TETHERING

[quackfly]

Hi
 I was wondering if anyone could advise me on the subject of tethering. I'm 4 weeks post op and both nipples have tethered to my pec wall. I had my surgery in Poland. I'm in the UK so there aren't any follow up visits to my plastic surgeon. I read a few posts on tethering from the Doctors on here but nobody confirmed whether massaging is likely to work or not. Can anyone be specific on perhaps if massage worked for them etc? My chest looks typical to pics ive seen online of tethering, not really noticable until I flex my chest then pecs swell while nipples appear indented. I've read about Kenalog injections to soften scar tissue, would my GP give me those since i cant go back to Poland to see my ps. Any advise would be gladly recieved

[Dr. Elliot Jacobs]

In general, tethering may indicate that too much tissue was removed and the undersurface of the skin is now attaching and scarring down to the underlying muscle and tissues.  It is frequently seen with a crater deformity.

If indeed this is the situation, then kenalog would not be useful -- it is only used when there is an increased amount of scar tissue which makes the areolas puff out.

You are still in the early stages of healing -- so be patient, there is not much that you can do at this point.  Ultimately, when 5-6 months have passed and you are looking at the final result, you will have a choice of accepting whatever you have, returning to your surgeon in Poland, or seeking another opinion  from a gyne expert in your area.

This is one of the problems in seeking less expensive surgery in another country.

Hope all works out well in the future.

Dr Jacobs

[quackfly]

Thank you for the reply doctor.  My chest is still pretty sensitive, should I try daily massage, are there any videos anywhere describing massage techniques?  I completely understand how early I am in my recovery, it is a daily battle to make my brain believe what I know to be correct, that is that I'm a long way from what the final result of my surgery will be. I would like to say though that the surgery was neat and I did discuss with my surgeon the possibilities of craters and he did say he does leave some tissue behind the nipple to help prevent this. My surgeon has worked in the UK and is on the UK list of registered plastic surgeons. I'm not sure of the exact wording of this but I did quite a bit of research on his surgery. The main problem I think with going abroad is the lack of any follow-up care. Even if it is only to reassure concerns a patient might have. Unfortunately for me and so many others the cheaper option is sometimes the only option that is financially possible and therefore the only way in which the treatment is obtainable.
Thank you for your advice and I will try to be patient. Like I said above it is a psychological battle. I know it is a six-month to a year healing process, however, it is difficult to absorb that on a daily basis. I just have to keep telling myself. I'm sure this is common with most patients.
Again, thank you for your answer.

[Dr. Elliot Jacobs]

Unfortunately, I must disagree with you.  The cheaper option is not always the only option.  There is an old adage:  you get what you pay for.

If you undergo cheaper surgery and do not end up with a satisfactory result, you will either have to live with that poor result or pay again for someone to fix it -- and revision surgery is always playing catch up. You may never get the ideal result that you seek. It is far better to get it done right the first time, even if you have to pay a bit more for it. 

Gynecomastia surgery is elective surgery -- it can be done at any time.  And one can hide it to some extent by wearing compression garments.  Many guys on this forum will work hard to save their money and then go to someone who has vast experience in the operation.

Further, the problem in going abroad is that if there is a poor result, or even a question, it is very difficult to communicate.  And then you are faced with either returning to the foreign doctor or having to deal with it at additional expense.  And worst case scenario, there is very little legal recourse available to you as well.

I have a great many patients from overseas and across the US who come to see me for surgery.  They are always carefully evaluated prior to their arrival.  And then, after surgery, I am always there for them -- just a mouse click away. 

Dr Jacobs