Is revision surgery worth it, and how to know who to trust? (Photo)

Question

2 yrs 'mommy makeover' in Bellevue Washington from someone ranked as one of the best board certified plastic surgeons. I was left with a huge bulge in the pubic area that really bothers me and can be seen clearly in any clothing, appearing as a male bulge. He also used implants he said were too big (wanted 275 got 425) , and made it where he couldn't close, or couldn't remove all the areole. Chose to leave a 1in*4 in strip of areola up the bottom. Also gnarly scar from infection. Photos below

Daniel Barrett, MD · Answer

Dear Jessallure22,
I understand your concern. However, without a proper assessment, it would be difficult to determine what went wrong. It is best that you visit your plastic surgeon for further assessment or ask for a second opinion. Only after a thorough examination, you can get proper recommendations and advice.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Zoran Potparic, MD · Answer

Very likely that deformity and bulge in pubic area is due to limited liposuction; more aggressive liposuction would correct it. Regarding breasts, exchange for smaller implants and breast lift revision seem to be a reasonable option. In person, second opinion consultation with board certified plastic surgeon with good reputation in body contouring surgery (look at website photos) is recommended. Good luck.

Gerald Minniti, MD, FACS · Answer

I'm sorry to see your results. Without even hearing any details or knowing the surgeon(s), your scar and the interface between belly and pubis represent a global thought process among plastic surgeons that is misguided: the belief that the hole in the belly skin where the belly button was attached needs to be part of the excised skin to avoid a small vertical scar. Well, as you can see this leaves patients with unacceptably high scars, large pubic mounds, and a 'double bubble' interface between belly and pubic mound that makes the pubic mound look even more protuberant. Further, this also forces the surgeon to pull skin too hard to get it to come down far enough, leading to wounds like you have. It also leads to an over-lifted pubis too. You will need to heal for at least a year or more before considering a revision that can adequately address this issue. To be clear, your surgeon DID NOT do anything 'wrong', or in legal terms, 'below the standard of care'. In fact, he did the standard of care and that's the problem. Fortunately, surgeons are learning that placement of the long transverse scar in a very low position and leaving the hole behind to close vertically (leaving a small, midline vertical scar) is far superior from a visual aesthetic standpoint. Your breast scars can also be addressed too.

George Marosan, MD · Answer

Thank you for your question and photos. It seems you had a "standard" tummy tuck with poor results. The large pubic mound needs to be removed, liposuction alone will not correct the deformity and high pubic scar. You still have lots of fat on the abdomen (unfortunately the sides and back are not shown, but I'm sure these were not contoured for you either). Difficult to comment on the breasts, besides the scars, since you cover them and distort them with your hands. You ask if it is worth to get a revision. If you just get a scar revision and pubic liposuction alone, I would say it is not worth it. You will need a whole new surgery to reshape your body into an hourglass figure. As a Total Definer surgeon, I specialize in advanced body sculpting techniques. See a board certified plastic surgeon experienced in these advanced body sculpting techniques. Good luck.

Scott Tucker, MD · Answer

The fullness in your months could be benefited with liposuction. By switching to a smaller implant and tightening her mastopexy the excess pigment in your vertical scar could be removed. I would go back and express her concerns to her original surgeon as they would probably work with you as far as the cost goes. If you start with a different surgeon he will be back to square one on how much it cost you to have this revised.
Good luck,Dr. T

Camille Cash, MD · Answer

I'm sorry to hear of the poor experience you had during your prior surgery.  A surgical revision will be needed for improvement.  I encourage you to review websites of board certified plastic surgeons near you.  Look at before/after photos and schedule consultations with those who meet your criteria.  The ASPS website may be helpful.

Darryl J. Blinski, MD · Answer

Nicely series posted photos. Sorry for poor results and experiences. Only revision can improve to some extent. I might offer revision vertical breasts scars to remove excess areolar tissue, pubic lift with TT scar revision. Lipo waist. Fee $10,000. Best to virtual consult with...

Mats Hagstrom, MD (license on probation) · Answer

The importance of choosing the right provider cannot be overstated. I suggest patients do this by having multiple in person consultations. During each consultation, ask each provider to open up your portfolio, showing you their entire collection of before and after pictures of previous patients with similar body characteristics to your owner. An experience plastic surgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Take careful notes during each consultation, especially regarding the quantity and quality of before and after pictures. Being shown a handful of pre-selected images, representing the best work in the providers career is insufficient to get a clear understanding of what average results look like in the hands of each provider. being board-certified in plastic surgery with years of experience, and an overall good reputation does not mean that somebody has mastered any one single procedure. Being famous is not related to being talented. Generally speaking the best plastic surgeons in the field are generally not the ones self promoting.
From my experience, there’s an inverse correlation between social media presence and actual surgical skill.
The best plastic surgeons, I know, do not advertise or brag about their accomplishments. They focus their efforts on patient care rather than self promotion.
In the end, your surgeon is responsible for the outcome of the procedure, and you are responsible for choosing that provider.
Revision Work is often more complex than doing primary procedures. The best shot and getting a quality outcome is going to be during the primary procedure.
A revision should be able to debulk your pubic area and breast revision should help reduce visible areola skin.
The decision for what size breasts you want should be thoroughly discussed during an in person consultation. I typically find that this is best done by reviewing numerous before and after pictures. each plastic surgeon has thrown the way. of deciding implant size. 
To make an assessment on the outcome of a plastic surgery procedure we generally need to see proper before and after pictures. If you don’t have before and after pictures, then ask your surgeon to forward the pictures they took. For a second opinion, consultations patient should come prepared to bring with them complete sets of before and after pictures and preferably a copy of the operative report. These are all available from your card providers office if you ask for them.
Best,
Mats Hagstrom, MD

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