Post-op UPDATE (+PICS) Surgery booked, but extremely apprehensive...

[yoobro]

Hi all, I'm currently 9 days away from my surgery with Dr. Lo in Philadelphia, to remove my pubertal gynecomastia. Trust that it's bothered me immensely since I got it about 10 years ago. I'm 23 now.

Let me say first that I have the utmost confidence in Dr. Lo's abilities. He's done hundreds of these, his pictures look great, and most importantly, I've spoken with two members of this forum who used him and got superb results (the pictures they sent me spoke for themselves). They highly recommended him.

That said, I'm just extremely apprehensive about going through with this. My case is very minor; I'm one of those who is pretty happy with his chest when my areolas are contracted, but very unhappy when my skin relaxes, and I have large puffy areolas that stick through my shirt. Here's some pics:

Areolas tighened:





Relaxed:





I have a lot of concerns that are kind of eating away at me right now, and was hoping some of you might be able to give me some guidance.

1. Areola scarring- Most of Dr. Lo's results show practically invisible areola scars, but I have pretty fair skin, so I'm really concerned the scars will be more obvious. granted, I don't scar very easily at all.

2. Skin quality- Dr. Lo told me in my consultation that my skin was average, and a "little loose." That kind of freaked me out, even though he thinks my chance of loose skin post-op is small. I really don't want to go through with the surgery only to be left with sagging skin or areolas that are still enormous.

3. Worried that my areolas won't be able to contract after surgery like they do now. Like most guys here, the only thing that saves me from embarassment is getting my nipples hard... if I lost that after surgery, and still had huge areolas, that would be rough.

Overall, I know my gyne is minor compared to what it could be. One of Lo's other patients was about the same degree, but he got a home run result and he says it's one of the best things he's ever done. If only we could all be so lucky.

I'm just terrified here. I'm spending a lot of money and subjecting my body to surgery, and I don't know how I would handle it if my results left me worse off than I was going into surgery. Maybe I'm not mentally prepared for this? I don't know, really. I guess I feel kind of trapped... I've dreamed of getting surgery for a long time, but now that it's a reality, I'm getting cold feet and wondering if I should just leave good enough alone.

Thanks to anyone who can provide any help, or has been there before and can offer any support.

[Dr. Elliot Jacobs]

You are young, have a mild case of gyne and are in good hands with Dr. Lo.

Would be best to discuss your concerns and anxieties directly with Dr. Lo -- I am sure he will answer them and reassure you.

You should have a good outcome given the experienced hands of Dr. Lo -- good luck!

Dr Jacobs

[yoobro]

You are young, have a mild case of gyne and are in good hands with Dr. Lo.

Would be best to discuss your concerns and anxieties directly with Dr. Lo -- I am sure he will answer them and reassure you.

You should have a good outcome given the experienced hands of Dr. Lo -- good luck!

Dr Jacobs

Thanks Dr. Jacobs. I'm glad to get some validation from such a well-respected gyne surgeon.

I have a question for you that addresses my main concern about surgery: What has been your experience with lighter skin tones and periareolar scarring? It seems that a tiny scar could easily get lost within a dark areola, but are guys with fair skin and pink areolas usually ok with the scar as well?

I always found it interesting how surgeons advise against exposing the scar to the sun too early on, so that the scar doesn't retain any color... I've always thought that slightly red scars would blend with my pink areolas far better than a white, faded one!

[Dr. Elliot Jacobs]

Some surgeons place the peri-areolar scar directly at the border of the areola and normal skin.  Others, like me, prefer an incision 1-2 millimeters within the edge.  Both incisions yield quite acceptable scars when sutured carefully by the surgeon (his job), are cared for properly by the patient (your job), and Mother Nature cooperates in the entire process (a crap shoot).

Looking at your skin type, I think you should heal with quite an acceptable scar.

Good luck!

Dr Jacobs

[saggyboobs]

Whats the total cost quoted for you mate? Do you stay in Philly?

Is it under local or general?

[yoobro]

Whats the total cost quoted for you mate? Do you stay in Philly?

Is it under local or general?

It's a flat rate of $5500, and $500 off if you pay with cash/ certified check... a very fair price, I think, considering some of his results I've seen and the fact that he does about 2-3 gyno surgeries a week.

He uses general anesthesia, but no need to stay overnight. I'll arrive early tomorrow morning, be in recovery for a few hours and hopefully will be on my way home by mid afternoon. I live about 2 hrs outside Philly.

[saggyboobs]

Best of luck mate will look forward to hearing from you

Take care

[saggyboobs]

How did it go mate?

[yoobro]

Hi all,

I'm now ~36 hours post-op. and am pretty happy so far. Of course, I'm still in the "honeymoon phase" of my recovery, with no scar tissue or significant swelling, but if the look of my chest now is a preview of the final result, then I am THRILLED!

My surgery story:

Got to the short procedure unit of Penn Hospital around 7:30. They run a tight ship there... everything went quickly and smoothly with no significant wait. Probably because I was Dr. Lo's first and only patient that day.

Got to the waiting room, signed some more consent forms, and was shortly taken to my own little cubicle upstairs by a nurse. He had me changed into my gown and then took my belongings. Took my temp, vitals, etc. Another nurse came in shortly after and got more of my medical history, including all medications, pre-existing conditions, etc. I believe the nurse anesthesiologist came next, and started me on my electrolyte IV to keep me hydrated. More of the same questions about my medical history. My biggest concern about going under general anesthesia is my frequent heart palpitations and PVCs... but no one seemed too concerned, as I had done  a few holter monitors in my lifetime and my irregular beats were found to be benign.

A nice surprise was having Gina, one of the women who works in Dr. Lo's office, come by and stay with me as I saw the various nurses and anesthesiologist. Turns out she was one of the OR nurses herself! Here I thought she was just one of his assistants/secretaries. She definitely helped calm my nerves.

Next, the actual anesthesiologist came and asked more of the same type of questions. Around this time, Dr. Lo had arrived and was standing around in the background, talking casually with some of the nurses. He eventually came over and marked me up. He was extremely friendly and in good spirits as he was doing this... definitely seems like he's a morning person!

Finally, the nurse anesthesiologist came back and told me it was time for the OR! By this point, I was shaking all over. At some points, I was wondering what the hell I was even doing here, scared out of my mind, about to get surgery for a little bit of breast tissue. No turning back now though!

Got to the OR and layed down on the big T-shaped operating table, and the nurse anesthesiologist told me she was starting my IV and that it would feel like a few cocktails. She was right... felt like I was slowly getting drunk.

I didn't have the experience that people often relate where they are awake one second and the next second they are in recovery. Instead, I felt like I was slowly drifting off. I was told later that I kept talking and kind of resisted falling asleep. I'm a big guy (6' 4" and ~210 lbs) so maybe it just took longer to hit me than most.

Funny thing... my first memory after surgery was NOT in recovery... I woke up  in the OR! I believe I said "are we done?" and someone said that it was over. I think I then tried to sit up and get off the table, and I remember everyone kind of freaking out and Dr. Lo yelling "Wrap him! Wrap him!" and everyone rushed over and held my arms up and quickly wrapped the ace bandage around me. Then I must have lost consciousness again, because next thing I know I'm in recovery, feeling TOTALLY FINE. No nausea, very little pain, and carrying on casual conversation with the nurses. A bit of pain started to set in, so they gave me some morphine and percocets. The percs in particular messed me up pretty good, and I was rambling on obnoxiously as I put my clothes back on, was wheeled out of the hospital, and rode home in the car.

Last night, I felt good for a while, but some dull aching eventually set in so I started to take the vicodin regularly. I have been BLOATED from the surgery and the pain meds, which both do a good job at constipating you.

Woke up this morning in a pretty significant amount of pain and promptly took some pain meds. A little later, I chaged the gauze around my drain tubes, and tried to change the gauze over my areola incisions but was just too damn sore. Most of the sorness subsided this evening, so I managed to get the areola gauze off and get a look at my new chest:



Note: the yellowish tint is NOT bruising, just the betadyne they use pre-op to sterilize the chest. So far, I have absolutely minimal bruising.

I was pretty lean and muscular going into surgery, with decent ab definition, but you wouldn't know it from the post-op pic! The bloating has made me look and feel pregnant. Can't wait to lose all that bloat and get back in the gym in a month or so!

There's a little crease in the right side (where more tissue was removed), but overall, I couldn't be happier. Chest contour looks perfect, my areolas shrunk, skin bounced back nicely... all I need now is the incisions to heal well and I think I'll be looking at a home run result!!

I think I'm going to be another happy patient of Dr. Lo's. He and his staff have made this a really comfortable and easy experience, and have been available for support every step of the way. Dr. Lo called me last night to check in, and I spoke with his office staff extensively today about my status. They told me if I have any concerns at all, I can take pictures and email or text them to Dr. Lo and that he'll get back to me promptly. Can't beat that!

[timbo68]

Good for you.  I had my surgery on Monday, Oct 14.  Same after affects, although the pain wasn't bad (only took one Lortab...managed the rest with OTC Acetimenaphin).  Was back to work on Friday, but only because I didn't want to go with the drains in.  Bruising is about the same as yours.  Still can't feel my left nipple at all.  I actually had lypo, gland removal and a donut lift.  Was able to keep on my three mile walks without missing a day at all.

I hear you on your bloating.  Same issue, plus, with the IV's, I am urinating constantly.  My drain tubes actually went in much lower than your's.  Because I am on a "weight loss kick", I was disappointed to stand on the scale and see I gained 10 pounds 2 days after surgery.  I am now down a 1 pound from my day of surgery weight.

Good luck to you!  I envy you on your price.  I paid double...not sure how much the lift would add to your price.

[yoobro]

Glad to hear you had minimal pain. I can live with the pain I've been having, but I gotta say it gets quite uncomfortable at times. Particularly when I release the compression garment to let my skin air out and change the guazes and let the skin air out... That's been hurting like a bitch.

Not sure how much the donut lift would have added to the price... I take it you had some loose skin?
 
With regards to the drains, I'm a big fan of Dr. Lo's drain placement, which is the same entry point through which he does lipo. It's in the fold of the armpit, so completely inconspicuous when my arms are down at my side. I think Dr. Delgado might do it the same way? Perhaps it's a bit more difficult than doing lipo from the incisions down on the sides, but I'll certainly be glad not to worry about the visibility of those incisions... The areola incisions are already enough scars to manage.

[cduub]

Your results look AWESOME!!!!! and for the price thats great for 5k. Im sitting around with 5k and ready to do surgery but cant find any experts in Miami. This would be my second one so I have to nail it this time. Good Luck dude,happy for ya!!

[Benign]

does everyone who does the surgery get this draining stuff done? I never heard of it before... how does it work and how long post-op does it take?

[Dr. Elliot Jacobs]

Drains (tubes left under the skin) are used at the discretion of the surgeon, based on their training and practice experience. Some surgeons use them routinely, others never and some (myself included) use them only when their instincts (based on decades of surgical experience) say they should use a drain.

Drains are used to remove any fluid that might possibly accumulate inside the wound.  That fluid could be blood or serum.  There is no right or wrong as to the use of drains.

If you are considering surgery, you should discuss possible use of drains by the surgeon so that you have some idea as to which way he leans.  Your decision to choose that surgeon should not be based on whether or not he uses drains -- that decision should be based on his overall post op results.  But at least you will know about them.

Dr Jacobs

[yoobro]

The drains suck, and are painful, there's no doubt about it. Luckily, they are only left in for 48 hours usually, or in my case, a bit longer (Thursday to Monday since my surgeon isn't in on the weekend).

If anyone is interested, here are my 15-day post op pics. I'm healing at blazing speed... the advantages of being young, healthy, and in shape I suppose.







Scars looking GREAT so far, and I imagine that in time, they will be completely invisible:







Only thing that's a bit off right now is some cratering when I flex. My doctor says it will all smooth out eventually, and I trust that it will. It's still quite early! The cratered areas are some hard, tender tissue (probably some scar tissue) that seems like it will soften up eventually and relieve the cratering. Even if the cratering doesn't go away, I don't really care... chest looks pretty great unflexed. If it persists I'll lean up or hit the gym or something and see if I can work it out, but if not, whatever.






Overall: SO happy I got the surgery done. I see people on here obsessing on the results during the recovery... I don't think about it hardly at all. It's crazy how I used to think about my chest so damn much, and now... never. My chest looks fine, even if it doesn't get any better from here on out.

So yeah... surgery is the way to go if it really bugs you. I'm starting to forget what it even feels like to be self-conscious about my chest. That's well worth my $5000.