Revision after surgery with Dr Delgado

[dav242]

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).

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. Please see first pic.

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. 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. I am worse off after surgery with Dr Delgado than when I had started.

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?

[dav242]

Below is a pre-op picture.

Please notice there are NO crevices or craters or indentations.

[dav242]

I just read about fat grafting - would I be a candidate for this?

I really need anyone's help at this point. i am on the verge of a very serious deprssion and feel like I've spent a ton of money for a worse result than I started out with.

I'm afraid that I am scarred and damaged for life.

I am in quite a large debt now and left disfigured, and I feel like there's no place to turn to anymore. Please - if anyone can help me, please do.

[DrPensler]

I will provide several general comments.Secondary surgery is much more difficult than primary surgery.Secondary surgery takes much longer to fully heal and soften than primary surgery.Secondary surgery while typically successful when performed by an experienced and skilled surgeon  has a different endpoint ie will never be perfect and may require small revisions.My secondary patients are always more anxious than primary patients,dramatically so!

Specific to your case,there is substantial bruising still ,so you are recently post op.Your post surgical photos are taken with your Pectoralis flexed which is of course different from your pre op photo.

I would just reiterate your anxiety is typical for your situation at this point in time. Take a deep breath and let things mature a bit. Good luck!

[Litlriki]

I would agree that it's too early to make definitive statements about your results.  The photos aren't great quality and angles and flexion affect what we are able to see.  Dynamic deformities improve with time and massage to the area, and after secondary procedures, prolonged swelling is common.  Don't write off your results just yet!  Fat grafting may be useful if there are permanent issues, but I would not rush to judgement.

Rick Silverman

[dav242]

Thank you so much for your input.

Certainly it helps to get such reassurance, but even in the pre-op photos (after my first surgery), I have NO problems or indentations with flexing my pectoralis muscles.

Will you agree, though, that the side with the muscle detached from the areola area is deformed-looking? I am concerned that this is beyond repair, but do you know if fat-grafting will help in that case?

I would also like to know how long you would suggest I actually wait for things to improve? It's been two months post op now, and these changes are not getting any better - in fact, they are definitely getting worse.

Thanks again. This has been a difficult time for me - emotionally, it has wreaked havoc on my self-esteem, knowing that I paid a great deal of money and in greater debt now only to find that I am even MORE self conscious about my chest, and am afraid to even flex or move my arms around out of fear of the underlying deformity that gets revealed.

[dav242]

Just out of curiosty:
I was told that NO checking of my chest was made with my arms in different positions during surgery. This seems like it would definitely affect outcomes. Is that normal or standard procedure??? To NOT check the chest in a variety of arm positions during surgery?

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 VERY 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 (MORE THAN DOUBLE the amount for a surgery nearby) of money to fly to a surgeon in california when I am from a completely different state.

This has created issues with follow-up, and incidentally, tehre were NEVER any formal follow-up plans from Dr Delgado's office, which was VERY concerning from the get-go. It seems like I have to beg for a follow-up appointment at this stage. And, what's worse, follow-up appointments will cost me EXTRA TIME and MONEY to fly to california. I am in such great debt already, and it is just adding insult to injury.

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.

I know that at the end of the day, I have to accept 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.

[Litlriki]

I don't routinely move patients' arms around while doing the surgery. I use visual inspection and palpation including a pinch test to assess an even result.  You are very early in the evolution of your chest area after your second procedure to be considering revision or legal action--Liposuction procedures require significant time to allow for full resolution of the healing and scar process.  8 weeks out from the procedure is really a year before any good final assessment can be made. 

Many of us treat patients from out of town, and I would suspect that Dr. Delgado may have a mechanism to do follow up with you without having you fly to California each time. I use Skype in my practice, which is useful for visual issues.  I sometimes meet with patients when I travel to bodybuilding events, since many of my patients come from that arena and attend similar events.  You should contact his office to see what possibilities exist.

RS