failed fat graft..PLEASE HELP!!!

[michaelmorey]

hi,
i had gyne sugery about a year ago,but had a really bad bleed on one side.after draining etc. it basically left that side deflated( if you drew a horizontal line at a height just above the areola, from centre of chest to the outer chest..below this line was deflated  with nipple/areola stuck to skin/muscle). i recently had a fat graft (fat taken from abs and approx 80cc injected into chest) and although doc overfilled,as is usual with this procedure, most of the transferred fat was reabsorped within the first week!  now i'm back to square one..i've read dr bermants posts about his fat flap technique, but that's BEFORE any problems occur and i really need help on what i might do NOW in my CURRENT situation..anybody/docs have any thoughts as to what my  other  options might be? are there any other materials that can be used to reconstruct the chest?pros cons of these ?even implants or prosthetics of some kind?? my PLEEAASSE help, any advice would be greatly appreciated!

[George Pope, M.D.]

That's really a tough problem.  How wide an area are you talking about?  What are the dimensions of the flat area?  And how much flatter is it than surrounding normal tissue?  As you know, fat grafting isn't a perfect answer, as more than half of the grafted fat resorbs.  If the flat area isn't too big, maybe a volume filler such as Radiesse or Sculptra may help.  Can you post some photos?

Dr. Pope, M.D.

[DrBermant]

hi,
i had gyne sugery about a year ago,but had a really bad bleed on one side.after draining etc. it basically left that side deflated( if you drew a horizontal line at a height just above the areola, from centre of chest to the outer chest..below this line was deflated  with nipple/areola stuck to skin/muscle). i recently had a fat graft (fat taken from abs and approx 80cc injected into chest) and although doc overfilled,as is usual with this procedure, most of the transferred fat was reabsorped within the first week!  now i'm back to square one..i've read dr bermants posts about his fat flap technique, but that's BEFORE any problems occur and i really need help on what i might do NOW in my CURRENT situation..anybody/docs have any thoughts as to what my  other  options might be? are there any other materials that can be used to reconstruct the chest?pros cons of these ?even implants or prosthetics of some kind?? my PLEEAASSE help, any advice would be greatly appreciated!

Yes, I have seen many complications of other doctors'  attempts at fat grafting the male chest.  The results just typically do not look good, especially on animation.  Fat grafts need to get their blood supply from nearby tissues.  Fat that dies or partially lives can be just as firm as scar or gland.  A natural moving chest is the goal of my chest sculpture.  That is why I evolved my Fat Flap Sculpture, to try to keep the blood supply intact and fat alive.  Dermal filler injections have the same problem, they just move like scar or at best, dermis - not fat. 

Standard After Gynecomastia Surgery Pictures can help others better understand your concerns.  Sometimes, revision surgery may be an option.  Such issues are best explored during a consultation after tissues have healed.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

[Paa_Paw]

I have nothing to add to the excellent responses posted by two Highly Qualified Surgeons that will be of help to the man who started this thread.

For any others who may be reading along, I urge you to note that both of these surgeons have a notation below their names that they are Board Certified by the American Board of Plastic Surgery.

Sometimes, usually in the interest of saving some money, Men will have their surgery performed by surgeons who lack this certification. Most of the post operative problems result from this kind of selection process.

These problems are difficult and costly to repair. Using the services of a well qualified surgeon, such as these two, would have prevented many problems.

To paraphrase an adage I heard many years ago from my Grandfather:

          If we don't have the means to do it right to begin with,
          When shall we ever have the means to do it over?

[flex1appeal]

Dr Bermant,

Oddly enough, after my revision with my PS, my chest looks almost identical to the man in the link you just posted under Standard After Gynecomastia Surgery Pictures. How do you personally correct that problem with the indent after created by another surgeon? Do you have any after pictures that show a revision you performed in correspondence to the picture of the man in that link? I'd like to get an idea of what he would look like after you helped him. Thanks

[Pacifico]

Well said Paa Paw. 

[DrBermant]

Dr Bermant,

Oddly enough, after my revision with my PS, my chest looks almost identical to the man in the link you just posted under Standard After Gynecomastia Surgery Pictures. How do you personally correct that problem with the indent after created by another surgeon? Do you have any after pictures that show a revision you performed in correspondence to the picture of the man in that link? I'd like to get an idea of what he would look like after you helped him. Thanks

When there is sufficient local fat, I prefer to use that material to rebuild the defect.  I use my Dynamic Technique for Gynecomastia and start by releasing the scar and removing what scar and residual gland remain. I then mobilize the surrounding fat in an  extended fat flap to fill the defect.  I then contour the remaining fat.

I have done many revision surgeries.   In reviewing at what I currently have posted on my website, I will need to take some time to post some more before and after examples.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery