Getting Revision Done Right

[eliliah]

I have had my initial Gynecomastia surgery done a little over two years ago. I had full blown Gynecomastia (about a B+cup) from being 12 years old from being obese and then "skinnying out" and weighed the same 150 at 18. The doctor informed me that I would need a revision before I got my surgery but I have yet to get one and have not had the resources to be able to. I have noticed over the years that the skin has seemed to tighten and I practically have no scarring (thanks to the amazing doctor I found here) but I am still aware that there is gland tissue left over and that I have "loose skin" I suppose I am not sure if I have an actual crater on my right side because their is a substantial amount of grabbable tissue tissue well my left side looks much worse but there is barely any tissue but it hangs more.  Anyways, I am just wondering what are you all's suggestions for revision for skin and leftover gland issue and? I am honestly a bit scared of it because I have seen pictures of people with giant enlarged nipples and scars. I attached pictures below. I don't know if this

[Dr. Elliot Jacobs]

You do have a crater deformity on the right and some lax skin (probably secondary to your prior obesity).

This can be a very tricky revision and would recommend you not rush into anything.  Suggest you consult with an experienced gyne surgeon to see what your options would be.

Good luck.

Dr Jacobs

[eliliah]

You do have a crater deformity on the right and some lax skin (probably secondary to your prior obesity).

This can be a very tricky revision and would recommend you not rush into anything.  Suggest you consult with an experienced gyne surgeon to see what your options would be.

Good luck.

Dr Jacobs

Dr. Jacobs,

Would you recommend going back to the surgeon who I had my first surgery with if these are the results? I don't want to hold it against the surgeon but I was also told that I would get the revision for a few hundred dollar amount and then it turned into 4000 after the surgery but I don't expect any handouts and know that would be the same price or more if I went to another surgeon...Is there any surgeons who specialize in revision? Thank you for your advice

[Dr. Elliot Jacobs]

You have to get your head together about whether it is money or the best possible result.  If it is a question of money, then go back to your surgeon and see what he has to say.  He may be willing to give it another try or he may honestly say that he doesn't have the expertise to revise it properly.

As for revision specialists, that is a real conundrum. Gyne surgery alone is a mini specialty within plastic surgery.  A revision specialist within that small group is even more rare.

Speaking for myself, I have seen an increasing number of patients over the years seeking revision surgery.  Most of the time, something can be done to improve the situation.  Notice I said "improve."  Doing secondary surgery (I have even done 4ths and 5ths) is more difficult and less predictable due to the deformities present as well as the predictable scar tissue under the skin, which affects how the tissues move, how they react to anesthesia, etc.  That is why I always play down what type of results I can get.  Fortunately, most of my revision patients are satisfied with their results.

I very very rarely have to revise my own cases.  Reason?  I never declare an operation to be over if I feel there is any indication of a contour deformity, crater, etc.  It is usually fixable at the initial surgery if it is recognized.  In the football vernacular, "The best offense is a good defense."

Dr Jacobs

[eliliah]

I actually meant to revise that post before I posted it but the surgeon stated that he would remove the loose skin and also remove the rest of the gland underneath both sides...would this be an appropriate route in this situation? Thank you.

[Dr. Elliot Jacobs]

I'm sorry but I cannot provide you with specific advice without examining you in person. 

Dr Jacobs