final results and then decide what to do.
All what people say here are just opinions out of experience. We need a doctor here to tell us what can be done.

[revolver]

Does anyone think that this problem will go away with healing?? I can't believe I would have to go under the knife again......

[mrmandudehat]

definitely dont start working out right now, lol

[Dr. Elliot Jacobs]

First of all, it is only a few days after surgery -- there are months of healing to go.

Your situation represents what I have discussed and warned against many times -- that often what appears as only one sided gyne is really gyne on BOTH sides, with one side worse than the other.  During the physical exam, I often check that out and explain to patients that is it extremely difficult to reduce the larger side and make it look identical to the other side.  In fact, as your case illustrates, oftentimes the operated side now looks better than the unoperated side.

Sometimes I have patients who want to save some money and want to do one side only.  If I examine them and find gyne on the other side, I will refuse to operate on them because I know they will be unhappy -- and will then require another operation to fix the "good side." And then they will be angry at me when in fact I had warned them of just this possibility.   This is additional expense that they may have avoided if both sides were corrected to be optimal at the first operation.

My gut feeling is that you may indeed eventually need to have additional surgery on the right side to make your chest symmetric -- I doubt that what you have on the right side is 100% muscle.

Dr Jacobs

[revolver]

Thank you very much Dr. Jacobs. Do you recommend that I go back now and get the other side fixed, so I only have to deal with one healing time? Or should I wait out and see the results, but have to go through the trouble of having surgery over again?

[revolver]

Also, my doctor never warned me of Gynecomastia being on both sides. He even told me that the other side of my chest was completely flat and there was nothing for him to take off. Will I have to foot the bill for this fix, or should he fix it?

[Dr. Elliot Jacobs]

Difficult question -- my guess is that you should have a heart to heart discussion with your surgeon.  He will probably want to wait a number of months to allow for complete healing and then discuss it again.  This is an ethical problem and honestly, I do not have an answer for you.

Dr Jacobs

[revolver]

Thank you very much Dr. Jacobs. You've helped lift some weight off my shoulders.

[DrBermant]

I had Unilateral gynecomastia and went in for surgery (incision and ultrasonic liposuction) 3 days ago. Yesterday was my 2-day post op where we removed bandages and to my surprise... it doesn't look right at all! Will it get better as time goes on? Is my left chest supposed to be this flat compared to my right?

I can't stand how it looks right now! I went in because I had gynecomastia glandular tissue on the left chest and after getting it removed.... the plastic surgeon made it look like I have gynecomastia on my right chest now!

Of course, I don't want any glandular tissue. But if you look at my right chest, the pectoral muscles look much larger than on the left chest where I got the procedure done. Will this be fixed over time? Or am I really screwed?

http://img175.imageshack.us/gal.php?g=dsci0004h.jpg

Also, my doctor never warned me of Gynecomastia being on both sides. He even told me that the other side of my chest was completely flat and there was nothing for him to take off. Will I have to foot the bill for this fix, or should he fix it?

Posting Standard Revision Gynecomastia Surgery Pictures can help others better understand your concerns.

One Sided or Unilateral Gynecomastia is quite common.  However, more often both sides have some problem one more so than the other with Uneven or Asymmetry Gynecomastia.  Contouring both sides on uneven gynecomastia is much easier than trying to make a larger side look like a smaller deformity.  One sided gynecomastia patients tend to be very lean. Once there is a contribution of fat to the chest contour, that makes the problem uneven gynecomastia. When only the larger side is done and made to look "flat," the contour of the other side stands out. That is why Uneven Gynecomastia is much more common in my office than one sided. This week alone I just did 3 patients with severe asymmetry, one side much larger than the other.

3 days is very early after surgery. This is an issue that has come up on this forum for many years as you can see in this older post (check the posting date):

i had my surgery done on march 9, and there is still swelling, is that normal?  it was only one sided, and the side is still bigger, and my skin sags like right under my nipple....is this normal?

One sided surgery is the ultimate in trying to make perfection since it can be very demanding to make a surgical site look like no surgery has been performed. You can see typical swelling after my unilateral one sided surgery here. And here is another example of my one sided sculpture.

Recovery after surgery depends on the problem to be treated, surgical technique, skill of your surgeon, how you heal, and other factors best discussed with your surgeon.  This is surgical sculpture and tissues must be given a chance to heal.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

Options depend on many factors that are best explored during a consultation after an evaluation.

Hope this helps,

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