Q about getting 2nd opinions for revision surgery?

[tonysoprano]

heres my dilemma : I had surgery 9 months ago and I was told that along with the glandular excision I had , also 15-20cc's of fat was lipo'd per side. Now that seems incredibly little liposculpture to me...
I can still grab the skin (and whatever's underneath there) of my chest area  way too easily between 2 fingers, and it just seems that there's a (un)healthy dose of fat there.

I spoke to my ps about this in a recent consultation (at 7 months post-op) and my ps wont do any more lipo (even if i pay) claiming that there is exactly the same ratio of fat there as on my abdomen, and removing more fat on my chest will be detrimental. -surely that cant be the deciding factor of it all.. .. why cant there be less fat on my chest then my abdomen? I mean, if this was the case, then most guys walking around with a little bit of a gut or lovehandles would have fatty chests, and in many cases even breasts...

how can I know for sure if my ps is correct, when saying that I cant afford to have any more fat lipo'd out?

I mean, if I get a second opinion, the second ps is just gonna say that yes theres still excess fat which he can and will take out, just so he can get the work...

Is this really this much of a catch-22 ??

(Im really not sure what to do now, regaRDING how to go about best planning the revision which Im planning to have at 1 yr. post-op (which will be march/april))

any advise from anyone , especially those who've had revisions/are planning one will be enormously aPPRECiated.

cheers,
Tony

[Hypo-is-here]

Do you have any pictures Tony so we could see what you are talking about?

A picture paints a thousand words as they say.

[tonysoprano]

Im putting some cash away to buy a digi-cam in the next few weeks so hopefully I'll be able to get some pics up sometime soon...

but what is your opinion on this dilemma anyway (without seeing any pics ?)

[nukem2k5]

I had rougly 800 cc's on one side and 1000 cc's on the other removed from my chest.  20-25% of this was glandular and the rest was fat.

I'm rougly 30 pounds overweight (so I have a bit of a tummy) and my chest was absolutely flat as wood and there was nothing underneath it once I had surgery except for my chest plate.  Over time my body has restabalized and I've noticed a bit of fat accruing where my breasts used to be.  This is probably the same thing your doctor referred to as your ratio being equal to your abdomen.  My point is that regardless of how much you take out, over the months it will eventually even back out to a stable level as the rest of your body (which makes me wish I was able to lose a bit more weight before surgery).

If you don't have a camera yet, could you at least tell is if you think you still have a breast problem?  Perhaps draw (in MS paint) a side-view of your chest / abdomen?  Needless to say, if you have a gut - as I do, you're still going to have a little flab where the breasts were but they aren't going to be boobs.

[Miclam]

My point is that regardless of how much you take out, over the months it will eventually even back out to a stable level as the rest of your body (which makes me wish I was able to lose a bit more weight before surgery).

I don't quite understand this.  If you just lose the weight now, wouldn't your chest fat also go away?  According to my surgeon, weight loss after surgery will improve the results.

[tonysoprano]

I had rougly 800 cc's on one side and 1000 cc's on the other removed from my chest.  20-25% of this was glandular and the rest was fat.

I'm rougly 30 pounds overweight (so I have a bit of a tummy) and my chest was absolutely flat as wood and there was nothing underneath it once I had surgery except for my chest plate.  Over time my body has restabalized and I've noticed a bit of fat accruing where my breasts used to be.  This is probably the same thing your doctor referred to as your ratio being equal to your abdomen.  My point is that regardless of how much you take out, over the months it will eventually even back out to a stable level as the rest of your body (which makes me wish I was able to lose a bit more weight before surgery).

If you don't have a camera yet, could you at least tell is if you think you still have a breast problem?  Perhaps draw (in MS paint) a side-view of your chest / abdomen?  Needless to say, if you have a gut - as I do, you're still going to have a little flab where the breasts were but they aren't going to be boobs.

thanks for your insight nuke. always very supportive you are mate!

what I meant is that my ps (original 1) is saying to me that  he wont remove any more fat from my chest via lipo, and that I shouldnt worry about it because - according to his measurements- I have the same amount of fat on my chest  as the amount of fat on the rest of me (ie. abdomen)... (which by the way is rather lean and trim, im 5'9ft and approx. 155 pounds .. very little of that is muscle though),

now Im just wondering what the helll difference it makes whether its the same as everywhere else... Its still more fat than I want to have across my chest

where is the golden rule that says that its preferable to keep the same ratio or amount of fat in a guy's chest relative to that of his abdomen ??
Does the ps sound likes hes spinning shhit ? or is it really a bad move to end up having a lesser amount of faT IN THE CHEST area, than the amount of fat that there is in the abdomen or elsewhere? ??

[tonysoprano]

Sounds like good advice from Nulem2k5.  I'm 3 months post op and I felt a little like you, but like nukem2k5 said its your body trying to restabilize.  I'm almost sure that if I had flat abs I would have a flat chest.

even when my torso and stomach area is pretty close to flat (ie. showing a six pack if I flex my abs) , my chest still has too much fatty tissue that I can both see and feel.
although my ps is saying that technically the level of fat is the same for both the chest and the abs ( implying that everyone would need to have visible abs to have a flat chest, or on the flipside that everyone with a little bit of a gut is going to have some degree of boob-age/gyne - and thats just not the way Ive seen it on other men, from my experiences of observing them and their chests)

[Miclam]

where is the golden rule that says that its preferable to keep the same ratio or amount of fat in a guy's chest relative to that of his abdomen ??
Does the ps sound likes hes spinning shhit ? or is it really a bad move to end up having a lesser amount of faT IN THE CHEST area, than the amount of fat that there is in the abdomen or elsewhere? ??

Honestly, I think when a PLASTIC SURGEON is trying to talk you out of surgery then you really don't need it.  Clearly he's not looking out for his own interests here, since if he was he'd just do whatever you asked and count the money.

[tonysoprano]

Honestly, I think when a PLASTIC SURGEON is trying to talk you out of surgery then you really don't need it.  Clearly he's not looking out for his own interests here, since if he was he'd just do whatever you asked and count the money.

He agrees that I need a revision for the nipple scar tissue and possibly a little more gland , but is refusing to do more lipo.

he's talking me out of it because he is the one who performed the surgery, and prides himself on performing as few revisions as possible, and getting it right the first time. Im sure he is especially unhappy performing revsisions on patients who had such minor cases to begin with also.

either way ... if he tells me there isnt much more he can do, and any more is too risky , and a second ps might say that he can certainly achieve more in terms of this or that (perhaps to get more work), well ... what is one to believe ?
thats my big dilemma. I can see that my chest is still far from being right or near flat enough, and I have my ps saying that he cant/wont do much more , and possibly second and thirs opinions from other ps's might be contradictory to that..... so how can I know what is truly going to be my best option with minimal additional  risks.

[Preds]

My opinion would be he is probably telling the truth.  He is admitting that there could be some more gland to be excised in a revision so why would he lie about the fat?  That is if I read your post correctly.  He may be afraid by taking too much then the sculpting would looke deformed.  Kind of like a famous "pop" singer we know and his "peter pan nose"  Just a thought

[nukem2k5]

I know what you mean, I just think that if he takes out more fat from your chest now, over the months it will just even back out to how it is currently.  Would you mind posting a few pics?

[nukem2k5]

I don't quite understand this.  If you just lose the weight now, wouldn't your chest fat also go away?  According to my surgeon, weight loss after surgery will improve the results.

Weight loss will improve the results, however it's pretty typical that chest fat is some of the hardest to lose through exercise.  That's why I wish I could have lost more weight prior to surgery (so I would have less coming back now) - losing chest fat is much easier through lipo than by exercising

[tonysoprano]

Weight loss will improve the results, however it's pretty typical that chest fat is some of the hardest to lose through exercise.  That's why I wish I could have lost more weight prior to surgery (so I would have less coming back now) - losing chest fat is much easier through lipo than by exercising

Do you think that losing too much weight in the weeks before surgery , or being dehydrated could give the ps the impression that there is not that much fat on your chest, or that there isnt enough fat to risk doing too much lipo (which you would otherwise need on a normal day of a normal month), and hence lead to the ps performing less lipo than he might really need to?

[nukem2k5]

I doubt that the shape and density of your chest changes that significantly due to dehydration.  As for having lost weight before surgery, this would be a good thing.  I would think that the surgeon could merely press on your chest during surgery to feel the mass of fat under the skin.  

In my situation, after surgery there was, as far as I could tell, absolutely no fat underneath my chest, but since then it seems to have restabalized and there is now a fair amount of fat (but not boobs) underneath my chest which seems in line with my being overweight.

Would you mind posting some chest pics?

[tonysoprano]

am looking to buy a digi camera this week, so hopefully I will finally  be able to put up some .