Hi....I hope everything is well...I have researched Dr. Bermant and have found that you are the best in Gynecomastia field. My name is - and I am from Toronto, Canada. I was wondering, since you are retired, If you know any good and skilled surgeons that could correct/fix crater deformity ? I had Gynecomastia surgey done 2 years ago, but unfortunately did not turn out properly. Basically too much tissue was removed and when I am flexing and also in warm temperatures, the nipples look like they cave inwards. Is there anyone that you know who could fix this problem..? Any advice/info would be greatly appreciated, Thanks
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.
Sorry to hear about your misfortune. I coined the term Crater Deformity
for the bad surgery I saw done elsewhere. The most often cause seemed to be gland was removed and nothing used to rebuild the contour. Such problems are best avoided in the selection of surgeon. I tried to set up resources here on How to Pick a Gynecomastia Surgeon
. They are based on many factors, but the most important is seeing actual results, not just 1 or two select views as some surgeons seem to feel is all that is needed to evaluate results. Revision surgery is more critical and I evolved my Standard Revision Gynecomastia Pictures
or better yet Standard Gynecomastia Videos
to more critically look how tissues move so I could make myself a better surgeon. Warm temperatures are critical in any Nipple Exam
as you can see documented on that link: see the thermometer we had to check that room temperature for the picture taking? We had another one in the exam room!
When picking a surgeon to fix a crater defect, consider looking for actual examples of their skills in fixing such problems. Learn from this unfortunate individual who came to me with a fixable crater defect after surgery in New Jersey. He tried to stay closer to home and underwent revision by someone who instead of using my techniques, tried to liposuction around the crater walls making this Extended Crater Defect After Revision Surgery Done in New York
. Take some time to watch the videos of that problem and how just one or two still pictures alone might look like an improvement, but once you see the whole picture, the nature of the failure of technique by that second doctor are revealed. There was a fixable crater turned into a nightmare without resources. Listen to the patient's description of the second surgeon's response to the result. Then compare that result to one of my compromise results listed below. We are trying to analyze the problem and result as critically and accurately as possible. Then decide yourself if one or two views of each patient tells enough of the story and surgeon's solution. That page was designed to demonstrate that issue of what is gained by a more critical look at the problem and result.
Here is another example of Pictures of Male Chest Deformity after Repeat Liposuction by Other Doctors for Gynecomastia - Depression and Adherent Scar Complication
. Where liposuction was used to try to fix an adhesion or scarred tissue. The result was one big crater defect, no resources were left to use to rebuild the animation layer between the skin and underlying fascia covering of muscle.
Sometimes there were barely enough resources left for me to work with requiring a Compromise Crater Deformity Revision for Patient Unhappy After Texas and Massachusetts Gynecomastia Surgery
Some craters were subtle, obvious on examination in person like this Bursa Crater Deformity Defect After Gynecomastia Surgery
. The shelving edge of resource material was easily felt on examination ready for my Fat Flap
component of my Dynamic Technique
More critical documentation as to how tissue moves is how I started to better understand and evolve my own methods. Such documentation is, in my opinion, what those with this problem should be looking for in surgeons' demonstrations of what they offer. This forum is also designed to attract those with a better way to fix something, to demonstrate that expertise, but more than just verbal hand waving. Links here are powerful tools to see what I am talking about. Such linking can be used to demonstrate what someone actually offers. Because of SEO link spamming, linking here is a privilege earned. But as a tool, the best I know how to explain problems and solutions.
The public is welcome to document their deformity here in the forum and show others what they have. Posters may be able to help educate others why they are not happy, what went wrong, and how to avoid similar issues. This documentation is a start to demonstrate the nature of the problem both of contour and emotional. Explain to surgeons what they are looking for. Posting and being proactive opens the possibilities of solutions unknown at present.
I am trying to plant the seeds to see what I learned from go beyond my ability to offer them in the operating room myself.
Hope this helps,
Michael Bermant, MDLearn More About Revision Gynecomastia and Chest Surgery