Dilemma on Revision options

[macman213]

About 3 months ago I had Lipo only for Puffy Nipples (160lbs,6 ft). Its clear that it was a mistake and excision was required as well. In fact, on one side, it actually looks worse and more prominan, I suppose given the little fat that was removed on an already thin frame. I saw my Original PS and and Dr. Jeffords this week and I'm having a little bit of a dilemma.

1. Original PS - Agreed with the need to do excision and would waive his fee. Didn't mention anything about undermining the skin around it. Said would be worried about going too thin for fear of necrosis of the nipple.
2. Dr. Jeffords- Would do both excision and undermining of the skin around it. Said he removes ALL of the gland  (this worried me slightly, as I've read on these boards that SOME is still needed to act as a buffer between the nipple and muscle). Had a TON of before and after. The cost would obviously be more (4500)

I'm stuck. On one hand, I'm thin, just had lipo from the original surgery and maybe excision is OK?Or maybe I just need to start from scratch? Other thoughts that are going through my mind are "Maybe the Original PS won't care so much, since this is 'pro-bono' or "maybe the Original PS will make sure that he does an awesome job because his pride is on the line.

Obviously, going with the Original one is easier on all fronts, but is it the right choice to get it right, when Jeffords does this all the time.

Your opinions would mean a lot.

Thanks!

Can post pre op and 3 months post if people want.

[Dr. Elliot Jacobs]

I see this all the time with my patients and admittedly it is a tough decision.  However, if I can contribute my two cents:  puffy nipple surgery is not easy.  It always requires excision of sub-areolar tissue and skin re-distribution surrounding the puffy nipple.  This can be done with surgical instruments or with a lipo-suction cannula, with or without suction as the case demands.

If your original surgeon only plans to do direct excision this time, it is quite possible that you may still end up with puffy nipples.  Going to him may save money in the short term but may not provide the best result in the long term.

Sorry -- there is no easy choice here.

Dr Jacobs