Please help. Desperate for advice.

[cphil19]

Tried posting this in the Doctors forum but didn’t get any responses and no surgeons will see me cause I’m only 3 months out from post op. Current surgeon zero help.

Desperate for guidance here as I’m not getting much support from my surgeon.

I had revisional gynecomastia surgery done a little over two months ago and having some big issues, both kind of the opposite from each other.

I had my first surgery done when I was 18 which was quite good. At 34 now, I admittedly got a bit greedy and wanted them to be perfect. My left chest the goal was to remove a bit of residual gland still there and use fat to fill in a little sunkeness at the bottom of the left aerola.

The right side goal was to simply remove more fat, as there was zero gland to be found but I still had a pretty loose chest with puffy nipple despite muscle.

Well, both sides are pretty much worse than pre op, and I’ve been left with a saggy, droopy chest. I’ve essentially lost my chest contour.

The right side, while no obvious crater deformity, is completely hollowed out, where I feel absolutely no tissue whatsoever under the aerola, so much so I can completely stretch out the aerola just by pulling on it, along with the entire right chest area. The area feels just completely empty, and when I raise my arms, the right aerola sinks in a ton. Yet, when my arms are at rest, the chest looks very loose and aerola is very puffy (again with NO tissue underneath causing the puffiness). What’s the issue here? Too much fat removal and left with bad laxity?

The left side is a bit different. The chest tightness is a tad better than right, but the incision to remove the remaining gland, which was actually quite small, is healing funky. Pink and raised and has a firm hard lump underneath that doesn’t seem to be getting better. Any advice on this? Injections? Massage? It almost feels like a pebble right underneath where the scar/incision is. Also the way it’s healing is causing a fold in the areola.

Again, really desperate for any advice I can get here. Thanks in advance. I don’t think there’s any fat or gland left. What are my options? Inject fat to regain some contour? Skin tightening? I just don’t know. My girlfriend has told me how turned off she is by it now and just has me so devastated and desperate to fix.

Thanks.

Photos: https://imgur.com/a/nIgLsg7

[Helpme55]

I had fat flap treatment with Dr. Elliot Jacobs in NYC - it worked and fixed the crater!

[Dr. Elliot Jacobs]

You have now had two gyne operations and have issues with the results.  First, you really have to wait at least 5-6 months from your last procedure in order to fully evaluate the results.  At this point, healing is still proceeding and things may yet change -- perhaps for the better -- or not.  Time is on your side, however.

Next, you must understand that revision surgery is always playing catch-up -- and revision surgery is much more difficult to do because of the cumulative residual scar tissue from your prior procedures.  So you have to set your expectations a bit lower.  All that said, there is usually something that can be done to improve the situation.  Residual tissue (gland, fat, scar) can be removed, skin can be widely undermined so that it self-tightens and re-distributes over the chest, and craters/depressions can frequently be filled in with fat flaps.  I have done hundreds of revisions and have only had to turn away one or two where I simply could not do anything to help the fellow -- there simply wasn't enough tissue to work with.  Usually I can find a way to help out.

There is hope.  Be patient and then seek out a gyne expert in your area for a thorough assessment of your situation.

Good luck!

Dr Jacobs