Doctor + Community Advice Needed

[digitalgod]

Hi guys, I had gynecomastia surgery over 9 months ago and I'm not totally satisfied with my results.
Don't get me wrong- the improvement is phenomenal. But I still have a few remaining concerns.
1) I notice my right nipple is quite puffy and the right side is protruded
2) I feel both nipples are too large.

I have some questions, both for the community and especially for the surgeons who are visiting this forum.

You can find my pictures here.

http://img824.imageshack.us/i/1000064a.jpg/
http://img90.imageshack.us/i/1000065f.jpg/
http://img264.imageshack.us/i/1000066.jpg/
http://img269.imageshack.us/i/1000067m.jpg/

The doctor said on my puffier side: what remains is mainly scar tissue and a little bit of remaining gland.
Then again, for all I know it could all be gland and he is trying to wiggle out of revision surgery.
When I visited him and told him about what I wasn't totally happy with, he said its close enough to perfect as I could expect. I asked him if I can get those kenalog injections to remove the remaining scar tissue, and he said its not a good idea because he can't control how the tissue shrinks. This, he said, could lead to worse problems.

I decided to come here, to get a real impartial opinion from the general "community". To be honest, I just don't know if my surgeon is saying I should relax and be satisfied because it really is totally normal (albeit with very minor imperfections), or I still have a weird and deformed chest and he just doesn't want to deal with revision surgery??

So here are my questions:

1) Do I still have "gyne"? How bad is it? Do you think its good enough and I should get on with my life? Or should I seek revision surgery or some other treatments with another surgeon?
2) Is there any chance that my chest will improve over time, this late in the game, or is it too late for major changes? The doctor said at this point any scar tissue that's here is going to stick around indefinitely. I've been trying to lift weights very consistently for almost two years now but progress is very slow and I'm not sure how much it will help anyway.
3) By societies standards, are my aerolas too large? IE, would people notice them at say a pool or a beach?

Thanks in advance for your feedback. I really need your help to put my mind at ease!!

[improving]

To me your areola's appear to be of normal size, and i don't think you should dwell on what people think at the pool because your nipple size is fine.

The "puffy" side as you describe does look a little swollen? I can't answer whether it'll get better in time so i'll leave that to the experienced posters. At the end of the day, surgery is expensive, and if i were in your shoes i'd be having questions with my surgeon as to the symmetry issue. Its not too bad, but i think if you pay for surgery it should be a little better. Just IMO of course.

[Rocky76]

Not that bad.. Since you haven't had much luck with training on your own I would get a trainer. There is much improvement you can do with your chest and body in general with some muscular development. After getting in shape see where your at and how you look. Right now you really don't look like you have much muscular development.

[digitalgod]

Thanks a lot, guys. I really appreciate the feedback and I'm still looking for some more comments (doctors?).
It seems that as you guys say, my case is not too abnormal and I can just relax and stop stressing about it.
That is a big relief for me!

@Rocky76: Thanks for your tips! I will seek out a personal trainer. You are right that there is much improvement I can make. I have been trying my best, and I am still somewhat happy with my results... I have gotten noticeably stronger in the last year, but still have a long way to go. Part of the problem is that I have too much bodyfat, that reduces my muscular "definition". I will work on this.

[DrBermant]

Hi guys, I had gynecomastia surgery over 9 months ago and I'm not totally satisfied with my results.
Don't get me wrong- the improvement is phenomenal. But I still have a few remaining concerns.
1) I notice my right nipple is quite puffy and the right side is protruded
2) I feel both nipples are too large.

I have some questions, both for the community and especially for the surgeons who are visiting this forum.

You can find my pictures here.

http://img824.imageshack.us/i/1000064a.jpg/
http://img90.imageshack.us/i/1000065f.jpg/
http://img264.imageshack.us/i/1000066.jpg/
http://img269.imageshack.us/i/1000067m.jpg/

The doctor said on my puffier side: what remains is mainly scar tissue and a little bit of remaining gland.
Then again, for all I know it could all be gland and he is trying to wiggle out of revision surgery.
When I visited him and told him about what I wasn't totally happy with, he said its close enough to perfect as I could expect. I asked him if I can get those kenalog injections to remove the remaining scar tissue, and he said its not a good idea because he can't control how the tissue shrinks. This, he said, could lead to worse problems.

I decided to come here, to get a real impartial opinion from the general "community". To be honest, I just don't know if my surgeon is saying I should relax and be satisfied because it really is totally normal (albeit with very minor imperfections), or I still have a weird and deformed chest and he just doesn't want to deal with revision surgery??

So here are my questions:

1) Do I still have "gyne"? How bad is it? Do you think its good enough and I should get on with my life? Or should I seek revision surgery or some other treatments with another surgeon?
2) Is there any chance that my chest will improve over time, this late in the game, or is it too late for major changes? The doctor said at this point any scar tissue that's here is going to stick around indefinitely. I've been trying to lift weights very consistently for almost two years now but progress is very slow and I'm not sure how much it will help anyway.
3) By societies standards, are my aerolas too large? IE, would people notice them at say a pool or a beach?

Thanks in advance for your feedback. I really need your help to put my mind at ease!!

Trying to evaluate an uneven or asymmetrical breast is almost impossible when one arm is raised to hold the camera. Arm position changes the contour of the breast. To help others understand your concerns try my Standard After Gynecomastia Pictures. You will see one of the criteria is to have the arms at the same level and at least one view with both arms at the sides.

There are many possible causes for residual Puffy Nipples after Gynecomastia Surgery. Options depend on many factors. I rarely use Kenalog for my patients' scars.

Areola diameter is another factor. Areola Reduction Surgery scars are a significant compromise. For cases where gland has been left behind the areola for "support," I find that targeting that gland and scar complex can result in a much smaller diameter nipple as the skin contracts beautifully once it is not held hostage to the adherent tissues.

Hope this helps,

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

[Rocky76]

Thanks a lot, guys. I really appreciate the feedback and I'm still looking for some more comments (doctors?).
It seems that as you guys say, my case is not too abnormal and I can just relax and stop stressing about it.
That is a big relief for me!

@Rocky76: Thanks for your tips! I will seek out a personal trainer. You are right that there is much improvement I can make. I have been trying my best, and I am still somewhat happy with my results... I have gotten noticeably stronger in the last year, but still have a long way to go. Part of the problem is that I have too much bodyfat, that reduces my muscular "definition". I will work on this.

No Problem... you will find as you get the ball rolling and getting in better shape and carrying more muscle mass the "set point" of your metabolism will change. When this happens you your body will efficiently burn calories as well as get at that extra fat. It takes a little time to change but it's so worth it and much easier to keep it once you have it. Good Luck

[George Pope, M.D.]

Digitalgod,

You have an obvious asymmetry that needs correction. I'm not sure why you're getting a roadblock from your surgeon, unless he just doesn't want to bother. (Not a valid reason). Scar tissue can be removed and is an indication for revision surgery. The larger right areolar diameter should reduce in size after gland/ scar tissue is removed.

Good luck.

Dr. Pope, MD