Post-Op Unsatisfied

[irishguy18]

Hi guys,

So, basically, I've had two operations so far but have been left with dish-deformity/cratering.

I've had a consultation with a surgeon here in Ireland (Dr. Alam) and he says that my current problem is to be expected when a surgeon employs the technique that was used on me i.e. no liposuction - just excision of tissue.

My two previous operations have been covered by VHI health insurance (which is not the same as - but similar to - getting procedures done via the NHS in the UK) who cover all costs apart from liposuction (as far as I'm aware) as it's classified as cosmetic in relation to gynecomastia.

My new surgeon (who's private by the way) recommends his procedure which uses Vaser lipo. He's pointed out that my problem is not severe and would respond well to surgery. However, I'd like to get your opinions before I shell out around €4,000.

Is Vaser lipo something a surgeon can do drastically wrong? Should I consider saving another grand or so and try to get my procedure done with a more frequently recommended surgeon in the UK?

http://img220.imageshack.us/i/dscf2868s.jpg/

http://img341.imageshack.us/i/dscf2870i.jpg/

[Rocky76]

If it where me personally... I would lose weight and workout that chest hard. If fat in the chest area is what's causing the now depressions where the Gyne tissue was removed then just reduce the fat in your chest. I wouldn't do the lipo until I did that first. To many risks with it and it's hard to undue if at all possible. I'm not a fan of Lipo at all....to me it should only be done in the most extreme cercumstanses where being lean and working out wouldnt alone do the job.

[DrBermant]

Hi guys,

So, basically, I've had two operations so far but have been left with dish-deformity/cratering.

I've had a consultation with a surgeon here in Ireland (Dr. Alam) and he says that my current problem is to be expected when a surgeon employs the technique that was used on me i.e. no liposuction - just excision of tissue.

My two previous operations have been covered by VHI health insurance (which is not the same as - but similar to - getting procedures done via the NHS in the UK) who cover all costs apart from liposuction (as far as I'm aware) as it's classified as cosmetic in relation to gynecomastia.

My new surgeon (who's private by the way) recommends his procedure which uses Vaser lipo. He's pointed out that my problem is not severe and would respond well to surgery. However, I'd like to get your opinions before I shell out around €4,000.

Is Vaser lipo something a surgeon can do drastically wrong? Should I consider saving another grand or so and try to get my procedure done with a more frequently recommended surgeon in the UK?

http://img220.imageshack.us/i/dscf2868s.jpg/

http://img341.imageshack.us/i/dscf2870i.jpg/

Crater Deformity Complications come in many different degrees. Most have both a static component, a hole or defect, and an animation component: how it moves - tissue stuck down. Reconstruction of a hole by digging the walls of the hole down to the holes depth is, in my opinion a terrible solution. Fixing a hole by extending the deep hole component and ending up with a wider hole makes little sense. This becomes more of an issue when there is a dynamic component. The hole walls can be a resource for the reconstruction, filling in the defect with living tissue still carrying a blood supply that will permit the stuck down parts to move naturally. That is why looking at this problem in motion is so critical. An entire chest now stuck down is a terrible solution to a crater problem.

Standard After Gynecomastia Surgery Pictures can better demonstrate subtle issues after surgery that just the limited views posted. Flexing and moving the arms tend to show off issues of the sculpture, how good, or possible defects. That is why I include them as part of my documentation, evaluation of my patients, and progression of my after surgery sculpture on my website.

Surface tissue held down to deeper tissues can look terrible on animation. Gynecomastia Movies are even more critical in showing the details of the problem. Here is one such example of Movies Showing Tissue Evolution After Revision Gynecomastia Surgery. That defect was too much tissue left behind, but the progression of healing demonstrates the issue (although on a more complex case). Here is a more complex crater after failed operations by two other surgeons: Crater Deformity Revision After Failed Gynecomastia Surgery showing tissue adhesion issues. The still picture arrays before and after surgery show the issue from different angles, but the video is even more revealing. There are many other such examples on my site.

Over and over again I have seen horrendous scars from VASER liposuction after other surgeons' misadventures. The damage to the tissues can leave scars just as firm and disfiguring as the gland on a male chest. Yesterday, I reconstructed another such disaster from Illinois. The sheer number of such unhappy patients I have seen may mean it is more than just a surgeon's lack of skill with the tool, it may mean the methodology just causes too much damage. I have even seen patients done by doctors who have written in the literature how great that method is for gynecomastia. Of course, I do not get to see the happy patients done elsewhere. Why should they come to me to show how good they look?  Yet those espousing the method just seem to show static views and I have yet to see movies of the results.

I have posted how to pick a gynecomastia surgeon here:

http://www.gynecomastia.org/smf/index.php?topic=16474.0

We see many UK Gynecomastia Patients who prefer my techniques. To minimize travel most start out with our Preliminary Remote Discussion.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

[Dr. Elliot Jacobs]

The two photos seem to reveal a mild to moderate crater deformity -- but a better series of photos (taken by another person) would be very helpful.

I am not crazy about Vaser -- it does not remove any residual gland.  However, I do feel that some additional lipo would be helpful -- and perhaps some reconstruction directly under the nipples with some fat flaps to fill in the cratering.

You must also be realistic in your expectations -- two prior operations have resulted in scar tissue as well as residual gland/fat.  That makes any subsequent surgery more difficult and less predictable.

With all that being said, I believe some improvement could be obtained for you.  If you wish, I would be pleased to provide a free email consultation for you -- just send me a PM with your name and email address and I will forward information to you.

Dr Jacobs

[corvette09]

be carefull there is spyware on the links. norton keeps blocking it.

[DrBermant]

be carefull there is spyware on the links. norton keeps blocking it.

Which links? The photo links do come from imageshack and they load their site with all sorts of advertising gimmick link mess. My links are all clean and certified.

Hope this helps,

Michael Bermant, M.D.
Board Certified
American Board of Plastic Surgery
Member: American Society of Plastic Surgeons and American Society of Aesthetic Plastic Surgeons
Specializing in Gynecomastia and Surgical Sculpture of the Male Chest
(804) 748-7737

[corvette09]

it's the first link. it's the AVG. anti-spyware crap

[thetodd]

Vaser lipo's going to make it worse, 4 grand for vaser lipo is taking the piss anyway!

go to a doc that can fix crater deforms!

[JamesDawson]

Vaser lipo's going to make it worse, 4 grand for vaser lipo is taking the piss anyway!

go to a doc that can fix crater deforms!

On his site he also says that vaser lipo will suck up all the breast tissue, does that even work?

[matt1]

Well that's socialized medicine for you I suppose...I would say it's worth it as long as the doc has a proven track record.