Am I Being Unreasonable?

[David1991]

I had surgery back in early January. Got a glimpse of it right afterwards and the right side looked great. Left side looked better but still a bit puffy. As many say the end result will look similar to how it looks right after surgery and that has been the case with me.

When contracted that both look great. But when completely relaxed it still bothers me. My doctor thinks there is almost no gland left but I know there is and regardless of what is there I'm more about the look than the actual tissue, so I will just say the right side when relaxed has about 10-20% of the original gyno look to it, which is acceptable, but the left side when at its worst still has 50% of the gyno look it once had.

The problem is when I go to the doctor it's cold and the nipples are contracted. I tell him how it is when relaxed but he still is adamant about recommending against revision surgery. So finally I took a video that I will show him at my next appointment in 1 month.


What do you guys think? I think I am being reasonable that I really don't like how that looks. Sure when contracted it's good but as you can see it is still quite puffy and there is a lot of palpable tissue there.

He did some kenalog injections which I think helped a bit on the right side but only so much. So I'd really like to get revision surgery at the very least on the left side, but don't want to throw his recommendations in his face. I just feel like if I let it go and don't get the revision surgery I will be almost as unhappy with it as pre-surgery. Part of the mental relief I've felt over the last 6 months hasn't been in that I thought it was perfect but that I figured it would eventually be fixed, so if we drop it now I will still feel quite uncomfortable with it.

Last point, I am very into bodybuilding, so while this may seem "fine" to the general public I am personally very aware of it and it is a big deal in my hobby.

Thanks for the input!

[David1991]

I couldn't post this video in the 1st post but if you take away the space between "https" and the colon ":" in the web link below you will be able to watch it.

https ://www.youtube.com/watch?v=pynF4wZCF0Y&feature=youtu.be

[macman213]

I'm a lot earlier on then you, about 3 weeks post op, but dealing with the same thing. My left side looks good and i'm comfortable with it (about 15% of what it was) but the right side still look about 50% of the way there. The nipple doesn't have that 'dome' look anymore when its relaxed, but beyond that it just doesn't match the right side. I brought it up during my first post op, but nipples were contracted  and so it was hard to point out. I took a picture that i'm going to bring with me the next time, so hopefully the differences are clear. Its a little frustrating because I get that it seems so nitpicky when they are contracted, but when I get home and I see them relaxed, it bothers the hell out of me

Here is the picture i'll be bringing for reference.

[David1991]

Yea that is the biggest problem. I would think I was crazy too if it was only like how my doctor is seeing it lol but that's not the case. As the pictures and video show it is still very puffy on the left side.

At one point he said "OK but what do you want me to do about it? At this point I really don't recommend having surgery again" which is a little disheartening because it seems like he's not confident in his ability to do it again without causing some issue.

Even if it's only at it's worst when relaxed that still means having to deal with seeing it, feeling it against my shirt, knowing it's there, etc. half of my life and the whole point of paying for the surgery was for my own mental relief.

[macman213]

half of my life and the whole point of paying for the surgery was for my own mental relief.

I couldn't have said it better myself.

[David1991]

Well, just had my appointment. He said he can't treat a video and has to go by what he is seeing and feeling, and that even if it is like it is in the video 1/3 of the time I really shouldn't be worried about it because it looks great most of the time. I partially agree with him but I'm reluctant to just let it go. He said he absolutely doesn't want to do revision surgery, that he doesn't think there is anything he could really improve at this point, and that he didn't even want to do kenalog injections today because eventually the risk for indentation and discoloration is just going to be too high :\


I guess it's his choice if he wants to refuse to do revision surgery. One 'hope' I kind of have is that maybe my dissatisfaction was partly due to thinking there would be a change, and now if I "know" this is it maybe I will be able to accept it at this point. In theory. I mean I know no one else notices it at all at this point but you know how it is....I am finding this very hard to just accept, even though I know no one else would notice it and even though I would not get surgery if this is how it was INITIALLY. But because I've already had the surgery I don't want to accept anything that's at all unsatisfying 

[Alchemist]

Hi David,

An awful lot of people are unhappy with cosmetic procedures.  At least in getting a gall bladder out they have that to measure it by, not how it looks.  I'm left 20 years later with a large hernia (not dangerous because of size).  So I either accept it or get split open to put a mesh in to hold things together, and that in itself can cause real trouble.  I dealt with unsatisfied patient complaints in group health reviews, on a mass basis.  You can expect x percentage for any given kind of surgery.  Breast alteration surgery has a high rate of dissatisfaction.  Almost none of the ones I've seen can pass the swimming pool test; all the surgeries can be seen from across the pool at the nudist club.  There it is more likely to elicit "Oh that poor person, all scared up."  Nobody asks why it was done and sympathy is usually the only result.  Somehow everybody thinks that the results will match their idealized image in their head.  Some have one surgery after another trying to get it "perfect".   Good luck in deciding whatever you do.

[David1991]

Hi David,

An awful lot of people are unhappy with cosmetic procedures.  At least in getting a gall bladder out they have that to measure it by, not how it looks.  I'm left 20 years later with a large hernia (not dangerous because of size).  So I either accept it or get split open to put a mesh in to hold things together, and that in itself can cause real trouble.  I dealt with unsatisfied patient complaints in group health reviews, on a mass basis.  You can expect x percentage for any given kind of surgery.  Breast alteration surgery has a high rate of dissatisfaction.  Almost none of the ones I've seen can pass the swimming pool test; all the surgeries can be seen from across the pool at the nudist club.  There it is more likely to elicit "Oh that poor person, all scared up."  Nobody asks why it was done and sympathy is usually the only result.  Somehow everybody thinks that the results will match their idealized image in their head.  Some have one surgery after another trying to get it "perfect".   Good luck in deciding whatever you do.

Depressing story is depressing lol. So you think I should just accept it and be glad there was no negative to the surgery or what?

[Paa_Paw]

I would suggest that you be satisfied with looking normal.

In the meantime, I have a little test for you. Using your digital camera, take a picture of your own face. Look as perfectly straight into the camera as possible. Then print out the picture on plain print paper. Using the largest scale that will fit on the page and still leave a decent margin.

Then use a ruler and carefully mark lines across the picture;
just touching the tops of both ears.
just touching to bottom of both ear lobes.
Through the center of each eye.
Just touching the top of each eyebrow.
just touching the bottom of each eyebrow.
Through the corners of each side of your mouth.

These lines will all be parrellel if your face is symmetrical. If your face is normal, some of the lines will actually cross each other.

Now place a dot in the center of the bridge of your nose On the picture. Continue:
At the tip of your nose,
the center of the cupids bow in your upper lip,
The center of the cleft of your chin.

Those marks will make a straight vertical line if your face is symmetrical, but that is not normal. Normal people cannot make a straight line down the center of their face.

My left foot is a full size longer than my right foot, but the right foot is actually wider. That too is perfectly normal.

My wedding ring is a full size too small to to be put on my right hand. That is normal.

Should the breasts be precisely the same size? That would not look natural.

I knew a man years ago who had an almost perfectly symmetrical face. He was without doubt the most homely person I ever knew.

Study portrait painting, This is lesson number 1.

[hammer]

Then feel your testicles and see if there the exact same size either! There isn't anything on the human body that is perfect!

[David1991]

Are you sure you have that right? From what I have always heard symmetry is one of the defining characteristics in what makes someone more attractive.

In any case, I realize there are many asymmetries in the body. I had maxillofacial surgery when I was 16 and there is a clear asymmetry there that I can notice in pictures easily, although no one else has ever made a comment. My left foot is half a size bigger than my right, etc etc

That doesn't mean I want that to be the case though lol especially when it comes to something like my nipples.

I agree it looks much better than it did, and I agree my chest on the whole looks better than many people's chests. I guess it's just that BECAUSE I already had surgery and paid $5400 for it I would like it to be as desired. At least more so. The right side is a little off here and there but nothing I would get too bummed out about. The left side though....eh...it is fine MOST of the time but that 1/4 of the time that it bulges out drives me nuts.

I guess I'm also upset that every time I've gone to see the plastic surgeon I would be very adamant that I wanted revision, and then because it looked fine when I was in the office (because it was contracted) I would get convinced by him that it was fine. Then leave being pissed off again later on lol. I get his points but I know there is still a little something there. Now whether or not it's worth an entire extra surgery for is another point altogether and as mentioned if this is how it was originally I wouldn't have even considered surgery, but yea I just hate this feeling of dissatisfaction even if it is much better.

I think if I were "forced" to accept it, like if somehow gyno surgery just wasn't a thing and wasn't available, then it would be a lot easier to just deal with, but there is this feeling in the back of my mind like I can still do more for it or something, if that makes sense.  

I appreciate the input guys

[Dr. Elliot Jacobs]

I understand your concern -- but allow me to put things into perspective.

First, I have no idea what you looked like pre-op but I would assume you are substantially better.  You seem most concerned about one nipple that puffs out on occasion.  This may be a very slight residual button of breast tissue.

The problem is that revision surgery to try to make this "perfect" is very difficult and delicate -- and there is every chance that you could end up looking worse, with a crater, etc.  I do a lot of gyne surgery and I am very confident of my skills -- but I also respect Mother Nature and know that even in the best of hands, surgery may not result in a 100% satisfactory result to a patient. Perfection in this world is very difficult to achieve -- look at Lexus, whose motto was "the relentless pursuit of perfect" -- note, they never state they have achieved a perfect car.  Now consider surgery, with all the vagaries of healing after surgery, none of which is controlled by the patient or the surgeon -- one can never achieve perfection.

Thus, I would humbly recommend that you accept your results and move on with your life -- don't dwell on this minor imperfection on an otherwise excellent post op result.  In other words, don't snatch defeat from the jaws of victory.

Dr Jacobs

[hammer]

There are over 500 shades of the color white! You asked for a "white" wall and that's what you now have a beautiful white wall! It's impossible to know the exact shade that will satisfy what is in your mind as that perfect shade of white!

[David1991]

There are over 500 shades of the color white! You asked for a "white" wall and that's what you now have a beautiful white wall! It's impossible to know the exact shade that will satisfy what is in your mind as that perfect shade of white!

Except in this case I can picture exactly what type of outcome would completely satisfy me

I understand your concern -- but allow me to put things into perspective.

First, I have no idea what you looked like pre-op but I would assume you are substantially better.  You seem most concerned about one nipple that puffs out on occasion.  This may be a very slight residual button of breast tissue.

The problem is that revision surgery to try to make this "perfect" is very difficult and delicate -- and there is every chance that you could end up looking worse, with a crater, etc.  I do a lot of gyne surgery and I am very confident of my skills -- but I also respect Mother Nature and know that even in the best of hands, surgery may not result in a 100% satisfactory result to a patient. Perfection in this world is very difficult to achieve -- look at Lexus, whose motto was "the relentless pursuit of perfect" -- note, they never state they have achieved a perfect car.  Now consider surgery, with all the vagaries of healing after surgery, none of which is controlled by the patient or the surgeon -- one can never achieve perfection.

Thus, I would humbly recommend that you accept your results and move on with your life -- don't dwell on this minor imperfection on an otherwise excellent post op result.  In other words, don't snatch defeat from the jaws of victory.

Dr Jacobs

Hey Dr. Jacobs. Thanks for replying, I was hoping to get your input. Your response does help and I think you know where I'm coming from with my dissatisfaction. As I mentioned above I think the two biggest issues for me at this point are that
1. I already invested the $5400 going into it looking for an ideal finished product and also, importantly,
2. Part of me feels like I could have pushed the issue more and/or still can. If I were somehow just 100% unable to do anything further about it I think it would be easier for me to move to acceptance but part of me just doesn't quite want to give up yet if I feel like there is something else that can be done (in my life in general I am often for delayed gratification so if it takes more work now for a better end result later that is generally the option I choose).

So I guess if I make the decision that "this is it, I have to accept it" then it would be mostly OK. I mean like I said if this is how it was naturally I sure wouldn't be looking into surgery, and mine is now better than my brother's who I also would not recommend surgery for, so that's something for me to consider too.

My surgeon did say he didn't think there was any more he could do surgically at this point and if he did it would come with high risk, to the point that he didn't even want to do those kenalog injections (which I don't really agree with actually) so in that sense maybe the reality is I really can't do anything else about it at this point (unless I went to an entirely new surgeon and paid for it all over again which I wouldn't do).

[Dr. Elliot Jacobs]

To answer your original question, yes, I do think you are being unreasonable.

You paid for an operation and for a surgeon to do his best.  No surgeon can guarantee perfect results or 100% satisfaction on the part of the patient.

I have had patients who had a 98% excellent result -- and instead of looking at the great improvement they had, they instead focused on the missing 2% and sought absolute perfection in their surgical results.  Just think -- did you achieve 100% on every exam you had in high school?  Well surgery is a lot harder and more unpredictable -- human tissue just isn't moldable and able to be sculpted to perfection.

As I previously stated, there is no perfection in this world.  Accept your results and move on with your life.  If you seek another surgeon (and pay for another operation), you may regret it.

'Nuf said.

Dr Jacobs