Unfortunate results after surgery - any advice?

[dav242]

I had surgery with Dr Delgado a few months ago.

In the early 2000s, I initially had a lipo-only procedure with a different PS on the east coast. Had no major issues after that procedure, but was still left with residual fat and possible gland that I learned to accept and live with over the past few years. Had no major regret after that surgery, except maybe that I shouldve had glandular excision done (though, as you'll find out, I had no gland anyway).

Fast forward to a few months ago, finally decided to bite the bullet and get a second surgery done and have possible glandular excision.

Chose Dr Delgado given his expertise, experience, credentials. Paid the extra money (easily Double what I would have paid with other PS for the same surgical intervention).

He and his office staff were very nice. Very helpful, receptive, attentive pre-operatively.

Day of surgery went well. I was told that I had little glandular tissue (they didn't even have enough to be sent for pathology), and so mainly fat was removed.

As I've healed (it's been two months now), however, I've noticed two large indentations/crevices around one of the areolas that are prominent and even worse with flexion or with any pulling movement of my arms. I will attach pics soon.

I also noticed that the areola on one side of my chest no longer pulls up when I flex my pectoralis muscle but rather gets depressed inward, which is incredibly disfiguring. YOu can essentially see the outline of my pectoralis muscle extending ABOVE the areola, like the areola is separate from the muscle completely (at this point, I don't think it is attached to the pec muscle anymore - I think scar tissue has built up).

I think Dr Delgado is a tremendous surgeon with great skill and experience. I think his office staff are as receptive to patients as possible, especially given what seems like such high volume of patients.

However, I only wish my results echoed what has been written here on these boards about their experiences.

Obviously, based on findings during surgery, I had no gland to resect, mainly had subQ fat in my chest area, which was all liposuctioned out.

But it almost seems like all that aggressive liposuctioning essentially left me deformed.

At this point, does anyone know if fat injections will help the crevices or indentations in my chest?

Or will fat injections allow my areola to actually tuck under rather than flatten and depress underneath my muscle with flexion?

I am trying to cope with the reality of these deformities and that, ironically, I will have to hide my body due to complications of a gynecomastia surgery, rather than from gynecomastia itself.

Bottom line: can anyone tell me if my situation seems even remotely salvageable or fixable? Or should I accept that my chest will be as deformed as it is now post-operatively?

Thanks

[dav242]

attached are the photos - at this point, i get the feeling that i am irreparably damaged.

[George Pope, M.D.]

You are only 2 months postop now; it takes a good 3 to 4 months for everything to calm down, for swelling to resolve, etc.  So try not to worry.  Have you kept all of your followup appts. with Dr. Delgado?  What does he say about your result so far? 

I can't tell if you're flexing your pecs in the two photos you've posted.  If flexed, post some relaxed photos.

Regarding fat injection, it's certainly possible to do that in the chest if it's necessary.  Fat injection has been around a long time in plastic surgery, but it has increased in popularity over the last couple of years as techniques have improved.

Don't give up hope - keep all appointments with your doc (you have a good one) and follow his instructions to the letter.

Dr. Pope, MD

[dav242]

Hi Dr. Pope,

thanks so much for the reply. Unfortunately, i have NO follow-ups planned with Dr Delgado. And that has been the unfortunate thing about seeing a physician out of state - he had no plans for formal follow-up. I almost feel completely taken advantage of in that respect. I have been actively trying to make an appointment, but he is telling me that there may be nothing that I can do until at least three more months.

On top of that, though, this is getting to be incredibly costly because I will have to pay for ANOTHER flight to california and ANOTHER hotel room and transportation to his office in Novato. So far, there has been absolutely no mention of any compensation here, which is unfortunate. 

I was told that no checking of my chest was made with my arms in different positions during surgery. Is that normal or standard procedure?

I appreciate knowing that fat grafting is an option here.  Will that at least lead to results that make me look somewhat more normal, or even closer to what I had before?

I am in the unfortuante subset who had a revision surgery only to end up WORSE than I started out with. I am kicking myself every day for having this surgery and spending the extra amount of money to fly to surgeon in california. And ironically I am wishing I had the chest that I had prior to this surgery. And that's a regret that's difficult to live with.

I am slowly accepting that the surgery that I had with Dr Delgado has given me deformities that I will have to live with for the rest of my life.

I am very close to considering legal action at this point, simply because I am in such great debt for a surgery with an incredibly poor outcome.

Attached is a pre-op photo. It isn't in the flexed position, but I can tell you that even FLEXED, i had absolutely NO deformities or indentations and that the areola looked NATURAL when my chest was in the flexed position.

[George Pope, M.D.]

Dav
Don't give up on Dr. Delgado.  He's a good surgeon and has a lot of experience with gynecomastia surgery.  If he said there's nothing that he can do for the next 3 months, it's because he wants to give you every opportunity to heal; you can't rush into revision surgery. Set up a follow up appointment with him for 3 months from now, if that's when he wants to see you.

Dr. Pope

[Alchemist]

Hi Dave,

Sorry to hear of your poor results.  Unfortunately unexpected outcomes happen.  I've spent decades in the group health business.  Anybody who expects 100% favorable outcomes isn't aware of how it happens in the real world.  As you point out, the unexpected happened.  The tissue wasn't there to work with due to previous surgery.  My father was just about killed by malpractice surgery. Yours sounds like a more ordinary unfavorable outcome.  I'm sorry to say I don't know what to suggest that will help.  I'm not a doc but an analyst.  On the plans I worked with we would identify the docs, internally, with a high rate of poor outcomes and we would use the docs with a high rate of good outcomes for second opinions.  Did you sign an arbitration agreement?

[Paa_Paw]

Sorry to hear of your dissatisfaction. Dr D has been mentioned a lot here and is highly regarded. Dr. Pope gave excellent advice, except I might encourage you to wait even longer for your final result. 2 months is way too soon to expect to see your final result.

[improving]

I've not long had surgery myself and I have similar indentations when I flex my pecs. I'm not worried in the slightest, it will take a fair amount of time for everything to settle. I'm going to wait at least 6 months before judging my chest critically. For now i'm so happy to be flat!

[letsfixthis]

Hi Dave.

I started a post on this exact very topic for people considering surgery to correct the gynecomastia and asked what advice should an individual be armed with during the interview with the doctor to ensure that a creator deformity would not occur.

My only response was by Poland2012 saying  " If it is necessary for you to provide information to your plastic surgeon on how to perform an operation, don't use them. You'll almost certainly be unhappy with the results. Find someone who knows what they're doing. "

I responded that the issue of preventing creator deformity was not something taught in medical school or during the normal plastic surgeon training and it was something that certain doctors seem to develop unique skill to prevent however the information is not commonly known( even among board certified and AMA approved doctors)  

gynecomastia.org/smf/4/how-can-i-prevent-creator-deformity-andor-nipple-inversion-from-happening/msg175418/#msg175418

This post simple proves my point that this creator deformity issue is something that need to be addressed on this message board so that patients can talk about it and verify that their plastic surgeon knows what they are doing ahead of time.

Its very hard to get a straight answer( even on this forum) about the issue of creator deformity and how to prevent it? Most doctors just say things like " refer to your current doctor for advice" and won't touch the issue with a 10 foot poll.

It would be nice if someone would step up and reveal the truth about what causes this creator deformity and what should you look for in a plastic surgeon to ensure that you are not left with it.

Unfortunately that Doctor you went to has gain control on this forum and I doubt he will allow this post to continue.

Thank you.

[cduub]

I think you should relax DAV,you have two pro gyno surgeons on this blog telling you that they believe in Dr. Delgado's work and to give it time. You can express your frustrations but dont blast the Dr until you have let things heal. Maybe at the end he did a good job and you detoured a potential candidate to his practice in which he makes a living. I know how you feel,but just give it time,also feel free to vent but dont attach a Dr name to it until a certain amount of time has passed and its clear the results where not good. 

[Viking75]

Hi dave,
I was just checking in on you. I hope things are starting to settle down and your results is improving.

[Alchemist]

 Hi Dav,

How's it working out with more time.  If you are still not satisfied be sure to talk about it with the doctor.  Then if not satisfied talk to others who might be able to give additional professional opinions, after studying your records and an exam.   Be glad you don't have a set of D or DD breasts and you have a minor "imperfection".  That is often as good as it gets.  Good luck.

[letsfixthis]

Does anyone have any theories on what those pictures look so different?


I have seen video of Dr. Jacobs surgery with aggressive liposuction and with a fantastic result however what exactly is making dave's chest look so unnatural? It is an abnormal scar tissue formation or uneven liposuction,etc..?

Is there anyway to know from these pictures or does it require an CT scan?

[sjwsjw]

I'm coming up to 9 weeks post op and my chest looks strange tensed up. It's normal, you and I are both still healing. Surgery is not the end of the story, look after yourself with your diet and exercise and wait things out. If you're unhappy after 12 months as I will, talk it over with your PS. Nothing can be done until things settle and things are not settled for you to even know what (if anything) is wrong.

Massaging will help with scar tissue so be sure to be doing that also.

[McGilli]

Any update on this?

It's been over a month since the last post by the OP and wondering if things have changed for the better?