>>> I just posted another case of Revision of Crater Deformity after Prior Gynecomastia Surgery in Texas and Massachusetts.
This is a real good job, Dr. Bermant. In fact the best that I have seen till date.
Questions:
1. Isnt 3 months too early to tell. Could you follow up on 6-9 mths progress period as well.
Thank you for your comments.
Travel From Around the WorldI would love to have longer follow up pictures on all of my patients. The problem with a practice like mine, that sees patients from around the world, is why should a happy patient come back to see me just to get longer term pictures? I was lucky to get the 3 months pictures and only had those because the patient had asked me to do something else surgically to another part of his body. It is rare that we get a week that we are not working with patients from at least 3 different continents.
Patient PhotosSome patients send in their own photos to show their results. These tend not to be with the same lighting, position, and details and are like comparing apples and oranges. Actually to get the degree of reproducibility of angles and framing for each of the views I need to have the before surgery pictures on the wall as I am taking the subsequent shots. We appreciate when our patients give us
Standard After Gynecomastia Surgery Pictures as part of their follow up. Here is one such
Pictures 2 Years After Revision Surgery. The issue of those pictures is here was a patient with a debilitating deformity who would hide indoors now out playing in the pool who came to me to repair the mess done by a surgeon in Australia. The photos actually came from his grateful mother, the patient had moved on. She was just expressing her gratitude for my sculpture. The views are not standard, but the emotion on the face and activity are enough to convey the result. Yes, even that quality had to be obscured so I could preserve his privacy.
Appreciated FollowupIdeally I would like to see 6 month, 1 year, 5 years, and 10 years follow up as a scientist evaluating progression of his sculpture. But then again dragging up an emotionally disturbing deformity just for science, marketing, or my own enjoyment over the evolution of my surgery seems unfair to my patient. When they do offer up such an experience, we appreciate it.
Camera TechnologySometimes they come back and the camera technology has evolved such that I no longer have that combination still available to match the before and after surgery. My practice has seen the onset of the digital age migrating from 36mm slide to digital video to HD video. Each format distorts the documentation to a degree such that patients in a transition period often had pictures taken with 2 different cameras. That is a hassle for someone who has been doing this for decades.
Successful Methodology of Surgical SculptureWith the system I have evolved over the years, we often do not often get a chance to enjoy the evaluation of longer term results. Many patients are off home the day after surgery. More complex cases either stay local, sight see, or return for the safety of my dressing removal at 6 to 10 days. Others come back so I can interact with their progression of scar care and comment on the progress or continue the education on what best to do at that point. One of the problems with a successful methodology is that we are also happy that patients are able to move on with their lives. We remain busy enough that we have never needed to press our patients to keep dwelling on their painful experiences for marketing games or long term documentation for the web, public education, or the furthering of my subspecialty. That is a common factor here on this forum. My patients tend to move on with their lives.
Perhaps if you become another of my surgical sculptures, you will come back for such documentation for others.
To the person who started this thread. I feel the same way in my armpits. My surgery was a absolute horror.
One of the reasons is that the gland holds the tissue from the center of the chest on side and the lateral tissue on the other providing nice taut tissues on both sides. Hence when they remove the gland, this tension needs to be recreated.
I am yet to go back to original PS to kick in his balls and show him some Newtons laws of momentum.
Yes, having a continuum of structural support both deep and on the surface is key for a dynamic sculpture. That is why I stress on how tissues move. Some doctors are content I have even heard some saying "it does not matter what it looks like with arms up overhead or while flexing."
It is amusing to consider desires to do something similar to surgeons I see repeat disfiguring deformity from unhappy patients asking me to fix a mess or from results shown at meetings, forums, or the doctor's own website. However, I just channel that into public education as best I can.
Hope this helps,
Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery
Topic: Revision surgery costs? (Read 10890 times)
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