Male Mastectomy and Crater Deformity with pain concerns.

[nycguy]

Good day folks, I recently found this site and is thank you. I have had two separate surgeries for Gynecomastia. I had liposuction on the sides in 2003. I learned at that time I was suffering from Primary Hypogonadism. That explained allot from my childhood and adulthood.

I gained weight so in 2005, I went to a not-very good hospital in NYC and was told I needed to have a "Male Mastectomy" surgery. I was in my mid 20's and didn't research other doctors. I had both sides operated on- one month apart.

The left side always felt odd- like it never fully healed but I could walk, exercise, etc without much problems.

I went back to the hospital and informed them my nipples were "inward" but I did not know the medical term. They said corrective surgery would be needed. Two separate doctors performed my surgeries in 2005. Now I know I am suffering from 'Crater Deformity Complication'.

I have two concerns I am preying qualified and trusting doctors can help me figure out.
________

1- I was given an electrocardiograph exam in 2010 (election day), due to excessive caffeine on an empty stomach requiring an ER visit. 

Please keep in mind, the condition of my breast and nipple on my left side; not fully healed from surgery in 2005.


The tech pushed really hard with the oval shaped device into my nipple region, causing me instant pain. But I didn't say anything and allowed it to hurt until the exam was finished.

Afterward, everything changed for me. I could not walk correctly and had take a bus from the hospital. I experienced shortness of breath. I could not eat anything because it would hurt going down my throat. I experienced muscle spams on the left side of my chest. I couldn't run or walk without stopping for breath.

Now it's 2013, with many more doctor visits and no one seems to know what's wrong.

_____

I am still suffering the above symptoms. Pain meds sometime works. I may also have GERD. When I burp, it helps somewhat; possibly trapped air caused by the trauma.

Oh, heart problems were ruled out aside from a Third-degree heart leaky Valve shown on the ECG.
_____

I was wondering if a doctor can help me with more theories on what's wrong with me. (1- Crater Deformity & 2- Pain in chest wall). If surgery to correct this matter can be performed I'll save money for it.

Thank you and God bless to all.

[hammer]

My brother in NYC, I have no answers for you, but I just want to say that I feel for you and I'm sorry that you had to go through that! Dealing with the unknown is no fun! My thoughts will be with you!

Welcome to the forum, you are among friends.


Bob

[Dr. Elliot Jacobs]

You do have a crater deformity on the lower photo.  Oftentimes, appropriate reconstructive surgery with fat grafts can be of help to restore a better contour.

Not sure of what to make about your other symptoms but perhaps a consultation with a surgeon can shed some light on it.

Dr Jacobs

[nycguy]

You do have a crater deformity on the lower photo.  Oftentimes, appropriate reconstructive surgery with fat grafts can be of help to restore a better contour.

Not sure of what to make about your other symptoms but perhaps a consultation with a surgeon can shed some light on it.

Dr Jacobs

Thank you for your response Dr. Jacobs. I have another question... If there isn't fat underneath the nipple causing the deformity, what would then be under the nipple?

My worry now is the pain like pressure I am feeling. The surgery can occur down the road, but I have to continue losing weight and the pain makes exercising and walking up stairs very difficult. 

If you or someone else can help me understand what's underneath given it's not fat, I can Google so more research and possibly pin-point the pathology  of this discomfort.

Take care Dr. Jacobs.

[Dr. Elliot Jacobs]

If there isn't fat underneath the nipple causing the deformity, what would then be under the nipple?

The deformity is lack of fat (ie lack of support).  More than likely, you have a minimal if any layer of fat under the niple.  and under that, there is your chest muscle.

As for your other questions, there is no way to evaluate that unless you speak to a physician/surgeon and have a complete physical exam and evaluation.

Dr Jacobs

[nycguy]

If there isn't fat underneath the nipple causing the deformity, what would then be under the nipple?

The deformity is lack of fat (ie lack of support).  More than likely, you have a minimal if any layer of fat under the niple.  and under that, there is your chest muscle.

As for your other questions, there is no way to evaluate that unless you speak to a physician/surgeon and have a complete physical exam and evaluation.

Dr Jacobs

Good day folks, thank you again Dr. Jacobs for replying. Very helpful information. I cannot tell you how many doctors I have seen since 2010.

I looked at your website and it seems you have a profound gift as a surgeon. No negative web searches should help your practice. I noticed deformity surgery isn't covered with insurance, is this correct?
______________

I think I know what happened to me.

I did not factor in the surgery took away fat, causing a crater. I also cannot feel sensation in my nipples; possible nerve damage from the surgery.

Back to my original point, I had an electrocardiogram done in 2010. (Caffeine poisoning from a GNC "energy" pill without food and then decided to exercise on a treadmill. Could have killed me.)

In the hospital, the technician pushed really hard with the Transducer  right on my left nipple. As the previous image of my nipple, I had little if not no fat underneath.

Therefore, what this technician hit with the Transducer was muscle causing a negative reaction.

That reaction caused me immediate pain until the test was done!!

Symptoms:
- Chest Pressure / left side of chest
- Difficulty walking / running
- Difficulty swallowing
- Muscle spasms of the left breast / nipple area

Three years later:
- Same symptoms (all from the left side of breast where this   Transducer device pushed inside my nipple
- No muscle spams (left three weeks after the test)

With these symptoms, what can be done to help me?

[Dr. Elliot Jacobs]

If the pain is localized to the area of the nipple or the area where the technician pressed very hard, then it may be nerve damage, scar tissue, muscle damage or any of all three.  No way to tell except, perhaps, during a history and examination.

It is impossible to tell if anything can be done to help this pain and tenderness.  Sometimes moving fat flaps into the area and releasing any scar tissue may be of help -- but that would be serendipitous.

As for insurance coverage for revision surgery, it is highly unlikely -- sorry.

Good luck!

Dr Jacobs

[nycguy]

If the pain is localized to the area of the nipple or the area where the technician pressed very hard, then it may be nerve damage, scar tissue, muscle damage or any of all three.  No way to tell except, perhaps, during a history and examination.

It is impossible to tell if anything can be done to help this pain and tenderness.  Sometimes moving fat flaps into the area and releasing any scar tissue may be of help -- but that would be serendipitous.

As for insurance coverage for revision surgery, it is highly unlikely -- sorry.

Good luck!

Dr Jacobs

Thank you once again for taking the time to answer my concerns Dr. Jacobs. It's really appreciated.

Let's say it's muscle damage caused by the Transducer due to a lack of tissue from Gynecomastia surgery.

(Allot of doctors didn't believe me or my symptoms, especially a Cardiac Doctor from Mt. Sinai who said in her own way, I was lying)...


I have tried over the counter meds, which work until I start to move and use, I guess muscles. When I eat for example, the left side of my chest starts to inflame. When I run or use the treadmill again, the left side of my chest starts to inflame and I can't do that action again.

I have tried Cymbalta for the pain, but it doesn't work when my  body is in motion.

Now, if my nerves in that area were damaged by the surgery in 2005, I couldn't have nerve damage, right Dr. Jacobs?

What can I take to a doctor to help me manage the chest pressure? A steroid shot for the inflammation? higher dose of Cymbalta?
 

[nycguy]

Before the surgeries in 2005, I was similar to the image below. I wasn't explained much other than I had to have this surgery. I wasn't explained the risk of crater deformity.

In the next year or so, I want to invest in revision surgery. However managing this pain will help me now.

[Dr. Elliot Jacobs]

What can I take to a doctor to help me manage the chest pressure? A steroid shot for the inflammation?

Since your symptoms seems chronologically related to your surgery and to the pressure applied to your chest by the technician, it would seem to be a physical problem rather than physiologic.  Suggest a visit to a "pain specialist" doctor -- who could take your history, examine you and perhaps consider either different pain meds or perhaps an injection to help deal with the pain.

Dr Jacobs