Dr Jacobs, and others

[ihatepropecia]

Dr Jacobs, 

can you PLEASEEE take a look at my photo?  I am 1.5 year post op.  I had mild gyno.  Had lipo and gland excision.  As I'm approaching my best weight, I see that my nipples are elongated and chest sags to the side some. I know its due to some slightly loose skin near the nipples and towards the armpit. And I realize that my results may be expected and acceptable to most but the fact is that this slight looseness is making me lose my mind! Its so uncomfortable to deal with when the rest of me is relatively tight.  Im willing to accept scars and I was wondering how this would be fixed? Are there different options? Where would my scars be?  Scars may be unsightly to some but comfort is #1 for me. Please help.  thank you so much! (Im going to post this elsewhere on this site to boost my chances of a response as well)

[Dr. Elliot Jacobs]

You have provided only one photo to look at -- and even that one is not great because you are clutching the camera in your hands, thereby partially distorting the chest.

However, from what I can see, you seem to have a reasonable and acceptable result from your gyne surgery. There is a limit as to how tight skin should be -- at a certain point you have to accept that you are human and that your skin will have some laxity in certain poses.  (This increases with age -- I can attest to that fact!).

When I discuss surgery with patients, I always want to get the very best results possible with the most minimum of scars.  Otherwise, one would be trading one problem (ie gyne) for another (ie scars) -- both of which might make you reluctant to be seen shirtless.  In other words, why not accept a 95% result (or more) with virtually no visible scars than try for 100% with permanent and visible scars on your chest?

I have many young patients who seem to feel that an absolutely perfect result is the only acceptable result -- perhaps that is our culture at the present.  And guess what?  With all their skills, etc, no surgeon (not even another surgeon on this site) can produce a perfect result on every single patient -- there are too many mitigating factors beyond anyone's control. A little maturity and reflection on your behalf might make you accept some of these truths.

As for an elongated nipple -- your photo does not show this.  If indeed there is an elongated nipple, this can be easily treated.

Dr Jacobs

[George Pope, M.D.]

I agree with Dr. Jacobs.  It's difficult to evaluate your condition with only one photo, but based on that one photo, I would not recommend any additional surgery to tighten your skin.  If it's loose, it appears to be only minimally so, and I would certainly prefer that over visible scars.  I think you look good.  Not the answer you want, I know, but as we say in surgery, "The enemy of good is better".  Be careful.

Dr. Pope, MD

[henry 41]

What nonsense this is. Your nipples are tiny, almost not there. Your pecs are absolutely normal.

What have we done to these young persons to encourage them to imagine a condition which simply is non-existent. This is complete nonsense. Can we please stop coddling these young persons into thinking they are somehow victims of something that does not apply to them?

[George Pope, M.D.]

Henry 41

This patient looks good because he has already had surgery.  If you look at the entries from both Dr. Jacobs and me, we both said he does not need additional surgery.  Your comment is probably well-intended but inappropriate here.

Dr. Pope, MD

[teetit]

[quote author=Dr. Pope link=topic=23604.msg156973#msg156973 date=1310299370]
This patient looks good because he has already had surgery. 
[/quote]

pwned

I'm no doctor but with the pic you have up now you look completely fine - the doc did a good job.  If you actually think you have a problem post a picture that better identifies it. 

[Raboze]

I wish my results will end up like this! I'm going threw surgery in a week