Author Topic: Surgery Experience with Dr Naveen Rao, Apollo Hospitals, Bangalore  (Read 5516 times)

Offline thegynoman

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MY GYNECOMASTIA SURGERY EXPERIENCE WITH DR. NAVEEN RAO, APOLLO HOSPITALS BANGALORE


I had my surgery done by Dr Naveen Rao at Apollo Hospitals, Bangalore last week. Today is Day no. 12 as I am writing this. This write-up experience is completely personal, so kindly take whatever you feel worth taking.

A BRIEF HISTORY
I am 28 yrs old. As far as I remember I am suffering from this condition since or before my college days. While I never had a rock flat chest since my teenage but it was not that bad. But it has been on the downfall since then.
Like other gyno-sufferers I totally left wearing t shirts, even formal shirts were not able to hide those. Finally I stuck to thick denim or corduroy shirts which somehow camouflaged the boobs, but not entirely. Only at home I used to wear t shirts and whenever I had to go to open the door or when guests come, I change into thick shirts and go in front of them. I have never got bare chested in front of anyone since very long. The constant cognizance of myself regarding my chest was killing me every single day. Until April 2017, I didn’t have the courage to search about this condition on web. I also often feared of having breast cancer and similar stuff. The biggest fear was that If these breasts grow even more what will I do. But eventually I gained courage and started searching on net and after a spree of research, I got a bit relieved when I came to know about the condition and was convinced that I am not alone and many people have this and they also feel the way I feel and that surgery was the only gold standard for this treatment. So, I made up my mind that I am going to get this done at the earliest. I only took my girlfriend into confidence. That said, I never consulted any doctor physically.
THE SEARCH FOR DOCTORS
1.      While searching for random videos, I came to know about Dr Prashant Yadav from Dezire clinic Pune. He replied to my mail with detailed answers and with an estimated cost of Rs 45000 total. He also replied to my further queries in details. He is a renowned doctor and a quick google search will give you excellent reviews of him. So, I tried to find contacts of his ex-patients but could not get it.
2.      I also contacted another doctor whom I didn't find like going with for various reasons.
3.      Meanwhile I had started following this forum and came to know about Dr Naveen Rao from Apollo Bangalore. I got the mail-id of a person from this forum who had done this surgery from Dr Rao. He was more than satisfied with the surgery. So, I mailed Dr Rao about my condition. He asked me to send some pictures of mine. He said I am having grade 2A gynecomastia and answered some of my other queries. His quote was Rs 68500 + 15 % VAT.
So I took the plunge. I decided to go with him as his credentials were impressive. I asked him to book the surgery date in August 2017. He sent a mail that he has blocked a slot for Aug 8th, and to contact him 15 days before surgery to complete the formalities.  So, I was set. I was in constant touch with his ex-patient ( of this forum) I talked about earlier, as well. I disclosed about the surgery with my parents and my younger brother, and my girlfriend. They were hesitant initially but finally got convinced.
PRE OP MONTH
I mailed him to remind him about my blocked surgery date in Aug 8th. Now surprisingly, he replied that he will do the surgery only if I pass certain tests, and gave me a list of tests : Estrogen, Testosterone, pt/APTT, FSH, LH, KFT, LFT, electrolytes, CBC, blood sugar etc. I took the tests and mailed him the report. Reports were normal. Then I asked for surgery date booking formalities. It was like I was pleading to get the surgery done. In fact I had booked our flights, guest house and applied for leave and in no case I could postpone the surgery. So, I was asked to pay Rs 5000 advance booking for surgery ( to be adjusted into total cost of surgery afterwards) by net banking. I paid the amount and was getting ready for surgery.
6TH AUGUST
I reached Bangalore in the evening and went to stay at a guest house, with my father. Next day(7th Aug) I had scheduled a consultation with Dr Naveen Rao at 10 am.
7th AUGUST-FIRST PHYSICAL CONSULTATION WITH DR NAVEEN RAO
We reached Apollo Banerghatta road at 8:30 am. Upon reaching the counter, we were directed to a yellow building to the right where he sits. After some quick registrations, we entered his room.
Before asking me to sit, he asked me to take my shirt off and show my chest. I did. Then he started explaining with diagrams. Firstly he tried to make us understand that gynecomastia is not a medical problem rather a psychosocial problem. We can live with it for our entire life if we are cool with it. He then explained the reasons, types of gyno, surgical method. He said he will be doing Lipo-Excision ( liposuction + excision of glands) and that the most imp part is leaving 10% gland to support the nipple otherwise crater deformity may arise. But leaving 10% glands is also a risk that if underlying problems are not arrested then gynecomastia may again come back from that 10%. So, that is like playing a gamble basically. But he said that recurrence occurs only in 1% of cases. He also said about post op complications like scarring, uneven chest. Then finally he asked me to go outside and think for an hour and revert if I really wanted to get the surgery done. We came out. My father was like ‘’What now? Want to do or not?’’ I said, obviously yes. I can’t let this condition kill my life. We have come here for this''. So, there was no second thought and we waited for Dr Rao to get free and entered inside and said ‘’Yes Sir. I am ready to do this’’. Then he told me to not to take any food and water after 12 midnight and report to the hospital before 5: 30 am. He gave me something written PAC ( I guess it was Pre Anesthestic Checkup) to meet the Anaesthesiologist. He asked his attendant to escort us to the anaesthesiologist. The anaesthesiologist we met was actually a junior doctor. He took all my history and other data and finally spoke to some lady on phone ( this lady was the senior anaesthesiologist who will be actually there during surgery the day after), explained her about my blood reports and finally said ‘’he is fit for surgery, mam’’.
Then we returned to the guest house. I had my dinner at 8 pm. Roti and Alu govi plus a mixed fruit juice. The juice after the food was a blunder. It gave me hyper acidity and adding to it was my pre-op anxiety. I started getting an extremely bad headache and acidity. At 9:30 pm, I received a message from Dr Rao which read '' Pl reach the hospital latest by 5: 30 am tomorrow’’. I tried to sleep early but could not.
8th AUGUST: SURGERY DAY
I woke up at 3 am and couldn’t sleep any more due to excitement. So, at 4:30 am, we were ready at the doors. Booked an Uber. The driver was driving very fast and my distance from the hospital was decreasing with each second passing. I really wanted the trip to get longer as I was slowly getting scared. My surgery was nearing. Heartbeat was increasing.
We somehow reached Apollo by 4:55 am and reported at the Admission counter. Some quick paper works and payment of Rs 60000 ( adv ), then we are asked to go to 5th floor. We reached the daycare ward allotted to me and get admitted at 5:10 am. The nurses asked me to change the clothes to a hospital gown ( you can’t even wear an underwear under the gown, literally nothing). It was very weird, I was feeling like I am partly nude(But actually it covers you completely, so don’t worry). Then I was asked to remove rings, chains, keep away mobiles and all. Then I signed on a few documents (the consent papers for the surgery). I tried reading it but closed it mid way and signed on it. I advise you not to read that. You know why J .
Anyway, the barber came in 10 min late and shaved my chest off. An IV was started on me and a few pre-op medications were administered. Everything was so smooth. At 5:40 I was asked whether I wanted to pee or not. Thereafter I was wheeled in to 2nd floor where the OT was. Then my father was asked to stay outside, he couldn’t go further. I was made to wait in another room for some 10 min where I saw other patients waiting for their surgery. I was like why have you made me lay down like a patient when I am absolutely fine and can run a marathonKJ!!!
Then a lady came and greeted me. She was the senior anaesthesiologist. She tried to make me feel easy and went. Then at around 6: 10 am, I entered the dreaded OT with that green coloured operating table with other equipments.
Dr Rao was waiting there. He asked me to drop the gown from above, took some photographs(without face) of my chest from various angles. This was for their records. Then he asked me to lay down on the operation table. I was getting nervous. Heart rate had increased. Then they put ECG leads on my back. There were 7-8 other surgeons inside the OT including the doctor. Dr Rao, anaesthesiologist, asst surgeon, asst anaesthesiologist, and few other people. They all introduced themselves to me and tried to make me comfortable, but how could I? It was natural, I was shaky. Dr Rao then held my hand and said nothing to be worried which did get me some courage. Then the anaesthesiologist told me that we will be making you sleep within few seconds and asked me to take 4-5 deep breathes. And as far as I remember, I had taken 2 or maximum 3 breathes after which I open my eyes in another room.
Yes!!! The surgery was over. It was like 1-2 minutes have passed. But, It was approx 11:30 am I guess. I was feeling extremely tired. The moment I regained consciousness I felt like I could not breathe. The oxygen mask was still on me. After trying 2-3 times I could breathe properly and normally. Then the nurse came and took out the mask. I was breathing absolutely normal. I tried to ask the nurse something but could not. Voice was not coming out. I tried again then was able to speak a word or two. My throat was sore. Voice was very low and harsh. Quite strange that before a moment I was fine, and now I am tired, can’t talk, blabbering and all. Then I saw the anaesthesiologist come to me. She took my name and asked how I was doing. I said fine. She came to me twice. Then I saw my father, looking very funny wearing those hospital gowns and coming to me. I was like very sleepy. Slowly talking to him and sleeping in the next moment. Then I saw a nurse showing three jars( my glands and fat) to my father. Then at about 1:00 pm I was given the clearance to move to the daycare ward where I had been admitted in the morning. I took a few selfies and all. Slowly my sleepiness was reducing. Then Dr Naveen Rao came to my daycare ward and checked me and told me that everything was fine. Gave me some important instructions to follow thereafter( which I wanted to record but couldn’t. I advise you to write down or record the instructions because you would be sleepy and might not recollect them later). I was given my lunch which was complementary. Rice, dal, khichdi, paneer and coconut water. I only took the rice , dal, khichdi and the coconut water. No mood for paneer then. I didn’t feel any vomiting or something as people often complain after general anaesthesia. Then I had a cup of coffee. My younger brother who works in Bangalore came in the evening. We laughed a few jokes. I, really, was enjoying my time there. The feeling of gynecomastia gone and a new dawn was just so fresh and amazing. I was trying to let it sink in that I had already changed. The gyno is no more!!!
I was on continuous administration of antibiotics and other medication. I was talking, taking official calls, whatsapping and all.  Doctor had said there are a few vital checklists to be checked before discharging, like:
1.      No vomiting
2.      Balance while walking
3.      Proper urination
I did get passed in all the above points and hence I was cleared for discharge at 7 pm. I got a call from the admission desk for the payment of balance (some Rs 16000 balance). My father and younger brother went and made the balance payment and purchased a few post-op medicines. I changed my dresses. [ I advise you to bring buttoned shirts on the day of surgery because you can't wear T-shirts as you can't raise your arms] .At around 7:10 pm I thanked the nurses ( who did amazingly awesome job throughout the day ) and came out of Apollo. I was steady but walking very slowly. Gave Rs 50 to the driver as tip and told him to drive extremely slowly so as not to pull apart the stitches. He drove very carefully thereafter.
Post surgery I visited the doc twice. On Day 2( Day 0 = Surgery day) for bandage removal and pressure garment. Then on Day 5 for his review on my recovery and instructions for next 3 months.
Pain : The only pain I had throughout the surgery day was when I was given the needle prick for IV. Thats it. No pain whatsoever for the day because you are on general anesthesia . Of course they will butcher you, but you are on anesthesia. But yes, if you try to move your arms then you will have pain, but normally you don’t have any pain.
Hospital and Nurses: Very professional and caring. Hassle free stay.
Price : Rs [ 68500 + GST (18%) + 3500 ( compression garment) + 800 ( medicines, aloe vera cream, gauges etc.) ] = Rs. 85000 approx. No other hidden cost. Cost may be on higher side, but I wanted the best surgeon, price wasn’t a concern for me. You may try and bargain, I didn’t do that. I don’t think they will reduce the price. This was a daycare package.
Food: Not quite good, especially for me being from another state, I frankly didn’t like the food.
Doctor: Dr Naveen Rao is learned, knowledgeable, genuine and straight forward. Doesn’t do any kind of false exaggeration. For me personally, he has given me this new life and I will be ever thankful to him.
Today is 12th day post-op. My chest is flat as I always wanted. Till now everything going well. I returned on 7th day of surgery. My father carried all the luggages and did all the work at the airport.
The real challenge is after surgery when you get pain while extending/ raising your arms. You have to sleep in a certain manner( elevated or plain doesn’t matter actually). Cannot open/ close a laptop, cannot close the door bolts, cannot drive, cannot open a jammed water tap etc. If you have studied physics, then the more torque needed to do certain work, the more strain will be on your chest. As simple as that. One advice is that if you require any kind of lifting then you move your body in that direction and lift it. Use your full body for even lifting a glass. Rotate, bend down, bend up. But don’t stretch your arms. Do every action slowly. If you have slept and your companion has left then you will have a hard time getting yourself up from bed. You can’t rise to sitting position from sleeping position on your own. If you try then your chest muscles will be taken to task and will make your sutures erupt. Somebody needs to take care of you at least for a week. They say you can go to office within 3-4 days. But I will advise you take it easy for at least a week. You can’t drive for 21 days. Not even car.  Wearing the garment 24X7, removing it daily, removing tapes, bandages and massaging aloe vera, bathing, then again putting the tapes and garment is extremely cumbersome. But you have to do it. There is no other option. You can’t afford to ruin your results. So, I request you to have somebody with you for at least a week. You might need someone to help you in your daily activities for two weeks(one week compulsory, 2nd week optional). Because today is 12th day, still I am not able to take my shirt off on my own completely. Arms are raising smoothly upto 90 degree. Above that they hurt a bit and I don’t want to take any risk and ruin the results. So, I take help from my family members. So, I request you people also to kindly involve your parents or near and dear ones in this process. It will help you a lot and also help in healing. Going for surgery alone is not bravery rather stupid. Their support after surgery is inevitable. The importance of this, you will understand after surgery.
Till now there is no seroma/ haematoma. Little swelling is there. The intermittent itching sucks. Chest contour is uneven. Initially you will hesitate to touch the chest area to massage aloe vera but eventually you will get used to it. For first week, often I got sharp pain at the stitch area. Now its gone. Also I felt like fluids flowing inside my chest in the first few days. He has said seroma might form within 1 month. I need to be careful. If seroma forms I will need to contact some local surgeon. I can't go back to Bangalore. Well, its very early. Lets see whats there in store. I pray and hope the journey is smooth hereafter. I will update in coming months about my results. I will post if any seroma/swelling forms. Bye for now.

« Last Edit: October 08, 2017, 06:50:55 AM by thegynoman »


Offline thegynoman

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21st DAY POST-OP UPDATE
No pain. 70% bruising gone. No issues in basic household lifting work. While, I haven't yet tried to lift more than 3 kg objects so no heavy duty works at present. But when I raise my arms vertically above my head there is a pulling force/inertia from my ribcage which doesn't allow it completely, though its improving day by day. Probably another week for complete mobility of arms. Will wait patiently. Massaging Aloe Vera cream daily for 10-15 min. Wearing the compression garment 24X7. Can start driving car from tomorrow. Have already started wearing T shirts from which I had banned myself since years and years. You can see in the pics attached in previous posts how big my glands were and how embarrassing they would be looking with T shirts on. The feeling of a flat chest and sporting a T shirt now is priceless!!! :-)  
Whether the overall swelling has reduced or not I am not able to figure out... you can see the pics and comment. But there is a small pocket of swelling beneath my left areola, apparently its seroma. I talked to my Doc (on telephone) and he advised me to do a sonogram to see any fluid collection. Tomorrow I am going for it. If there is any significant seroma I will ask a general surgeon to aspirate it ( since I am far away from my surgeon). The task of finding the right surgeon is not easy. He must understand this process of this surgery and more importantly about seroma/hematoma. Lets see how it goes.
Any other questions are welcome. Will update soon. Bye.
« Last Edit: September 01, 2017, 11:53:31 PM by thegynoman »

Offline thegynoman

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QUICK UPDATE : 26TH DAY POST SURGERY
Yesterday I did a 40 min-long ultrasound to find out any seroma. They did find a minor seroma/fluid collection underneath my left nipple. My surgeon told that its very minor and there is no need of any aspirations. So, I hope it will absorb eventually.  

Offline thegynoman

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32 DAYS POST OP:
Brusing : Almost gone
Arm mobility : regained 85-90% movement of arms
Swelling: Normal
Exercise: Not started any exercise yet
Aloe vera Massage: Daily 10 min
Compression garment: 23.5 hrs a day
There is little puffiness under left nipple. I also feel a little hardened tissue under that nipple. Rest all OK. Pics attached.

Offline nonini

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Pretty good result, Aloe Vera doesnt do anything for scars. Look for a pure silicone gel for the scars.

Offline thegynoman

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Pretty good result, Aloe Vera doesnt do anything for scars. Look for a pure silicone gel for the scars.

Thanx brother for your input...but my doc hasnt said anything about silicon gels. He just advised me to massage alo vera...And said all that swelling will go away on its own and if scar tissue develops he wl give injections after 3 months. BDW what r the functions of aloe vera and silicon gel? 

Offline thegynoman

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52 DAYS POST OP :
Still wearing compression garment almost always. 
Massaging elovera cream once daily.
+ ves: 
Bruising gone completely, chest looking close to normal. People can't make out if I had any surgery. 
Started exercising with light weights, slow and confined movements. Arm movements are normal. 
Started sleeping on sides. Not yet started sleeping on chest though. 
- ves :
Hard, lumpy [4 cm X 1 cm ] scar tissues ( probably) formed on both sides. When I roll my palm from upper chest to stomach I can absolutely feel the new hard tissues like small stone mountains. They are just underneath the lower half nipple areolas on both sides. These are new born and were not there just after surgery in any form. The right chest is still normal but the left chest has become a little puffy, probably due to the scar tissue formation. Asked my surgeon (on phone) regarding the puffyness, he said these are scar tissues and the period of maximum scar tissue formation is 1 month - 3 months post op. So, no need to worry. This is normal and temporary. I shall wait till December first week for getting kenalog injections for flattening the scar tissues.

Offline MammaryMan

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"But leaving 10% glands is also a risk that if underlying problems are not arrested then gynecomastia may again come back from that 10%."


Prostate cancer patients undergoing hormone blockade very often develop gynecomastia. To help prevent this a short course of radiation (3 to 4 Gy) is sometimes  administered to the breasts. Was this ever mentioned as a prophylactic measure to prevent regrowth?

Offline thegynoman

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"But leaving 10% glands is also a risk that if underlying problems are not arrested then gynecomastia may again come back from that 10%."


Prostate cancer patients undergoing hormone blockade very often develop gynecomastia. To help prevent this a short course of radiation (3 to 4 Gy) is sometimes  administered to the breasts. Was this ever mentioned as a prophylactic measure to prevent regrowth?

No friend, I am not aware of this. He said only 1 % of patients undergo regrowth.

Can you pl let me know what is the potential of that 10% left out glands? Even if it regrows then what will be its size? Somewhere I read on this forum that the left out glands are very less and the response to stimuli (whatever it may be) will also be less. So if there is regrowth then it will be limited. Can anyone enlighten on this? 

Thank you.

Offline gyno678

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Thanks! for the detailed post bro... very helpful :)

I have the following queries please:
# Is someone's help really needed in the first week? Can't we come out the bed ourselves very slowly, is that really hard? (You had mentioned that the sutures might break)

#Can one wear and remove the compact vest oneself? Is external help needed? (I mean folding your forearms and reaching behind to 'close' the vest?)

# Do you notice any crater deformity on nipples now?

# I  guess the sutures are dissolvable ones? And is it OK to get them wet while taking bath?! How sooner can you have first shower after surgery?

# I heard that you need to wear the vest for 6 weeks? But you are still wearing it? Is that needed beyond 6 weeks, how long are you planning to wear it?

Look forward to your reply, please...

Offline thegynoman

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Thanks! for the detailed post bro... very helpful :)

I have the following queries please:
# Is someone's help really needed in the first week? Can't we come out the bed ourselves very slowly, is that really hard? (You had mentioned that the sutures might break)

#Can one wear and remove the compact vest oneself? Is external help needed? (I mean folding your forearms and reaching behind to 'close' the vest?)

# Do you notice any crater deformity on nipples now?

# I  guess the sutures are dissolvable ones? And is it OK to get them wet while taking bath?! How sooner can you have first shower after surgery?

# I heard that you need to wear the vest for 6 weeks? But you are still wearing it? Is that needed beyond 6 weeks, how long are you planning to wear it?

Look forward to your reply, please...

Hello bro! my ans to your questions :

1. See, without support of our arms if we try to sit up then all the pressure will be on your chest and belly. My case was kind of severe ( u can see my before pics). So may be my chest was more butchered during surgery. So, it was extremely difficult to sit up from sleeping position for first 5-6 days.  Also, my doc had warned me against doing so using my arms for first few days. It would definitely expand ur chest which is not wise to do. But if your case is minor gyno, you might feel less pain while doing so. Differs from person to person.

2. You can wear by yourself but it might be difficult, you might feel the pain while doing so.

3. No crater deformity. Instead, I have developed some hard as well as puffy scar tissues (probably) underneath my both nipples, although they are less bothersome. 

4. Sutures are dissolvable in my case. You can have your first bath on Day no. 3. I took bath on 3rd day post op.

5.  Yes, its seldom necessary after 1.5 months. But my doc advised me to wear it as long as I am comfortable. Since I developed some seroma (which I couldn't treat or aspirate as I am far from my doctor), I had to wear it for long. Even now after 2 months post op, I am wearing it as long as I am comfortable. After all we all want best results, so whats harm in wearing it. In fact it gives me a little toned look as well!

with regards,

Offline gyno678

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Thanks! again friend. 
One query on bathing part :)
So, wouldn't it be bad to take bath just on third day, since as the cut might get wet(water may seep also) and cause infection..
Also, I hope dissolvable sutures mean that you really don't have to do anything to remove them after healing. Will the thread get removed itself? Just wanted to know..

Offline thegynoman

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Thanks! again friend.
One query on bathing part :)
So, wouldn't it be bad to take bath just on third day, since as the cut might get wet(water may seep also) and cause infection..
Also, I hope dissolvable sutures mean that you really don't have to do anything to remove them after healing. Will the thread get removed itself? Just wanted to know..

No dude...bathing is fine on Day 3 in my opinion...but ONLY after bandage removal and first dressing at the hospital. 

U need not think about the sutures. They will vanish on their own. I don't see them now, although the ends of the suture were visible for the first month.

All these are minor ones and u shdnt b worried about them now..



 

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