Another Revision Topic

[wolfpack24]

I'm 7 months post op and I'm due to go in for a revision in a week.    I'm getting the surgery done in the PS office since I dont need lypo. It turns out that he is going to "shave" down the gland that has appeared in each breast. My question is (which my PS couldnt answer) did this gland grow back in 7 months time or did it just get pushed forward or did he not take enough out.  I just dont want to do this and have it grow back again. Before my 1st surgery my endocronologist said everything was fine with my hormone levels. Anyone ever have a revision like this or can provide any advice?  Thanks for the help

[moobius]

sounds like the PS didn't do a solid job the first go-around... if they only partially removed the gland then theres no telling what the results will look like post-op (ie did they take enough?). sounds like this is what happened and since he didnt' take enough out he's going in again.

personally, i wouldn't have the surgery unless the entire gland was being removed.

[wolfpack24]

Thanks for the response Moobius.

I thought he took out enough since after surgery I was completely flat when I took off my vest. Thats what is so vexing. I'm gonna do the surgery since he only charging me $50 for supplies. I just hope its not something that grows back.

[moobius]

interesting, maybe scar tissue formation? if the entire gland was removed then i would imagine that scar tissue would for the most part be limited to the incision. if they "shaved" the gland, that sounds like its just asking for scar tissue formation?

i dunno, perhaps someone with more knowledge of this will chime in

[wolfpack24]

He said he left a little gland in there so that the nipple wouldnt sink in.  I guess he left too much in there thats why hes going to shave it down this time.  But i was flat before but now the nipple protrudes out.

[Paa_Paw]

If you are going to have an error, it would be best by far to have a tad bit not enough removed rather than a tad bit too much.

I cannot find serious fault with a surgeon who has erred on the side of safety.

[shiver]

i agree. i actually just had a revision surgery yesterday and it was lipo only. gland tissue would have been removed if it was necessary. after more than 6 mos after my initial surgery, my ps and i weren't satisified with the symmetry of the two sides even though i had perfectly fine results from the first time around. i'm hoping for even better results this time. my surgeon was also against taking too much because she has seen some patients come in with depressions in their chest from procedures in which too much gland had been removed.

[wolfpack24]

Do you think he took out enough during the inital surgery but in 7 months time it somehow grew back?  

[jc71]

Good thread. I'd like to hear Dr. Bermants opinion.

[DrBermant]

I'm 7 months post op and I'm due to go in for a revision in a week.    I'm getting the surgery done in the PS office since I dont need lypo. It turns out that he is going to "shave" down the gland that has appeared in each breast. My question is (which my PS couldnt answer) did this gland grow back in 7 months time or did it just get pushed forward or did he not take enough out.  I just dont want to do this and have it grow back again. Before my 1st surgery my endocronologist said everything was fine with my hormone levels. Anyone ever have a revision like this or can provide any advice?  Thanks for the help

Gynecomastia Surgery Does Not Prevent Regrowth


I caution each of my patients that surgery does not typically stop male breast growth.  If there is a problem with growing breasts, recurrence can happen.  Any of these medical problems and or these medications can cause gynecomastia. So, if you want to get worried about regrowth, you could get yourself evaluated for each of these conditions to see if they could be a factor.

Surgery also does not prevent weight gain in the chest.  Men tend to put weight on the belly and chest regions.  I educate each of my patients that this surgery will not prevent further breast growth.  It is like changing/fixing a tire with a nail.  Fixing/changing the tire will not prevent you from getting a new nail in that tire.

I take care of many patients with gynecomastia, as many as 8 in one day alone.  With all the gynecomastia surgery I have done, it is very rare to have regrowth for patients I have sculpted.  One patient (who had surgery on only side by another doctor) came to me with pro hormone induced gynecomastia that only came back on the side that had no surgery.  His growth was massive on the one side and none on the other.  His surgery by that other doctor had left a massive crater - the skin was adherent against the chest wall with normal fat surrounding the ugly deformity.  One side looked like the deformity seen here.  The other side was almost a B cup breast so tender that I could barely examine it.  As with each patient who presented to me with current breast growth, he was referred for an endocrinology evaluation and stabilization before considering surgery.  I do not know if such radical surgery was a factor or not.   Even if it did, removing all fat under the skin just gives an unnatural look.

I prefer to target the gland first with my Dynamic Technique. This permits me to remove most of the gland and then sculpt the remainng tissue to minimze contour problems.  Any surgery technique, even radical breast mastectomy for male breast cancer can leave gland behind.  The problem is that there are fine fingers of gland that dissect between fingers of fat and can extend quite far into the chest.

You can see what I mean by fingers of gland here.

By concentrating on the gland first I am able to minimize the chance of breast regrowth.  It is very rare for my patients to have recurrence.  However, gynecomastia surgery does not stop breast regrowth.  For patients having breast growth, I have advised for many years that they should get their problem under control before surgery.  There are exceptions, such as young men with massive breasts that have not stopped growing.  That is why each case needs to be individually evaluated.  

Prevention of gynecomastia, when possible, is much better.

Secondary Surgery is often an option for those who had prior surgery.  Such issues are better discussed during a consultation with your surgeon or someone who can advise you about your options.  We help patients explore such issues during consultations or preliminary remote discussions.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[jc71]

Dr. Bermant - I noticed you have an active Medical License in the state of Missouri. Do you ever practice in or around St. Louis?

[DrBermant]

Dr. Bermant - I noticed you have an active Medical License in the state of Missouri. Do you ever practice in or around St. Louis?

Although I could operate elsewhere, I typically sculpt patients in my office in Chester Virginia.  It can be expensive to bring my team and tools to the patient.  We see many patients from Missouri and around the world who often start with our preliminary remote discussion.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture