Gynecomastia Surgery with Liposuction of the Abdomen and Flanks. Los Angeles, CA

My consultation with Dr. Dadvand went extremely...

My consultation with Dr. Dadvand went extremely well. I was very much at ease within the first few minutes of talking with him. He told me what procedures he would preform on my chest (lipo and excision) and also showed me where he would make the incisions for lipo on my abs and flanks. He answered all my questions, and also showed me pictures of the many gyno surgeries he'd completed and also pointed out patients similar to my situation, so I could get an idea of my prognosis. His PS consultant, Deborah was also great. She too was easy talk to, and made me feel very relaxed. I never felt rushed with Dr. Dadvand or with Deborah even after spending almost 2 hours with them. I know I am in good hands and can't wait for my procedure.

Pre-Op

I had my Pre-op yesterday and spent 1 1/2 hours with my doctor going over the procedures, asking questions, getting BEFORE pictures taken, and getting fitted for my compression garment. I definitely feel good about my doctor and the procedure. However I was somewhat surprised when he said that my surgery would last 4.5-5 hours. He says he likes to take his time and doesn't rush things. And I am okay with that, since a true artist would not rush a masterpiece.

Recovery Post Op & Day 1 Post Op

It's been just over 24 hours since my surgery completed and I have to admit that I am not feeling as bad as I thought I would feel, so I will try to recap what I can remember from the last 32 hours. I eagerly arrived at the surgery center at 6:50 am for my 8:00 am surgery. In fact the office had not yet opened. The staff arrived promptly at 7:00 am and ushered me into the waiting room where I proceeded to complete the obligatory paperwork. Shortly thereafter I was taken to an examination room to don my surgical gown, cap and booties. It was finally happening. I felt like Cinderella getting ready for the Ball. Once I was dressed, the nurse brought in some additional paperwork for me to read and sign. You know the one that describes the procedure you are about to have and the other one that describes all the risks with general anesthesia. Up to that point I hadn’t been worried about something going wrong, but after reading and signing the papers, that is all I could think about.

But then my Prince Charm….err…I mean Dr. Dadvand walked in and all my worries immediately went away. Dr. Dadvand was very chipper for 7:30 am. He made a joke about the x-large paper boxers the nurse had me put on under my surgical gown. I think he called them “party pants”. I was glad he was in a good mood because it totally put me at ease.

Then it was time for him to mark me up. Watching him make the marks on my body was like watching a sculptor work. He would make a mark, then step back look at it from various angles and continue marking. He took at least 20-30 minutes until he felt satisfied that he marked me up enough to get the optimum results I wanted.

After my markup, I was led to the OR, and I climbed up on the operating table, where I met the Anesthesiologist for the first time. He asked me some questions as he set-up my IV, and that is the last thing I remember. I don’t even remember Dr. Dadvand coming into the OR.

Six hours later I woke up in recovery. I remember asking the nurse when my surgery was going to start and she said, “It’s already over, you’ve been in recovery for 45 minutes”.

There was one very little hiccup. I had expected my surgery to end at around 12:00, however it did not end until 1:30, and my ride had another commitment she could not get out of and now would not be able to pick me up until after 4:00, but that was not a big deal to me anyway since I didn’t have anywhere to go but home. However, since the nurse thought my ride was coming around 2:30, they had already taken out my IV, which also had my pain medication in it. Around 3:15, the pain became unbearable, but thankfully the nurse was able to give me a shot of Demerol to get me through “recovery”.

My ride arrived shortly after 4:00 and I was home in my bed by 5:30. I woke up shortly after 8:00 and really needed to go to the bathroom. I painfully got out of bed and went for what seemed like forever. (I later learned from Dr. Dadvand that I was dehydrated in the OR and they had given me extra fluids during surgery.) The Demerol was starting to wear off, so I thought I’d better take the Norco before the pain got too intense. However, I forgot that I hadn’t eaten anything in 24 hours, so within 10 minutes of me taking the Norco, I started feeling nauseous, and I started to perspire, and my legs started shaking to the point I thought I was going to pass out. At first I thought I was having some type of complication from the surgery and almost started to panic, but I was able to calm myself and that is when I realized I was supposed to eat something before taking the meds. So I promptly hobbled to the kitchen and gobbled down a huge tablespoon of Almond Butter, and within minutes I was feeling normal again.

After that experience, I looked down at my drain bulbs and realized that the left one was already completely filled and needed to be emptied, and I didn’t know how to properly do it. Thank goodness for YouTube.

My first night was not as uncomfortable as I thought it was going to be. I had no problem sleeping upright at a 20-30 degree angle. All the pain that I was experiencing the first night was due to the liposuction. And that was only when I got in or out of bed. But once settled, I was fine. I had no pain in my chest area and only a little discomfort where the drain tube went into my armpits.

My first morning after surgery, I felt about 20% better than the day before. I wasn’t in any major pain. I just felt achy like I’d done a thousand crunches and side planks. And I had just a minimum amount of discomfort in the chest area, most likely from the lipo. But the tape holding the gauze and foam on my chest started itching like crazy, but there was nothing I could do but lightly rub it through my compression vest.

I also noticed that my entire body was swollen. Not just the areas where lipo was performed, but also on my arms, hands, legs, feet and MY JUNK. It was huge. I later learned this additional swelling was due the extra fluids I was given during surgery and should be back to normal in 3-4 days.

My Day-1 Post Op with Dr. Dadvand went very well. He explained the swollen Junk before I had a chance to ask him, and said he was sorry he hadn’t warned me about it in advance. Seriously, that is one side effect I wouldn’t mind keeping. ?

The amount of fat taken out of my abdominal and flanks was about 1.5 liters, which is a fair amount. The amount taken out of each side of my chest was about 200 CC. But what was really shocking was the amount of breast tissue and fibrous fatty tissue that was removed. I don’t remember the dimensions but even Dr. Dadvand said it was more than he had expected based on his examination. (He’s going to send me the picture and I will post it once I receive it).

After recounting how the procedure went, Dr. Dadvand opened my vest and took off my binder to make sure everything was looking good, and I could tell in his eyes how pleased he was with his “work”. And when I looked in the mirror, I couldn’t believe how good it looked. I could even see my abdominal muscles that had been hidden for the last 10 years. And that was with a substantial amount of swelling. Unfortunately, I could not see my chest since it is still covered in bandages and foam padding. Those will come off next Thursday when I go in for my 1-week post op, and I expect my chest to look just as good. Dr. Dadvand is a true artist.

And those pesky drains may come out as early as Tuesday, if the amount of fluid that drains is less than 20 ml a day between now and Monday. He gave me a specimen cup to start measuring. But if they aren’t ready for Tuesday, then they will definitely come out next Thursday.

By the way, everyone at the surgery center was extremely nice and went out of their way to ensure I was comfortable and that all of my needs were taken care of, especially the recovery nurse.

I’ll check in again when I get my drains out or after my 1-week Post Op, whichever comes first.

Day 2 Update

Okay, so I wasn't going to post again until I got my drains out but I wanted to share my 2nd night experience because it was much worse than my first night. In fact it was so bad that I had to double the pain medication and that still just made it barely tolerable. The areas where I had Lipo started to itch like crazy and of course I couldn't scratch, so I just lightly rubbed my compression garment to try to get some relief. But then the itch turned into a burn and I started to get a sharp pain in my right nipple. After about 10 minutes of this everything would then settle down and I would be fine. I must of had about 6 episodes like this before the extra meds kicked in and I was able to get a few hours sleep. I read that the 2nd-4th days can actually be more painful than the first because your body is actually starting heal. So far today has not been too bad, but I am doubling up on the pain meds 'cause I do not want to go through that again.

Day 3 Post-Op Update

Okay, so my third night after surgery was much much much better than my second night. Because I doubled up on the pain medication, I only had a few of the episodes I experienced on my second night and they were much less intense. Today was the first day I was allowed to bathe. I was warned not to get my upper body where I had surgery wet. In order to do this, I first showered from the waist down using a handheld shower. Once I dried myself off, I put on some clean sweatpants and then put my drain bulbs in the pocket of my sweatpants. This allowed my to take off my compression vest and binder. My chest area still has foam padding that is taped to my chest and I was told not to remove it. Since my abs and flanks are still extremely sensitive to the touch, I avoided washing those areas. I was only able to wash my hair, face, neck, underarms (being VERY careful of the drain tubes), arms, and back. I also managed to shave. And because I was being overly careful not to get anything wet that was not supposed to get wet, this entire process took me an hour to complete. After all this I was extremely tired and because of all of the moving around, I started to itch again, so I promptly took my pain medication and took a nap.

Outside of the itching that started after I bathed, I haven't had a lot of pain or discomfort from the liposuction today, just some minor discomfort from the lipo incisions. And a little more discomfort around the areolar incisions, so I am definitely seeing a pattern with the healing process. First the lipo areas, then the incisions. Based on today's level of pain, I should be able to get a fair amount of sleep tonight with a minimum amount of discomfort. And that's a good thing, since I only have enough narcotics to last me through tomorrow evening, if I have to double up tonight. And I want to have some for when I get my drains removed on Tuesday, since I've heard that can be a painful experience. I will post new pics after my 1 week Post-Op on Thursday.

Day 4 Post-Op

Just a quick update to report that I had minimal amount of pain last night. The pain that I am feeling is from the 2 incisions that were made for my liposuction. It's not a sharp pain I am feeling, it is more like a dull burning sensation. Interesting enough the incision on my right, (which Dr. Dadvand used my existing appendectomy scar for the incision spot) is a little more painful than the left one. I have had little to no pain related to the liposuction in the last 18 hours. The swelling of my extremities is gone and they look normal again. I'm weaning myself off the Narcotics and will hopefully be able to get by with just Tylenol by Thursday. The amount in my drains has decreased to 18 ml in my left and 10 ml in my right in a 24 hour period, so I am scheduled to have my drains removed tomorrow. Happy Healing!

1-Week Post Op

My drains were removed 2 days ago without any issues. The only thing I experienced was some additional itching in my chest from the areas where the tubes were. It only lasted that night, so when I woke up Wednesday morning, I had absolutely no pain in my chest except some tenderness when I touched it.

Today is my 1-week post-op and I woke-up this morning so excited, that finally the foam padding that was covering my chest was going to be removed and my chest would be revealed to me for the first time. (Over the last 2-3 days the tape holding the foam pads were getting looser and looser, and it took everything for me not to peek.)

I walked into Dr. Dadvand’s office this morning grinning ear to ear. But I kept telling myself to expect the worst and hope for the best. I’d already taken off my binder a number of times to bathe, and my abdomen and flanks looked far worse now than they did on my day 1 post-op. But I know not to think about how things look now because of the swelling, and that they can only get better. Besides I had a 6 pack in my 30’s, so I knew that I could always get back there again. Having lipo will just help me get there faster.

But the success of the gynecomastia surgery was much more psychological, because I never had a flat chest, no matter what I did. After Dr. Dadvand removed all the sutures, he said everything looked great and he was quite pleased. He asked me to stand up to look in the mirror. At first I was a little apprehensive, even though this is something I had waited for, for years. I know this may sound funny, but as I type this to reflect on that moment, it seems like everything was in slow motion. I remember turning to face the mirror but not directly in front of it. It was more to the side, so if I didn’t like what I saw, I could quickly retreat. But once I stood completely in front of the mirror, I stared at myself, almost as if I was looking at a different person. And I was so pleased, even with all the swelling; I now had a manly chest. I was still somewhat in shock and I don’t think I was able to sufficiently communicate to Dr. Dadvand how pleased I was with the outcome. Dr. Dadvand pulled out my before pictures to remind me how I looked a week ago. There was such a dramatic difference. As I left his office, I was all smiles again.

At a stoplight on the way home, I touched my chest and tried to cup each breast as I had been able to do in the past, but I couldn’t. And that is when I started to tear up.

I start Lymphatic Massage and Endermologie next Monday, which is supposed to help with the swelling, break-up scar tissue, and help me heal faster. If I see any significant improvements, I will post new pics next week.

I am very grateful to Dr. Dadvand and his skills as both a surgeon and an artist. I am also fortunate and blessed to have been able to do this for myself. I won’t say I wished I had done this years ago, because things happen, when they happen, for a reason. But I will say to anyone contemplating Gynecomastia surgery; if you have the means, then don’t put it off. Of course, make sure you find a board certified PS that does 100’s of these procedures a year. And if you are in Los Angeles, then Dr. Dadvand is the man. You won’t regret it.

Almost there....3 more months?

I have been very neglectful in keeping my RealSelf community up to date on my progress. Partly because I have been busy with work and also because I am not exactly where I wanted to be at this point. I am 9 weeks out from my initial surgery. I am much happier with the progress to date that I have made from the Gynecomastia surgery than I am from the liposuction on my abs and flanks.

I now have 100% feeling again in both nipples, but they are still tender to the touch. The incisions around the areola are almost invisible, but the two spots where the cannulas entered when he performed lipo to contour my chest are still very visible but fading. Also, I still have some tethering that I have been aggressively massaging and I am seeing some improvement there too. My abs and flanks were he performed lipo ( 1.5 liters were removed) are still numb, and on occasion it looks like I have cellulite, that absolutely was not there before my surgery! But I have noticed where the numbness and lumpiness was previously on all of my flanks and abs at week 4, it is slowly going south. In other words, the upper part of my abs and flanks look great (nice and smooth), but the lower part is still numb and lumpy. My Endermologist says this is gravity taking its course and is normal.

I started back at the gym at week 6 post-op, and I think that has caused me to still have swelling in my lower abdomen, despite the fact that I have been having weekly Endermologie treatments since week 2 post-op. But I must admit that the Endermologie treatments work. I didn't go one week due to other commitments and I was more swollen than I had been the prior week, and two days after my treatment, the swelling had gone down considerably. By the way, I stopped wearing my binder at week 8 post-op.

My pre-surgery weight was 185 and because of my strict eating and workout dedication, I am now down to 172. But I still have that little lower abdomen pooch. My Endermologist, (who's been doing this for 20 years and has been written up in several publications), is telling me my results are great for 9 weeks, but the magic number is 6 months. But I have a wedding in Costa Rica to attend in 4 weeks.

If I weren't under the the wedding time constraint, I think I would be a little happier with my progress. But I have to look at the big picture and be thankful that I have had no complications and everything is coming along very well. So I'm really looking forward to the 4th of July. :-)

My Endermologist has been taking pictures of me over the last 6 weeks, so I will post updated pics once she sends them to me. Good Luck to all and Happy Healing!

Pictures from the last 10 weeks.

Hi RealSelf family,
As promised, here are updates to my pics over the last 2.5 month. For the most part I am very pleased with my results thus far. I know that final results are not usually seen until 6 months or longer after surgery. My Endermologist keeps telling me I am still a little swollen around my abdominal area due to the fact that I am working out. SO of course my response was, "does that mean I will always be swollen, because I won't stop working out?" and she responded, ask me that question after 6 months post-op. So as we've all heard a million times, "I just have to be patient".

-

Los Angeles Plastic Surgeon

5 out of 5 stars Overall rating
5 out of 5 stars Doctor's bedside manner
5 out of 5 stars Answered my questions
5 out of 5 stars After care follow-up
5 out of 5 stars Time spent with me
5 out of 5 stars Phone or email responsiveness
5 out of 5 stars Staff professionalism & courtesy
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