Jefrey Fishman, MD, FACS

Thank you for your question. 

If you are healthy and undergo liposuction alone for gynecomastia, the risk or skin necrosis should be very low.  The risk is increased in patients with some medical conditions.  It can also more likely to occur with some techniques, such as ultrasonic or laser assisted liposuction.

That said, if your Plastic Surgeon is experienced and well trained, I would expect skin necrosis as a complication of liposuction for gynecomastia to be uncommon. 

I am wondering if you might have a reason for and increase in risk based on your question and your concern for the complication.

Please ask your surgeon.  He would best able to advise you.

Please accept my wishes for a successful procedure.

Jefrey Fishman, MD, FACS

Associate Professor of Surgery

     Oakland University William Beaumont School of Medicine

Chief, Section of Plastic Surgery

     St John Providence Hospital - Ascension Health System

Diplomate, American Board of Surgery

Subspecialty Certification in Hand Surgery

Diplomate, American Board of Plastic Surgery

I am sorry to hear you are not please with your treatment.

I will assume (although I don't know for sure) that you received your treatment to address the "circles under the eyes", also know as the tear trough area.  Unfortunately, swelling of the lower eyelids does occur after this treatment in some individuals.  Also unfortunately, it is more common with Juvederm than some other fillers for this area (Juvederm is more hydrophilic than other fillers).  In my experience, Belotero is the optimal performing filler for this region.  That said, many plastic surgeons like to use Juvederm.

Do you know how much "dissolvent" was used?  It may be that an additional treatment with Hyaluronidase, the treatment to dissolve Juvederm may be needed.  Sometimes several treatments are needed.

It may be that lower eyelift surgery may be what you are looking for, although I would allow the swelling to be treated and subside before having any surgery performed.

It is also my hope that your plastic surgeon is responsive to your concerns and will work with you to a satisfactory resolution.  

If you have additional question, please submit.

Jefrey Fishman, MD, FACS

Associate Professor of Surgery

     Oakland University William Beaumont School of Medicine

Chief, Section of Plastic Surgery

     St John Providence Hospital - Ascension Health System

Diplomate, American Board of Surgery

Subspecialty Certification in Hand Surgery

Diplomate, American Board of Plastic Surgery

Thank you for your question. 

Plastic surgeon's in the US would not use an expired product.  That said, if it were a product that was used beyond it's expiration date, the filler would work exactly the same.  It does not become less effective over time.

It would be easy to check.  Next time you are in your surgeons office, look at the product information sticker that is in your chart.  The expiration date will be noted there.

As suggested by the other physician responses, perhaps you now will require more product than in the past.

Thank you,

Jefrey Fishman, MD, FACS

Every patient and every surgery requires an individual approach.  The photographs you have provided, it looks like you underwent a breast lift on the left and implants for both.  This is a challenging procedure.

That said, it requires at least 6 months for the surgery to fully heal.  Typically, after surgery, the implants are a little to high, tight, and sometimes unnatural looking.  As time passes, the implants with settle in and the appearance will improve.  The final result requires a good 6 months.

You could take photographs once a month.  It will show the changes that occur as time passes.  You will likely be surprised.

Follow up with your surgeon and try to be patient (easier said than done).  I beleive in the long run you will be happy.

Jefrey Fishman, MD, FACS

Your question is a very good one.  There are companies that provide insurance for complications that arise out of having plastic surgery.  Many plastic surgeons provide this as part of surgery.  Sometimes patients will pay the premium for this insurance.  Sometimes the premium is included in the cost of surgery.

In the US, this type of insurance policy is becoming more common as health insurance companies, more and more, does not cover complications that arise after cosmetic surgery.

Ask you plastic surgeon if this type of insurance is an available to you through his or her office and if so, specifically what does it cover.  If he or she does not have this available to you, it may be desireable to consult another surgeon.

Jefrey Fishman, MD, FACS