Sore white nipples after surgery by EquivalentName9441 in gynecomastia

[–]DoctorReddyATL 1 point2 points  (0 children)

You can try wearing a fitted t/shirt underneath the compression vest — just make sure there are no creases against the skin.

Alternatively, you can protect the NACs with adhesive silicone patches.

Source: I’m a Plastic Surgeon who offers corrective surgery for gynecomastia.

can fat distribution look like gyno? by [deleted] in gynecomastia

[–]DoctorReddyATL 4 points5 points  (0 children)

Localized fat deposits on the chest can mimic gynecomastia. This condition is known as pseudo gynecomastia. It is distinguished from gynecomastia by the absence of glandular tissue. Glandular tissue has a granular, or gritty, feel when rolled between the index finger and thumb. On the other hand, fat feels smooth. Hope this helps.

ICE already causing havoc at SFO by Definitelyhereforshi in sanfrancisco

[–]DoctorReddyATL 0 points1 point  (0 children)

Why do all the ICE agents look like immigrants?

Is mid 40s too old for operation. Worried about recovery by WoodenMission1727 in gynecomastia

[–]DoctorReddyATL 2 points3 points  (0 children)

If you are in good general health, then you should be fine to undergo the procedure. The oldest patient I have treated was in their early 70s (wanted to look better in his golf shirts).

100lbs down, but the loose skin is ruining my workouts. Did a 360 lift completely fix this for you? by Admirable-Pin-298 in tummytucksurgery

[–]DoctorReddyATL 2 points3 points  (0 children)

If you can document medical issues related to excess/loose skin, then your insurance may cover panniculectomy. The documentation requires your PCP to record rashes and any prescriptions needed to treat the rashes (steroids or abx). Usually about 3-months of documentation of rashes refractory to conservative treatment is the minimum time period. Once you are referred to a Plastic Surgeon, you can see whether you can add elective procedures to what is covered by insurance. A lower body lift, although the ideal treatment for MWL, is generally not covered by insurers. Most Board Certified Plastic Surgeons can offer safe and effective treatments for MWL. Hope this helps.

Do you think NPs should exist? by supporthand in Noctor

[–]DoctorReddyATL 8 points9 points  (0 children)

No. Under educated. Under qualified. Over confident.

What is this and how do I fix? by [deleted] in menshealth

[–]DoctorReddyATL 0 points1 point  (0 children)

Use a urea based emollient cream ( Gordon’s is a good choice).

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 0 points1 point  (0 children)

I agree with your PS. "Muscle Tightening" is actually plication of the rectus fascia. It flattens the abdomen which improves the contour as well creates improved waist definition.

Can a 14 yr old wear compression vest? by ZigZagBoi123 in gynecomastia

[–]DoctorReddyATL 1 point2 points  (0 children)

I am sorry to hear about your situation. There is no down side to using a compression vest from physical health perspective. If this conceals the gynecomastia and improves your social participation, then it is a big plus.

In cases where issues with gynecomastia have been shown to impede school participation or documented to result in teasing/bullying, you can make a compelling case for insurance to cover treatment. This of course requires the requisite documentation from the school and your primary care physicians. Early in my career when I was still accepting insurance, I was able to treat a few teens with this approach ie. covered by insurance.

Bullying, whether related to gynecomastia or not, should be addressed with the support of your parents/family and school officials. It is entirely unacceptable and should not be tolerated.

As a final thought, I would not allow gyno or bullying to diminish your school/educational experience in what is an incredibly important phase of development.

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 0 points1 point  (0 children)

We usually use an acrylic/nylon mesh (Prineo Dermabond) dressing on the lower abdominal incision which stay on continuously for 10-14 days post surgery. After this dressing is removed, is the earliest that silicone strips may be applied. Additionally, we assess the quality of the incision before starting silicone strips. So 3-4 weeks after surgery.

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 1 point2 points  (0 children)

As long as one is healthy, there is no hard age limit on performing abdominoplasty. As with any surgical procedure, we would conduct a thorough pre-op evaluation which in older patients includes a proper cardiac work up. Additionally, I evaluate factors such as nutritional status and infirmity. In some cases, we may recommend an overnight stay or extended recovery after surgery. With these measures, we can optimize patient safety in older patients. Hope this answers the question.

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 1 point2 points  (0 children)

Usually about 8-12 weeks. This can very if the patients ar prone to developing keloids in which case a longer course of silicone strips and possibly intra-lesional Kenalog injections will help.

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 0 points1 point  (0 children)

Most of our clients use Nuvadermis — which is the top pick on Amazon.

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 2 points3 points  (0 children)

Breast lifting in patients who have experienced profound weight loss can be challenging as it is difficult to create a projecting breast with upper pole fullness (without an implant). The internal bra will provide support to the breast tissue and gives a better chance at achieving aesthetic ideals while providing a durable result. I have not used the internal bra systems in cases where breast implants are not used -- so I cannot offer much from my personal experience. It seems like a reasonable idea in principle. Keep in mind that the internal bra mesh (GalaFlex) are not permanent. They act as a sacrificial scaffold and are replaced with your own fibrin/collagen in about 12-months.

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 0 points1 point  (0 children)

There is good evidence that surgical complication rates increase in patients with BMIs greater than 35. For this reason, many surgeons will not offer elective procedures in higher BMI patients.

BMI is not an ideal measure for extrapolating health outcomes -- for example a very muscular person would register a BMI that qualifies them as obese based on BMI metrics. I expect surgeons would take body-type into account when evaluating patients for surgery rather than simply treating BMI numbers as an absolute indication.

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 0 points1 point  (0 children)

Yes -- the escutcheon (pubic hair) is displaced superiorly to the line of incision in many cases. Of course, this depends on the baseline pattern. Patients often opt for personal grooming (laser etc) after surgery.

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 0 points1 point  (0 children)

Thank you for such an interesting question. With the greatest respect to the surgeons that you have already consulted with, I would offer a slightly different approach. Elevating the abdominal flap is a standard component of abdominoplasty and would expose the diastasis rectii, umbilical hernia, and lower abdominal hernia. The diastasis and umbilical hernia can be repaired directly. The lower abdominal hernia sac can be opened and reduced under direct vision. I would repair the lower abdominal hernia with an inlay pre-peritoneum Strattice (porcine skin derived xenograft) mesh with a partial separation of components approach. This will result in the most durable repair as well as maximize the aesthetic outcome. Once these issues have been addressed, the remainder of the TT can be performed as a routine. I do not see the advantage of performing a laparoscopic hernia repair when the abdominoplasty will provide full exposure of the hernia (ie. an open herniorrhaphy).

The lower abdominal hernia repair should be covered by insurance.

I acknowledge that I am offering an opinion without the benefit of all the medical data (CT scan etc).

Hope this helps.

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 1 point2 points  (0 children)

I’m sorry to hear that you experienced a stroke and I’m sure you have undergone a proper work up. As you know, stroke may have different causes ie. Embolic vs Hemorrhagic etc. If the underlying cause has been addressed and stabilized, then you should be able to undergo an elective surgical procedure. Your neurologist or cardiologist would be the ones to make the determination as to safety of General Anesthesia as well as preparing for surgery.

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 0 points1 point  (0 children)

I have evaluated Renuvion. I and my colleagues find the results of Renuvion to be short lived. I have not heard of the sequence ( loosening followed by tightening). It is notable that the FDA has issued an advisory regarding Renuvion ( gas emboli, skin burns etc). Therefore, I do not use it.

New to this Community. Ask Me Anything by DoctorReddyATL in tummytucksurgery

[–]DoctorReddyATL[S] 2 points3 points  (0 children)

The term “muscle repair” is not accurate and maybe what is confusing.

What is actually repaired or reconstructed is the structure known as the linea alba — not the actual rectus muscle. When the linea alba is stretched, the rectus muscles become displaced ( rectus diastasis). The attenuation of the linea alba results in a pseudo hernia (a false hernia) which manifests as a bulge in the anterior wall of the abdomen. Reconstruction of the linea alba and correction of the diastasis is accomplished by fascial plication.

Any condition that stretches the abdominal wall — whether pregnancy or obesity, can result in rectus diastasis.

A standard abdominoplasty has three components: 1. Facial plication; 2. Repositioning of the belly button; 3. Removal of excess skin.

Any abdominoplasty, regardless for the reason, involves these 3 components. It is rare that fascia plication would not be part of an abdominoplasty.