__ REVISION “REDO” or SECONDARY GYNECOMASTIA SURGERY
Gynecomastia revision surgeries comprise about 40 percent of Dr. Delgado’s gynecomastia practice. For the patient that is unhappy with the result of his original gynecomastia surgery, secondary surgery will be his option. These men consult with Dr. Delgado for a revision or “redo,” because they are disappointed with their first surgery.
A secondary revision surgery is needed for various reasons. Some examples are; the initial procedure was performed using only liposuction, or over resection the breast tissue causing a “crater deformity” or depression. The most common would be under resecting the male breast tissue and a “gynecomastia look” still remains.
Many surgeons perform gynecomastia surgery using the liposuction technique without breast gland excision. The techniques of liposuction that are utilized today include: ultrasonic liposuction, tumescent liposuction, smart liposuction, and sharp liposuction cannulas. The technique of sharp liposuction cannula is intended to cut up the breast tissue so that the gland can be suctioned. However, the breast gland does not respond well, but it does do a good job on the fibro fatty-tissue successfully and allows good extraction of fat. In the same way, ultrasonic liposuction breaks through the fibro fatty-tissue quite well, but it does not cut up the breast glandular tissue. Ultrasonic liposuction includes heat production to the treatment, which is believed to improve the contraction of the skin. However, Dr. Delgado states that he has seen an increase with the formation of seroma and also notes that the areola does not heal well, and therefore he has abandoned this treatment. Smart liposuction is a laser which produces heat. The heat component creates much more scar tissue and makes the revision surgery more difficult. Dr. Delgado prefers tumescent liposuction because it offers him more control in his hands.
It is difficult to perform a revision gynecomastia. The first surgery leaves scar tissue making the dissection a lot more difficult and the contraction of the skin is much less predictable. Unless it is a touch up procedure, liposuction by itself is not the solution for revision gynecomastia. As previously mentioned, with a secondary surgery the scar tissue will not allow the skin will not contract well. Dr. Delgado explains this complication in detail to his patients.
Avoiding complications with gynecomastia surgery is Dr. Delgado’s goal, he feels one complication is one too many. Nevertheless should a complication occur, Dr. Delgado’s expertise, and compassion gives him the ability to correct all issues if they arise. It takes a tremendous amount of skill to perform secondary gynecomastia surgery. The unhappy patient needs to take great care in the selection of their revision surgeon, keeping in mind that experience and confidence level must be extremely high to deliver the desired results.
This leads to the question of “How to pick a gynecomastia surgeon?” This can be very difficult for patients but a critical one. Some important factors to consider:
- Select a Board Certified Plastic Surgeon.
- Determine his/her reputation online through patient reviews.
- There is wealth of information about physicians on the internet. Use this to your advantage. All doctors have some poor reviews, but you are looking for consistent trend.
- Select two or three physicians and make sure their website has a section on gynecomastia with before and after photos.
- Call the office for an appointment. Ask the staff how many gynecomastia surgeries the surgeon performs a year.
- When you arrive for your consultation, note if the office is warm and inviting. If you get a good feeling, now it is time to meet the doctor.
- Is the doctor approachable and does he/she spend enough time with you to understand your needs? Ask to see before and after pictures. Understand the cost of the surgery.
- If all these things check-out then you will likely be in good hands.
- If you need revision gynecomastia surgery, then, you’re looking for someone who performs more gynecomastia treatment and has more experience.