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David Teplica, MD

Board Certified Plastic Surgeon
803 West Hutchinson Street, Chicago, Illinois773-296-9900 Website
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9 Questions Answered
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Before and After Photos

QUESTIONS ANSWERED

Could mouth breathing be one of the causes of my weak chin? (Photo)

Asked By:AnonymousANSWERS (1)

Odin123:

We now know from twin studies that environment has little to no permanent impact on anyone's anatomy.  It looks like you were born with a chin and jaw that are smaller than the anatomy of the upper two thirds of your face.  It is much more likely that having this configuration (and the related  inborn internal anatomy) causes your mouth breathing, instead of the other way around.  Your nose appears to be attractive, masculine, and proportionate with the upper two thirds of your face -- so procedures that enhance the size and masculinity of your chin and jaw line would make more sense to bring the whole face into balance.  There are now less-invasive methods to do just that, if the more invasive and expensive bony work is not of interest to you. 

David Teplica MD, MFA

provider-David Teplica, MD-photo

David Teplica, MD

Board Certified Plastic Surgeon

Penis enlargement. Could a silicone implant be used?

Asked By:AnonymousANSWERS (1)
No, sadly, solid implants and silicone sheets placed beneath the skin can cause major damage. With the usual changes in size that the penis undergoes and with repetitive motion, these often erode through the skin and can create horrible infections.

Also, scar capsules form around silicone (even worse than in breast implants) and can lead to buckling and other major deformities.

Instead, safer strategies should be considered.
provider-David Teplica, MD-photo

David Teplica, MD

Board Certified Plastic Surgeon

Is this a gynecomastia? How can I treat it? (Photo)

Asked By:AnonymousANSWERS (1)
Yes, a small amount of asymmetrical gynecomastia can have a big effect on the overall impression of an otherwise great male chest.

One-sided, minor enlargement of male breast ducts or breast fat can lead to visual asymmetry. It appears from the photos that you also have minor enlargement of some surrounding accessory breast mounds, giving the chest a slightly softer look than many guys might prefer.

The biggest danger for you would be to either ask for or to unknowingly receive surgical removal of a large amount (or even a typical volume) of tissue from one or both sides of the chest. Instead, the best approach would likely involve highly focused, small volume correction to avoid the appearance of postoperative flatness or actual nipple/areolar indentation that can show up more than a year later when all swelling finally subsides.

Although I haven't examined you, I believe that relatively minor ASYMMETRICAL removal of volume with tiny cannulas and through small hidden scars would produce natural, masculine, symmetrical results. There are a few image sets on my website that illustrate how small volume shifting can produce big perceptual results.
provider-David Teplica, MD-photo

David Teplica, MD

Board Certified Plastic Surgeon

I'm 11 wks post gynecomastia (liposuction/gland incision). I can see first signs of gland regrowth. What can I do? (Photo)

Asked By:AnonymousANSWERS (1)
Donie888:

It may be somewhat reassuring to hear that it is very common for hard lumps of injured/healing tissue to form after gynecomastia surgery. These are called induration nodules and they begin showing up in many patients (60-70 % of patients in my practice) around the 4th week. It frustrates guys that these often persist for over a year -- but they almost always go away completely with time. Your body is attacking and degrading the tissue that was traumatized and it takes many months for swelling and lumps to settle down.

Using highly standardized imaging techniques, I recently showed that every patient stays swollen (to a greater or lesser degree, depending upon their genetics) for a minimum of 18 months after gynecomastia surgery and plain liposuction as well. 

I wouldn't worry too much -- certainly not for many many months. You may be able to speed up the resolution of the lumps with GENTLE circular massage. But, I would totally avoid squeezing or pinching skin of the chest, as you want this plane to seal down to the underlying structures without being loosened.

Patience and time will be your greatest helpers...

dt
provider-David Teplica, MD-photo

David Teplica, MD

Board Certified Plastic Surgeon

Gynecomastia surgery + excess skin. Do I need a second surgery? (Photo)

Asked By:AnonymousANSWERS (1)
I explain to all of my patients that swelling takes over a year to go down completely.  I certainly wouldn't recommend doing anything further until all that swelling is gone.

Also, I wouldn't squeeze and pinch the area to test thickness -- you need to let the skin to tighten and seal down without being stretched.

After a year, it's not uncommon for skin to be a little bit loose, but that doesn't necessarily mean that more tissue should be removed -- and cutting skin out often results in scars that are far worse than a little looseness...

Dr. Dave Teplica
provider-David Teplica, MD-photo

David Teplica, MD

Board Certified Plastic Surgeon

Post Gynecomastia surgery looking for fix for slight concavity/contour deformity with flat nipples pulling inward? (Photo)

Asked By:AnonymousANSWERS (1)
Michael87:

You developed scar bands between the nipple on each side and the underlying pecs. In most cases, this is easily corrected under local anesthesia through tiny incisions (1/8 inch) -- with the release of the scars and grafting of a very small amount of fat beneath each nipple.

Dr. Dave Teplica
provider-David Teplica, MD-photo

David Teplica, MD

Board Certified Plastic Surgeon

From 324lbs (2011-12) to between (155-164) currently, Male, 5'10''. Post-Weight-loss and expectations within limits? (Photo)

Asked By:AnonymousANSWERS (1)
You've done a remarkable job of losing weight and maintaining a stable state -- and by all means, deserve to have a body in which you can feel more comfortable!

One of the most important things to consider when approaching body contouring after major weight loss is that you get gender-appropriate care. It's also critical that each of your planned procedures happens at the same relative fat content so that your final result can be proportionate from head to toe.

provider-David Teplica, MD-photo

David Teplica, MD

Board Certified Plastic Surgeon

Do I have a micropenis? (Photo)

Asked By:AnonymousANSWERS (1)
There is no solid definition for the term 'micropenis', in part because there is a lack of good information about what really is normal. Part of the issue is that the medical world has not standardized the collection of data when studying body structures like the penis. For example, at different temperatures the penis in any given man has a different length, yet I know of no study of the penis that has controlled for temperature when the study-subjects are being measured.

In your particular situation, it is likely that your penis is significantly camouflaged by a thick fat pad of the pubic mound. It is rare for a 15 year old to have significant fat beneath the pubic hair (except in cases of significant obesity), but it is very common for men of 30 to have an inch or more of fatty fullness (as i see in your photographs). As a result, you may well still have your original length, albeit hidden within the fat of the surrounding pubic mound.

Fortunately, there is a safe and effective procedure to address this. Micro-liposuction with fine cannulas and careful technique allow for better visualization of your assets! 

Over the past 20 years I have performed this technique on hundreds of men on an outpatient basis without a single significant complication, perhaps making it one of the safest genital procedures we do. Please realize that this does not actually enlarge the penis, but instead maximizes its visibility and functional length.

I hope to upload photographs soon and would be more than happy to answer any questions.
provider-David Teplica, MD-photo

David Teplica, MD

Board Certified Plastic Surgeon

Is this a mild case of pectus excavatum? (Photo)

Asked By:AnonymousANSWERS (1)
Severe cases of Pectus excavatum have been treated with invasive "rib flip" operations or the placement of large customized silicone implants. Metal plates have even been used to push the ribcage forward. Unfortunately, these operations create large scars and have high complication rates --and they were therefore reserved for the most severe cases. Sadly, natural-looking results were rarely achieved.

Your situation -- which is much more subtle that what some men and women deal with -- is, nonetheless, of concern to you and to many others like you who want a more robust-appearing chest. Fortunately, we now have a great technique to build up isolated areas where volume is needed using fat grafting. Your own living fat cells are harvested from areas where you have more than you'd like (using a modified liposuction technique) and are transplanted to the areas of the chest where you need more volume. Scarring is minimal.

Once the fat heals in place it is remarkably similar in both 'look' and 'feel' to normal pectoral muscle, giving the appearance of a more masculine chest. Depending on the depth of the original depression on the chest, my patients sometimes need 2 procedures to get enough 'fill', since we can only transplant a certain amount at one time in order to avoid killing the transplanted cells.

The procedure is done on an out-patient basis and people are almost always back to work within 3 days unless heavy lifting is needed for your job. There's a 3-week downtime from working out afterwards or from any heavy lifting in the work place. The more minor second procedures can often be done under local anesthesia and have a quicker recovery.

I hope to publish the cases I've done over the past five years very soon. 
provider-David Teplica, MD-photo

David Teplica, MD

Board Certified Plastic Surgeon

David Teplica, MD reviews

David Teplica, MD

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