Would a revision surgery be worthwhile? Surgeons opinion sought... (pics inside)

[billowy]

Hi,

I had gyne surgery 10 years ago (glandular plus some lipo). I was never completely happy with the results. The nipples are distorted and uneven -- the right in particular looks odd because it kind of folders over on itself. Both sides also project forward, especially when I'm warm, and I still don't feel comfortable wearing a t-shirt.

I'd really appreciate a surgeons opinion on whether a revision surgery could improve upon the appearance of my chest, and what kind of procedure(s) could be done.

Thanks!

[Dr. Elliot Jacobs]

It appears that there is residual tissue on the left and too much tissue removed on the right.  There may also be scar deformity of the right nipple.

Most of these problems could be improved (maybe not made perfect, though) with revision surgery.  Suggest you research an experienced gyne surgeon in your area.

Dr Jacobs

[billowy]

Thanks, Dr Jacobs. I've decided to go ahead with a revision surgery.

[Rocky76]

Dr. Jacobs do you do revisions?

[Dr. Elliot Jacobs]

Yes, I do revisions.

Revisions are difficult.  We are dealing with not only fat and breast tissue, but scar tissue as well from prior surgery.  We may be dealing with residual tissue, over-removed tissue, or combinations of both.  In addition, there may be poor surgical scars -- which sometimes can be improved but not totally eliminated.

Revision may require additional, very precise liposuction of surrounding excess residual tissues and/or fat grafting or fat flaps to fill in areas of  prior over-resection (crater deformities)  -- or both.  And sometimes excess gland tissue (under the areola) has not been properly removed and therefore this must be addressed as well. Further, there may be lax skin or malposition of the nipples which have to be corrected.  Finally, no additional surgery may be required at all -- simply a steroid injection to melt away scar tissue. And sometimes, it is possible that nothing more can be done to improve the situation.  Only a consultation and examination can determine what is truly necessary. Please bear in mind, secondary or revision surgery is much more difficult and less predictable due to the natural scarring processes that result from the initial surgery.  In a sense, you do not have "virgin" breasts.  Therefore, improvement -- and sometimes significant improvement, but not perfection, is the goal for these operations. That is what we call "realistic expectations."

The way to limit the need for revision surgery is truly to do your research and find the proper gyne specialist so that the operation is done properly in the first place!

Dr Jacobs

[Rocky76]

Yes, I do revisions.

Revisions are difficult.  We are dealing with not only fat and breast tissue, but scar tissue as well from prior surgery.  We may be dealing with residual tissue, over-removed tissue, or combinations of both.  In addition, there may be poor surgical scars -- which sometimes can be improved but not totally eliminated.

Revision may require additional, very precise liposuction of surrounding excess residual tissues and/or fat grafting or fat flaps to fill in areas of  prior over-resection (crater deformities)  -- or both.  And sometimes excess gland tissue (under the areola) has not been properly removed and therefore this must be addressed as well. Further, there may be lax skin or malposition of the nipples which have to be corrected.  Finally, no additional surgery may be required at all -- simply a steroid injection to melt away scar tissue. And sometimes, it is possible that nothing more can be done to improve the situation.  Only a consultation and examination can determine what is truly necessary. Please bear in mind, secondary or revision surgery is much more difficult and less predictable due to the natural scarring processes that result from the initial surgery.  In a sense, you do not have "virgin" breasts.  Therefore, improvement -- and sometimes significant improvement, but not perfection, is the goal for these operations. That is what we call "realistic expectations."

The way to limit the need for revision surgery is truly to do your research and find the proper gyne specialist so that the operation is done properly in the first place!

Dr Jacobs

Thank you Dr... I will be contacting your office soon about a consult. Hopefully something can be done to improve my situation.