Revision with Dr Bermant (pictures included)

[scope]

I moved the strips almost a week ago. They were still very strong but nonetheless, once I took them off, the nipples looked great  . The left is pretty much perfect whereas the right needs a bit more healing as the scars can be felt more. I would take pictures but I don't have a camera on me at the moment. So far I am happy and following scar care instructions so everything will look good.

I also noticed more gland removed? Wow didnt look like you had anymore in there, but hey it looks great.

Sheesh.... yeah really.... where did all that come from? So let me get this straight... You had all that taken out, and had your PS 'fill-in' the not very evident 'craters'? However, your pre-op and post-op pics look almost identical?   

Hmmm.........


Well, as long as you are happy... that is what matters most...


GB...

As said many times before pictures do not show the entire story. I tried my best to take a picture of the crater effect before my surgery and here it was:



I don't lie, nor do I have a reason to. The crater was terrible looking, making my areola look flat, wrinkled and inverted. The reason why you don't see a difference because while standing up in cold temperatures it does not show significantly. So for those who think I looked fine, please remember that gynecomastia is not a binary problem. There are many different complications that come with it--especially those who need revision. I was also surprised that there was gland still left inside. Apparently it was flat inside so it did not show. However, it is great to know that it has been removed along with the scar tissue.

[DrBermant]

I moved the strips almost a week ago. They were still very strong but nonetheless, once I took them off, the nipples looked great  . The left is pretty much perfect whereas the right needs a bit more healing as the scars can be felt more. I would take pictures but I don't have a camera on me at the moment. So far I am happy and following scar care instructions so everything will look good.

As said many times before pictures do not show the entire story. I tried my best to take a picture of the crater effect before my surgery and here it was:

I don't lie, nor do I have a reason to. The crater was terrible looking, making my areola look flat, wrinkled and inverted. The reason why you don't see a difference because while standing up in cold temperatures it does not show significantly. So for those who think I looked fine, please remember that gynecomastia is not a binary problem. There are many different complications that come with it--especially those who need revision. I was also surprised that there was gland still left inside. Apparently it was flat inside so it did not show. However, it is great to know that it has been removed along with the scar tissue.

That is what I also observed during my clinical examination. What did not show well in photographs was obvious in person and when I examined the chest. My patient exam includes both the patient lying down and standing up. Both at rest and in motion. Both by visual observation and by touch. The room is maintained at a standardized warm temperature for consistency with exam and picture documentation.

I have attempted to show with pictures the obvious nature of this unusual Bursa Crater Deformity. The pictures and video are as close as I can come to show what I was seeing in person.

I see many patients from around the world and try to minimize travel to Richmond with my standardized Photographs for Revision Gynecomastia Surgery. This works for about 98% of all patients in that I can help them during our Preliminary Remote Discussion based on these pictures and limit their travel to Virginia. The rare exception is a case like this where the patient tells me that the pictures do not capture what he sees in person. That is when I ask the patient to come to Virginia with no tentative surgery such that I can see for myself and examine the problem in person before scheduling surgery. That is what happened in this case, what was even more unusual, is that we had a cancellation enabling his surgery on the same visit.

The scars inside the areola have also been moved to the edge.

How exactly do you 'move' a scar?

GB...

Very carefully. I remove the unwanted scars and design that sculpture with a more natural looking micro jagged cut that matches the edge of a normal nipple much better than just a curved incision.

Hope this helps,

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

[DrBermant]

Doc B...

Also... scope's chest pre/post-op looks almost identical... Where did you get all that adipose tissue from?

GB...

You can see where I got the tissue from to rebuild the defect from these drawings on a different problem page Residual Puffy Nipples Complication after Gynecomastia Surgery. Look at the row with 4 small images labeled "larger defect."  That is how versatile my Fat Flap Technique can be in filling in defects such as larger glands, scars, or defects such as craters.

Hope this helps,

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