Dr. Jeffrey D. Wagner is dedicated to his professional mission of enhancing patients' self-esteem and well-being, approaching each individual with a tailored treatment plan. With an extensive 25-year career in plastic and reconstructive surgery, Dr. Wagner has successfully conducted over 15,000 surgical procedures, earning admiration from both patients in Indianapolis and fellow plastic surgeons for his exceptional skills. Dr. Wagner earned his medical degree from the University of Minnesota School of Medicine. He furthered his education with a general surgery residency at the University of Washington and specialized in plastic surgery through training at the University of Michigan. He holds certification from the American Board of Plastic Surgery and maintains active membership in various esteemed professional associations, including the Indianapolis Medical Society, Indiana State Medical Association, American Medical Association, American Society of Plastic Surgery, American Association of Plastic Surgeons, Plastic Surgery Research Council, American Society of Clinical Oncology, American Society of Maxillofacial Surgeons, and the American Head and Neck Society. Additionally, he is a fellow of the American College of Surgeons and the Society of Surgical Oncology. Dr. Wagner enjoys international recognition as a researcher and authority in areas such as melanoma, skin cancer, plastic and reconstructive techniques, and patient outcomes. He is a frequent speaker on a diverse range of plastic surgery topics, both within the United States and internationally, contributing to the advancement of knowledge in the field.
A: Drains are used in surgery to evacuate blood and serum from the surgical space where tissue was removed, which helps protect the incision from pressure arising from underneath, as well as aids in smooth adherence of the tissues to heal the space closed in a predictable and smooth manner. Drains are not always necessary, but they help prevent he need for multiple trips to the doctor to drain seromas that may accumulate and prolong recovery, or even become infected. Many surgeons use drains for moderate or larger gynecomastia procedures. I have never seen a significant problem arising from use of a drain in gynecomastia, but have seen many problems that could have been prevented by using a drain. Therefore, I tend to use drains in most significant gynecomastia procedures.
A: Based upon your pictures, you have an element of the tuberous breast shape, however it is not particularly constricted or severe. Shape correction is possible and depends on your size desires. If you like your current size, you would get a decent shape with a mastopexy alone. However, I believe your best result may be a combination of implant and mastopexy, as a combined or staged procedure. This is preferable to fat grafting in your case.
A: It is not possible to be sure without any photos or examination, but I wonder if you may be developing a capsular contracture. This often looks like a rounder, firmer breast that looks higher than the other side. This is not serious, and can be easily revised to restore your softness and symmetry. I advise you seek consultation with an experienced board certified surgeon with experience in revisional implant surgery.
A: Based upon your description and photos, I believe you have a pretty nice result with respect to your mastopexy. You may benefit from larger (and/or wider) implants with possible pocket revision to achieve your goals of upper breast fullness. If your surgeon is not comfortable, it is certainly within their right to decline to do any operation they are not comfortable with. However, it is also within your right to seek additional opinions. I am fairly sure your result can be modified to achieve your stated goals.
A: Your pictures show a wound dehiscence at the inframammary trifurcation, which is a common complication of mastopexy. It is usually minor and will heal in within a few weeks with conservative care. I do not think you have an infection, but you should discuss with your plastic surgeon.