Did I make a really big mistake? 2 weeks post-op HELP

[DrPensler]

I just read Ron Schuster's comment and thought the same thing. If you went to a new restaurant and had a terrible meal , why would you go back again?

[Litlriki]

I would also encourage you to hold off on surgery on the un-operated side and find a good surgeon to revise the first side and address the second side.  General surgeons don't usually do liposuction, which has provided a much better outcome for gynecomastia surgery as compared to excisional subcutaneous mastectomy, which can leave more uneven results.  Regrettably, patience is critical at this point to allow for scar maturation, and as you've seen, things do improve slowly.

[NedStark]

So it has been 1.5 years since surgery. Here is how it looks now. It is a crater deformity especially when the pectoral is flexed. Underneath the nipple it actually hurts and I think that is due to how it wrinkles. Numbness still present. 

In terms of revision because I never chose to continue with the right, and there was no lipo, what are the odds with lipo the crater could be reduced. Also Doctors, in your experience and expertise, is it possible to improve the cosmetic appearance of the nipple? I would prefer that scar tissue area cut and new stitching bringing the skin closer again and creating a circular nipple again. I will post what happened in the surgery again.

[NedStark]

Immediately post surgery and the healing months after. You can see something happened under the nipple of the areola and it like lost the melanin and it really hurt for a while too and it still does if my nipple gets hard. But I wanted to know if what it was to now, can the side of the areola be salvaged during revision and it not look like how it is now? There isn't really any scar tissue underneath the areola on that side. Very smooth.

[Dr. Elliot Jacobs]

Your photos show a crater deformity and poor scars.  In the hands of a gyne expert surgeon, both should be able to be improved.

Dr Jacobs

[NedStark]

The problem is finding the Gyne expert surgeon Dr. Jacobs. I have been saving since the surgery so that I can have a qualified plastic surgeon and gynecomastia focused surgeon who would understand the need for cosmetic appearance as much as gland excision. I still feel full mastectomy and gland excision was unnecessary as was the scar from the drain tube hole as there was no lipo and no real issues with fluid retention. I may decide it is worth it to fly to the cities you are all in on this board as you are all qualified doctors in this field and would be able to correct the issues. I drew in red sort of how I would want the scarred area underneath the nipple to be 'cut' out and stitched and healed properly. Is that something thst is doable or would I risk more scarring. I have also lost 40 pounds since the surgery and while it did cause some loose skin it did lessen some fat which would make lipo and sculpting a bit easier to lessen the deformity. To be honest I regret ever becoming obese, using hormone changers like Finasteride/Dutasteride to maintain hair. Has just been a vicious cycle of side effects trying to restore the balance. I also have not gone shirtless in 1.5 years anywhere as the right breast is full gyno and the left is this crater deformity with scarring.

[Dr. Elliot Jacobs]

A visit to an expert gyne surgeon should be able to answer a bunch of your questions and concerns.  

Realize that revision surgery is always playing "catch-up" -- it can never replace properly performed initial surgery.  So you have to set your goals a bit lower and more realistic, looking for improvement and not perfection.

Good luck!

Dr Jacobs

[Dr. Schuster]

I agree with Dr. Jacobs. But I also would caution you about trying to delegate what should or should not be done. Try not to micro manage your care. Let the experts explain to you what they recommend and if it make sencse to you, let it go. Good luck.

[NedStark]

So it has been almost 3.5 years since this biggest mistake of my life. In that time, I have not gone to a beach or swimming pool once. I did lose weight as requested by the Doctors here. I am maintaining around 195 pounds which is still high for my height but a far cry from what it was upto.











Thoughts on how to proceed now? Obviously Covid-19 and the pandemic makes travel hard but would welcome all advice from the Doctors if they still post.

Any recommendations? If I do it now I'd want to do it right and sort of hope for a better cosmetic result. The left breast still pains to this day, especially the nipple. Some loss of sensation occurred directly above too which I think will never come back.

[NedStark]

Do any of the doctors still check the forum or no?

[Dr. Elliot Jacobs]

You still have a crater on the left -- it would require revision surgery to have any chance of improvement.

Dr Jacobs

[Miguel Delgado MD]

Yes, we doctors visit the site weekly.  Sometimes it takes a few days or so.  

[NedStark]

You still have a crater on the left -- it would require revision surgery to have any chance of improvement.

Dr Jacobs

Yes. I tried to send some photos to you Dr. Jacobs on your site but I kept getting errors. Will resend eventually or email. I just want this somewhat fixed and both sides looking somewhat symmetrical. It is why I never pursued the right side with the same general surgeon. Another issue has been Covid-19 and as these are elective cosmetic surgeries and with flights being rare or even restricted in some parts, hard to schedule anything. Do you think some of the pain I feel on the left side to this date is just scar tissue? I will defer to any cosmetic surgeon I see. I am thinking proper lipo on the left, proper stitching and kenalog injections could help. This time, will ensure proper compression vest and rolling as well as much silicone scar cream and polysporin for healing as I can. Been 3.5 years of no swimming, no shirt off at gyms. Just want this ended with. If it wasn't for Covid, I would have seen one of you fine doctors already.

[Dr. Elliot Jacobs]

Sorry to hear about trouble emailing photos.  Try sending them to me at my personal email:  dr.j@elliotjacobsmd.com.  Make sure the images are not too large.

As for Covid, obviously it is a factor but we are still operating on patients despite it.  For out of town patients, the NY state quarantine rules do not apply for patients seeking medical treatment.  We do, however, request a negative Covid test prior to your departure and another negative test within a few days of arrival.

Hope this helps.

Dr Jacobs