* No visible extra tissue when laying down on my back*

[Thelake1944]

Hello, I'm 27 years old. I'm pretty skinny, but I have always carried fat in my chest. I am having revision surgery September 5th. I had gynecomastia surgery in 2012, but I was not satisfied with the results. This revision will be with a new surgeon. I will be having just lipo done, as I have no glandular problems. My concern is this; when I lay down on my back the extra tissue is not visible. In fact, my chest appears completely flat when I lay down. Are surgeons able to locate the fat during the surgery even when someone is laying on their back? I just don't want anything to be missed. Also, it seems that some of the fat on my chest comes from under my armpit and on my back. Is this accurate? Or does the fat on my chest solely sit in my chest area. Or would the surgeon have to take tissue out of my lower armpit and back area to help the chest become flat? Thank you.

[Dr. Elliot Jacobs]

When you lie on your back, all the tissues on your chest flatten and splay out.

Your surgeon will be marking your chest prior to surgery while you are standing up -- thus making the tissues more apparent.  When you are lying down for surgery, the markings will serve as a map for your surgeon.

Best of luck!

Dr Jacobs

[DrPensler]

I agree with Dr .Jacobs  however I would stress excess skin also flattens when you lie down. Also while you are not concerned about "glandular problems", with no photo or much of a history I cannot say if there is residual tissue which would be the most common cause for reoperation.

[Dr. Elliot Jacobs]

Thanks for the photo.  If this is your result after prior surgery, then I can understand the desire for revision.  Even at this point, you are fairly large -- and I would strongly suggest that you and your surgeon be on the same page as regards lipo and the very real possibility of the need for simultaneous excision as well. He should be prepared to do excision during the same procedure if it appears to be needed.   I think it may be cavalier to think that there is no possibility for the need of gland excision.  You certainly do not want to face the possible need for a further procedure.  

Good luck!

Dr Jacobs

[Thelake1944]

Doctor Jacobs,
Thank you for your reply. I was very upset with the results from the first procedure. I have carried weight around my chest for so many years, so I was hoping for the best. I will certainly make sure that I'm on the same page with my surgeon. I have lived with this for longer than I care to remember. I really want it remedied.

[Dr. Schuster]

I agree with Dr. Pensler. It is possible that in addition to further glandular removal, you need skin removal as well. probably just a peri-areolar skin reduction will be enough. make sure you new surgeon is experienced in all types of gynecomastia procedures.

[DrPensler]

After review of your photo I certainly see what you are referring to. I think a revision is warranted. I would may sure you see a surgeon with a lot of experience.

[Thelake1944]

Thank you to Doctors Jacobs, Pensler, and Schuster for replying. know ya'll are busy, so it means a lot that you replied. My surgery is Saturday, I'll keep everyone updated.