Please take a look. Don't know if I should get a surgery again? With Pictures!

[AndreasN]

Hello everyone. 5 Weeks ago I had a gyno operation involving the removal of both my breast glands and also got a liposuction of my breast. After the operation was done I got a quick look on the result before I got the vest on. I looked so nice. I wore the vest for 14 days and after that I got it off and also the stings around my areolas.

After about 1 month I contacted my surgeon telling him I was abit unsure / unhappy about the result. The problem is that I still have puffy nipples once i'm getting sweaty, hot and so on. All in all the surgery HAS helped me with my puffy nipples in a degree, but its still there. The surgeon told me that there was no fat left under my breast / under my areolas and that he had removed the glands also which is the main cause of gyno / puffy nipples.

He told me that it is "normal" about my areolas.. That I get puffy nipples because of the skin on them? Can this really be true? Please take a look on all the pictures I upload and you can take a look for your self and judge. The first ones are before my surgery and I wish my areola / nipples would stay that way  

The ones after are when its "bad"

The surgeon told me he had done lots of those surgery's before and I also read alot on him on the internet about people telling he did a good job. The scars from the operation and minimal - so perfectly done there

Please .. What can I do? "Demand" he do a new operation free of charge or how does it works? I paid ALOT of money and I cannot afford a new operation.

The healing process has gone very well. Even after 2 weeks I thought it was completely healed up? It has looked the same ever since.

Pics 14 days after the I got the vest and strings off:

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3
4
5

A week after or so it started to look like this

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I'd wish my nipples would stay the same way as in picture 1,2,3,4 and 5 Those days after the operation I have never been more happy in my life. But the joy was soon over as you can see in the rest of the pictures
Thank you in advance for your help and time.
Best regards - Andreas

[DrBermant]

Hello everyone. 5 Weeks ago I had a gyno operation involving the removal of both my breast glands and also got a liposuction of my breast. After the operation was done I got a quick look on the result before I got the vest on. I looked so nice. I wore the vest for 14 days and after that I got it off and also the stings around my areolas.

After about 1 month I contacted my surgeon telling him I was abit unsure / unhappy about the result. The problem is that I still have puffy nipples once i'm getting sweaty, hot and so on. All in all the surgery HAS helped me with my puffy nipples in a degree, but its still there. The surgeon told me that there was no fat left under my breast / under my areolas and that he had removed the glands also which is the main cause of gyno / puffy nipples.

He told me that it is "normal" about my areolas.. That I get puffy nipples because of the skin on them? Can this really be true? Please take a look on all the pictures I upload and you can take a look for your self and judge. The first ones are before my surgery and I wish my areola / nipples would stay that way  

The ones after are when its "bad"

The surgeon told me he had done lots of those surgery's before and I also read alot on him on the internet about people telling he did a good job. The scars from the operation and minimal - so perfectly done there

Please .. What can I do? "Demand" he do a new operation free of charge or how does it works? I paid ALOT of money and I cannot afford a new operation.

The healing process has gone very well. Even after 2 weeks I thought it was completely healed up? It has looked the same ever since.



A week after or so it started to look like this

11

I'd wish my nipples would stay the same way as in picture 1,2,3,4 and 5 Those days after the operation I have never been more happy in my life. But the joy was soon over as you can see in the rest of the pictures
Thank you in advance for your help and time.
Best regards - Andreas

Hello DrBermant. I was hoping you could take a look the forum post I have made today. I could really use some guidance on my operation I have had. It's about I still got puffy nipples and abnormal areolas now.
Thank you in advance.

Best Regards

Swelling after some surgery can mask deformity such as what I have described as the Puffy Nipple Complication. That is why I concentrated on minimizing my patients' early swelling and tissue damage, so I could see what I was sculpting and not have such issues. Documenting the progression also has value, but whatever might be there is lost on the sheer number of images without order. (Part of the fault of that is the way this site permits images, which is why I prefer formatting I can achieve on my own pages to show such critical issues. My Standard After Gynecomastia Surgery set can be really revealing, but you are looking for one of each of the pictures featured, the entire set. If there are to be time sequence images, they need to be labeled to demonstrate what time after surgery.

What I never understood is the concept why trust the same surgeon to go back for the revision if they did not have the skills to address the problem the first time. I have seen patients come to me after up to 7 revisions by the same surgeon! Is poorly done surgery for free really any advantage? If a doctor has that type of revision skills, he / she should be able to demonstrate such skills with before and after pictures of revision surgery. Seeing such documentation lessens the gamble unless there was a complication during surgery discussed as part of the operation or recovery. That that can be a different matter as would be a second stage operation. It is my personal philosophy that if banging a head against the wall hurts, do not keep banging the head against the wall.

Hope this helps,

Michael Bermant, M.D.

[AndreasN]

Well your answer really didn't help me out that much. I'm a bit lost here to be honest. I don't know how to describe my situation I am in? I had both of my glands removed? Liposuction done also? They took 250ml fat from each breast. Yesteday I actually took some new pictures. Its been 68 days since I had surgery so the pictures are all brand new so you can see my how my current situation is.











I really can't afford a new operation since I have been studying for the past years now. Been saving up / taking loans for this surgery.

Thank you.
Andreas

[DrBermant]

Well your answer really didn't help me out that much. I'm a bit lost here to be honest. I don't know how to describe my situation I am in? I had both of my glands removed? Liposuction done also? They took 250ml fat from each breast. Yesteday I actually took some new pictures. Its been 68 days since I had surgery so the pictures are all brand new so you can see my how my current situation is.

I really can't afford a new operation since I have been studying for the past years now. Been saving up / taking loans for this surgery.

Thank you.
Andreas

Your new images again are not the standard set and provide little new details other than the contour does not look good as it should at this time when a minimally traumatic technique is used to manage puffy nipples. The progression of healing seen on my site is typical for my patients and what I expect my surgery to look like as it heals.

Prevention is Better Than Having A Deformity Possibly Needing Revision
I have seen so many unhappy patients from other surgeons operations over the years, I have been trying to help with public education about my findings during revision surgery on these patients. Posts here without links to those resources have very little power of information, but that is the choice of the new forum owner.

I am glad to help you explore your concerns during a consultation or a preliminary remote discussion. That is where I provide my patients specific advice after reviewing information from forums, operative reports, a complete set op images (at least my standard set for Revision Gynecomastia), doctors' office notes, and other critical details. Forum answers must be general in nature. Specific answers on a forum can establish a doctor patient relationship and when the details of the situation are not given are frankly irresponsible. So your expectations for specific help in a forum setting without the details of what happened and other critical issues is simply unrealistic. However, perhaps others are willing to take on the responsibility of providing such specific answers, telling you what to do, and establishing that relationship without those details.

If interested in learning more, Jane is my office manager.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Hope this helps,

Michael Bermant, M.D.

[Dr. Elliot Jacobs]

The original post op photos looked quite good.  then you developed swelling/tissue beneath the nipples -- this can only be scar tissue and swelling.  Wearing a really snug compression garment for a month or more would be helpful.  If the situation continues, would consider a cortisone injection after four months or so.

Dr Jacobs

[AndreasN]

Dr. Elliot Jacobs: Thank you very much good Dr. Jacobs! Im so "revealed" in an odd way that I finally got a answer to my condition.
Very nice and clean answer.

Once again, thank you much very

[gynebob3]

Pics 14 days after the I got the vest and strings off:

1
2

in those photos it looks to me like your areolas are contracted ....
if you touch/pinch your areolas now or you are cold, don't they look exactly like those photos ?

[Pooz]

Agreed. They look contracted to me too.
I just had surgery recently, and my nipples look a lot better(currently), but they'll still contract when cold or pinched.

Then again, I've seen many post ops on here where people have nipples that look that small right after surgery.

[gynebob3]

there are some cases where it looks like its impossible to make the areolas 100% flat and ive seen one of those examples on Bermant website..
and in my opinion he is one of the best gynecomastia experts in the world!

check the photos of this patient in this post:  https://www.gynecomastia.org/smf/index.php?topic=21191.0
and youll see that the areaolas are still puffy even after removing all gland