Queries on Revision surgery

[mohan80]

Hi Doctors,
I am undergoing revision surgery.
my pics available here:
https://www.gynecomastia.org/smf/4/do-i-still-have-gynecomastia/

I am a little bit scared about the revision.
first what should be my expectation? should i expect a flat chest? should i suggest the doctor to go for flat chest?
What if doctor removes too much fat? can it result in bony chest? do you any such case of patient with photos?
i had little bit gland left on right gland? how much more gland can the doctor remove? And what if doctor removes too much gland? would it result in inverted nipple? or what else could be the side effect?

[Dr. Elliot Jacobs]

From your original photos, it appears that most of your problem was lax skin, probably from being overweight.  I don't know the surgical plan but no matter what, in my humble opinion, one would have to deal with the lax skin in some manner, no matter if additional fat or gland is removed.  Hope it turns out to your expectations.

Dr Jacobs

[mohan80]

sharing some pre-op pics

[mohan80]

sharing recent post-op

[mohan80]

Thanks Doctor for your reply.   i shared some pre-op pic and a recent post-op pic.  I guess you meant I was overweight before surgery.. but do I look overweight in pre-op pic?
also are you saying that removing further fat/gland may not help much in my case?

[mohan80]

My surgeon said he would do slight liposuction beneath the skin (he used some medical term that ends with "dermis" I don't remember that well) and that can contract the skin as well.
Can the liposuction help contract the skin? Could you clarify?

[Dr. Elliot Jacobs]

It seems that your skin did tighten a bit after your initial surgery -- but there is still some lax skin present..

In my opinion, the skin has basically used up all of its ability to tighten and whatever loose skin is left probably won't be able to tighten more if additional lipo is done.  Sometimes, surgeon use laser lipo in an attempt to coax the skin to tighten more.  i am very doubtful about this.  Usually, if there is lax skin after initial gyne surgery, then the best alternative is to remove the residual lax skin -- but that would leave some additional scars on the chest -- this becomes a trade-off for a more taut chest.

Best to speak candidly with your surgeon about how much he thinks it can tighten with lipo alone.

Dr Jacobs

[mohan80]

Thanks Dr for your reply. In my post-op pics, do you see loose skin on both sides of chest? or only on right-side?

[mohan80]

I consulted my original surgeon who operated me. He clearly told me that there's no loose skin. but he said there's 90% improvement already and i have only minimal fat and everybody needs to have this much fat. He said even if i still desire to have surgery, removing small amount of fat may not be that easy. He said it would be difficult to even control how much fat to remove with liposuction and he may end up removing more than required and that can cause depression and may make my condition worse.
my pics available here:
https://www.gynecomastia.org/smf/4/do-i-still-have-gynecomastia/

What do you feel about his opinion? is it not possible for surgeon to control how much he can remove? how would chest look with small amount of depression? would it look worse?
If I don't get surgery, then this is going to haunt me for life. Please advice what I should do.

[DrPensler]

How long after surgery are you?

[mohan80]

Two years Doctor.

[DrPensler]

If you look at your breasts as a clock the key issue is weather the area from 4 o'clock to eight o'clock particularly on the left but also on the right represents loose skin or retained tissue.Without a physical exam its tough to say exactly what the situation is.I agree with Dr. Jacobs  that after two years you are not going to see additional skin contraction.

[mohan80]

Sharing my 1st month post-op pics

[mohan80]

sharing my 6th month post-op

[mohan80]

Sharing my recent pic

I had surgery 2 years back. I have shared my 1st and 6th month post-op pics as well.
In my first month post-op pics, I nearly had flat chest. please check-out. How could it have changed like this?
I don't have hormone issues which means it didn't grow back.

is it then loose skin only? or did i put-on some fat?