Possible Post Gynecomastia Surgery Complications

[Freakazoid]

Hope, the sugeons on here can help with this question.  I am 46 years old in relatively good shape and I have gynecomesita but not nearly as bad as what I have seen with others.  If it wasn't for the darned puffy nipples, I could probably live with it.   I also have slight breast asymmetry which is not noticeable enough to be a problem but am wondering if surgery will amplify that asymmetry.  It still bothers me enough that I am contemplating sugery. I reside in Canada where right now Medical Insurance covers a portion of it but I would still be on the hook for $2000, which is not too bad.  Since medical insurance is thinking of deinsuring the entire procedure and if that happens, it would not be covered at all.  So, I am scheduled for surgery on April 19 2010 but am reconsidering cause my fear is that any potential post surgery complications no matter how remote will be worse and the aftemath and scarring that they could cause could leave be looking worse than the problem itself.  On top of that the surgeon that will be doing the operation has mixed reviews by his patients 50% good 50% bad.  The ones that gave him a really bad review indicated that he does not readily accomodate them if post surgery complications arise and some claim they were forced to attend the hospital emergency room to resolve post surgery complications like hematoma.  He also does not use drains after surgery which I thought were important to help minimize post surgery complications.  My doctor referred me to this surgeon and my doctor claims he is one of the best plastic surgeons in my city.  

It would put me at ease and help me be better decide if I want to get the surgery done if someone can help answers the following questions.  What is the worst case scenario after surgery and how easily are these issues resolved without creating a situtaion that is not worse than before.  I undestand that every surgical procedure carries the possiblity for risk and complciations but I want to weigh the risks vs benefits before deciding.

For instance, assuming that someone ends up with hematoma or seroma how will this effect the aesthetic appearance of the chest once it has been treated. Will there me increased ugly scarring  For the surgeons who have perfomed this procedure.  What was your experience on the occurence of the following complications and how easy or difficult was it to deal with and what and how did it effect the final and long term result of the procedure.
    *   Unfavorable scarring
    * Bleeding (hematoma)
    * Blood clots
    * Infection
    * Poor wound healing
    * Changes in nipple or breast sensation temporary or permanent
    * If liposuction is used, uneven contours, rippling or loose skin, irregular pigmentation, excessive fluid loss or fluid accumulation
    * Anesthesia risks
    * Breast contour and shape irregularities
    * Skin discoloration, permanent pigmentation changes, swelling and bruising
    * Damage to deeper structures – such as nerves, blood vessels, muscles, and lungs – can occur and may be temporary or permanent
    * Allergies to tape, suture materials, glues, blood products, topical preparations or injected agents
    * Breast asymmetry
    * Fatty tissue found deep in the skin might die (fat necrosis)
    * Fluid accumulation
    * Deep vein thrombosis, cardiac and pulmonary complications
    * Pain , which may persist
    * Possibility of revisional surgery

[George Pope, M.D.]

You are scheduled to have this surgery on April 19th. These are questions that you need to ask your plastic surgeon, and you need to be comfortable with his answers.  It doesn't matter what type of experience other surgeons have had if you are not going to them.  You sound hesitant to have this surgeon operate on you, given the mixed reviews you have received from others.  It's not too late to seek the opinion of another plastic surgeon there in your home town. 

You should print out your list of questions you posted and take those questions to your plastic surgeon.  If you don't feel comfortable with his/her answers, move on to the next.

Good luck-

Dr. Pope, M.D.

[Freakazoid]

Many thanks for the sound advice and direction Dr. Pope, it is much appreciated. 

[Dr. Elliot Jacobs]

Could not agree more with Dr. Pope.  All of your questions should be posed directly to your surgeon -- and if you are not satisfied with his answers, then consider other surgeons.  This is elective surgery -- not an emergency to save life or limb.  You have time to consult with other surgeons.  Choose carefully.  Most of your concerns are with possible complications after surgery -- and the best way to avoid them is to have the best possible surgeon performing your operation.  Not that complications cannot occur with any surgeon, but the odds are better with a surgeon who is very experienced in gyne surgery.  Treating a complication is always a game of "catch-up."  You are better not having the complication in the first place.

The fee, while important, should be the least of your concerns.  Remember, you will enjoy the results of your surgery for many years to come -- and long after the fee is forgotten!

Best of luck to you!

Dr Jacobs