Revision Surgery tomorrow... PICS.... Is this Gland, Loose skin, crater ??

[relicfolio]

This will be my 3rd surgery.
1st surgery - excission/lipo
2nd surgery - just lipo (I had expressed that I was concerned that there was extra gland, Dr said it was loose skin


As you can see that on both the right and left side the nipples are still very puffy, unless cold. Also there seems to be uneven puffiness outside the nipple area. Is this excess gland or fat that also needs to be liposuctioned.

As far as the nipples go, my 2nd revision the doctor thought that they hang over during flexing was because I had excess skin. I questioned that because my gyne was not as serious as many others I've seen and who have had flatter results then me.

Dr's if you could please give me any advice on what could be my problem that I could tell the doctor.

Dr. Bermant, my surgeon was open to looking at your website like i had suggested to her.

Thank you everyone

[DrBermant]

[img][img]This will be my 3rd surgery. Last time, the doctor just did liposuction to try and countour, but I am wondering if it is gland still left over.

As you can see there on both the right and left side the nipples are still very puffy, unless cold. Also there seems to be uneven puffiness outside the nipple area. Is this excess gland or fat that also needs to be liposuctioned.

As far as the nipples go, my 2nd revision the doctor thought that they hang over during flexing was because I had excess skin. I questioned that because my gyne was not as serious as many others I've seen and who have had flatter results then me.

Dr's if you could please give me any advice on what could be my problem that I could tell the doctor.

Dr. Bermant, my sergean was open to looking at your website like i had suggested to her.

Thank you everyone

How do I post the pictures?

No pictures came across in your post. Correcting a puffy nipple complication is difficult sculpture. You should be looking at what your doctor's results are like before having surgery.

Surgery should be undertaken with confidence in the surgeon of choice. If you feel you need comment by others to advise your doctor, or you need to ask your surgeon to look at my website, why are you having the operation done by that individual?  These are issues that are much better settled way before the night before surgery!  What you see on my website are results I achieve with my techniques. Asking an artist to go to a museum and then give you something like you saw in that museum may or may not happen. You are better off looking at what that artist offers and see if such results are what you are looking for. My website is set up for public education. It lacks the refinement details a surgeon would need to duplicate what I offer. Putting that much detail on a public site would tend to lose the average reader.

Good luck on what ever you decide.

Hope this helps,

Michael Bermant, M.D.

[relicfolio]

The pictures are now up.

I was very confident with the Dr that I had chosen because she was someone who came highly recommended on this site, for the West Coast. I, like many people, browsed this site for years in fear of choosing the wrong Dr.

All I ask is an expert opinion on my pictures so I can go into the revision with knowledge of what I would like to see as a result.

[DrBermant]

The pictures are now up.

I was very confident with the Dr that I had chosen because she was someone who came highly recommended on this site, for the West Coast. I, like many people, browsed this site for years in fear of choosing the wrong Dr.

All I ask is an expert opinion on my pictures so I can go into the revision with knowledge of what I would like to see as a result.

Thank you for posting the images. You are missing many critical views of my Standard After Gynecomastia Surgery Picture set that show the interaction of the tissues while flexing, lifting arms up overhead. Those flexing views accent adhesion, scars, residual gland factors that are even more enhanced with the standard videos.

Sorry from what you show, the result is not satisfactory. That is why looking for actual examples of a surgeon's work is so much more important than using someone "who came highly recommended on this site" or for that matter by anyone else. Are your results something you like? If so why are you having your third revision? Are these results typical of your surgeon?  Did you check for examples of her work before surgery? Are you results similar to what you were shown? Where are the images of the results by those "who came highly recommended on this site?" Are there actual documentation of what that doctor did for those posters? Are those posts still here on the forum?

Some contour problems are combinations of deformities. I am not sure what you are hoping to achieve by the same person who gave you that chest. Revision surgery is an art form. Unless you have checked for images that have these components addressed, then you may be making the same mistake again.

My suggestion is to get your prior operative reports, before each surgery images, take a set of my Standard Pictures After Gynecomastia Surgery, yes you need to take time to read the instructions and follow them if you are trying to use images to base a discussion about what further surgery may have to offer, and seek another opinion from a surgeon who demonstrates such skills with actual examples with more than just a few photos. Some problems just do not show to the same degree when only one or 2 views are used. The in person evaluation will have more power with the touch and feel component, but I have seen many patients that the standard images are enough. Your deformity may be beyond a photo analysis and for that matter may be beyond current revision options. You cannot remove scars, only replace them with new scars. If enough resources are gone, there may be few options to make tissues look good while moving.

If your surgeon has demonstrated such skills, ask why you ended up looking like what your limited images seem to show. Sorry to be so blunt but if hitting your head against the wall hurts, why keep banging away?

Hope this helps,

Michael Bermant, M.D.

[relicfolio]

I had the revision done this afternoon.
The doctor was adiment that there was no left over gland or fat, but in fact excess skin. She is surprised that the skin did not retract enough because I'm pretty young, and my gynecomastia wasn't very severe.

She was very hesitant about trying anything and making it worse. What she ended up doing was cutting out a very small piece of my skin on the sides of the nipple area in order to stretch the loose skin tighter. She did it in very small increments to avoid the areola gettin stretched. I'll post pictures in a couple days.

[DrBermant]

I had the revision done this afternoon.
The doctor was adiment that there was no left over gland or fat, but in fact excess skin. She is surprised that the skin did not retract enough because I'm pretty young, and my gynecomastia wasn't very severe.

She was very hesitant about trying anything and making it worse. What she ended up doing was cutting out a very small piece of my skin on the sides of the nipple area in order to stretch the loose skin tighter. She did it in very small increments to avoid the areola gettin stretched. I'll post pictures in a couple days.

Unfortunately tightening the tiny male areola skin is a trap that can result in the Large Areola Complication of Reduction Surgery that I have described, defined, and demonstrated on my site. The forces to keep the male areola small need to be balanced when skin is reduced. It is a basic physics issue. The smaller male areola diameter means that the forces to pull that areola to a much larger size can result in major disfigurement as I demonstrate on that example on that sad patient from Australia who came to me for help. If so it takes time for that to show up. If enough skin is removed, the forces need to be balanced by a permanent buried suture. Hopefully that will not factor into your situation.

Hope this helps,

Michael Bermant, M.D.

[relicfolio]

Can you please link to this procedure. I was unable to find it earlier when I was looking

[DrBermant]

Can you please link to this procedure. I was unable to find it earlier when I was looking

Linking is no longer permitted by the new site owner. Email me a request if interested.

Hope this helps,

Michael Bermant, M.D.