New revision gynecomastia surgery website

[Dr. Elliot Jacobs]

I am pleased to announce the launch of my new website dedicated to revision gynecomastia surgery.  It will answer many questions for men on this forum who are considering another operation to improve upon their first one.

Hope the information is helpful to all.

Dr Jacobs

(The URL is below under my signature)

[jusken]

Very nice Dr. Jacobs.  It is a relief to see that atleast some surgeons (only you that I know of now) are starting to include revision as an information resource on their site.


I have been dealing with a crater deformity for years now after a surgery with a less than qualified surgeon.  I have seen Miguel Delgado about my options - he said fat flaps were out of the question (not enough resources), so it'd have to be fat grafting.

Have you heard of Cell-Assisted Lipotransfer?  There are many innovations in fat grafting procedures related to mastectomy patients (also breast augmentation), but this seems to not be working its way over to Gynecomastia specialized surgeons.  All the literature I've found makes it seem drastically superior to traditional fat grafting techniques.  I have hope that a procedure like this could bring predictable results to those left with crater deformities.

A simple Google search would yield tons of results on the topic.  Unfortunately I can't link them here.


I'd be interested in hearing what you think about this.  How great it is to have such an active and knowledgeable surgeon on these boards!

[Dr. Elliot Jacobs]

Fat grafting techniques have substantially improved over the past 10-15 years and grafting is now a standard and accepted part of the plastic surgeon's repertoire.  It's use in female breast augmentation and breast reconstruction has been a bit more controversial because of questions about possible masking of breast cancer -- but it is being used by some pioneering plastic surgeons.  It is also now a standard part of facial rejuvenation surgery and in reconstruction on other parts of the body.

One of the more recent discoveries is that a certain portion of the grafted fat is particularly rich in stem cells, which is thought to enhance the "take" of the grafted fat (not all grafted fat will survive or "take" -- this has been the big problem with fat grafting).  I believe that is what you are talking about when you mentioned cell assisted lipotransfer.

My preferred method for crater reconstruction is with the use of fat flaps.  If sufficient adjacent tissue is not available, then fat grafting is my next choice.  Understand that sometimes more than one fat grafting operation is needed to achieve optimal results.

Hope this has helped.

Dr Jacobs

[greatlakes]

Nice section on your website.

You list several conditions (reasons) for revisions - one of them being too much residual  tissue, which is what I am going in for in a few weeks (mainly side flank with a touch of underside). I assume this condition would the easier of the conditions to revise?

[Dr. Elliot Jacobs]

You are correct -- it is always easier to remove a bit more that has been left than to replace tissue which has been removed in excess.  Even then, however, revision surgery is more difficult and less predictable due to the fact that scar tissue is now present when it was not present during the initial surgery.

Make sure your surgeon is experienced in this type of surgery and good luck!

Dr Jacobs

[greatlakes]

I trust he is - i did do my homework before choosing him. Also he is is sticking to his promise to revise if I was not happy with results. I am not sure why - but I was told I was made "flat on the table" but once I stood up the right one came hanging out a bit again. When laying flat now on the bed - same thing - I am flat. It is almost like they ought to do the revision with me sitting up.


Which brings up a difficult consideration for any patient. Even the best of doctors may not achieve perfect (or good) results 100% of the time. I think good doctors will standby their work and revise for modest fees. I think it does always present us patients with a quandary - stick with the doc who got less than ideal results 1st time - or try another doctor. In my case I know my doctor has the reputation and background (I have checked his reputation with many other doctors in the area) and frankly I don't have the dollars to revise with a new doctor.

[Dr. Elliot Jacobs]

It sounds as if he is a responsible physician and one who stands by his work.  Good luck with your revision surgery.

Dr Jacobs