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Surgery Experience, Dr. Pensler Chicago, IL

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Surgery Experience, Dr. Pensler Chicago, IL
« on: February 10, 2008, 09:27:34 AM »
Hey all,  I’ve been reading the board forever, and just got my procedure done with Dr. J. Pensler of Chicago IL, and thought I would share my story so far.

Right now I’m about 1 week post op and couldn’t be happier.

Consult: 

I went to his office about 2 months ago, I was planning on loosing weight first and getting my ducks in a row, but I decided that if I kept putting it off I wouldn’t be in the position I would have liked to be until the end of winter and I was intent on getting the procedure done when it was still cold (to cover the vest etc.) so I made the call on a random day, set up a time to make the trip into Chicago (about 2 hours) and see what he had to say.

Dr. Pensler and his staff were very kind and I was not kept waiting.  I was taken into an exam room, and given a paper shirt/gown to change into.  I thought that was kind of awkward, I mean I had no objections to just sitting there waiting for the Dr. with my shirt off, but I realized that it showed quite a bit of understanding about the situation many men with gyne have and their potential embarrassment etc.  Dr. Pensler came in, was very polite and professional. He explained a little bit about the procedure took some pictures with a (way overpriced for this purpose and I had to resist the urge to ask to play with it) digital camera. 

After the pictures he did a lightining fast assessment of my breast tissue which pretty much was a quick couple pinches around my chest, where he wrote down what I think was his assumed fat/gland ratio.  Then he told me I could put my shirt on and follow him into another office.  There he uploaded the pictures, did a very elementary edit using Photoshop which some people may or may not find helpful (again after reading this site for so long I had an idea of what kind of results to expect).  He printed the images, discussed very briefly how he did the procedure (lipo from incisions near the armpit and incisions below the areolas for glandular tissue) something I did make note of, was his statement of “I will” when he said make an incision for the gland, which was important as you sometimes read of people who ended up with just lipo b/c their Dr. decided it wasn’t necessary during the operation and eventually would end up needing excision at a later date.  After that I asked a few questions but really I felt like I knew what I needed to know from the site, and really couldn’t think of anything I didn’t think I already had an answer too.  It is probably in your best interest to write down questions for your surgeon so you don’t just make assumptions based on your own research as I did and potentially miss something unique to your Dr. 

He then spent a few minutes showing me a few pictures of other cases he had done.  Something that I found very encouraging was the way he spoke of the other cases.  He didn’t talk about what he did, or how he got his results, he told me about remarks his patients had made.  That is to say, that not only did he show great pride in his work, it seemed that he took great pride in his patients satisfaction and their feelings about his work.

Somehow in the course of conversation I mentioned this site, and he said something about talking to Merle which was the only offsetting thing about the visit (I’m assuming Merle gets financial support from some of the surgeons mentioned on the board)  but I don’t find that all that unsettling as long as peoples posts don’t start disappearing.  Anyways he then went into a discussion about the psychological effects of gynecomastia etc, which I really didn’t care for, I certainly haven’t been in the situations many sufferers of the condition have endured, but it definitely is a testament to how well he understands patients concerns regarding this condition.
We shook hands, and he handed me over to his assistant who went over the pre-op information, and fees etc. (see the end of this post) and essentially give be the nuts and bolts of the time leading up to the operation.  She told me I didn’t need to schedule right away, but I was ready, unfortunately both of my dates would not work, as he was booked solid for about 6 weeks.  So I went home to see what kind of juggling I could do.

I called a few days later and found a time that would work and set up a date about a month and a half later (beginning of FEB).  I then faxed them a copy of the Reservation Authorization form which included payment of the $500 reservation fee.

Pre-op:


After setting up the date, I received a phone call and a letter from his office confirming my date, and included a copy of the pre-op instructions, as well as a request for the number of my local pharmacy so that they could call in the prescriptions.

I spoke with my girlfriend about it (the only person I had told I was going to have the operation) and she set up the time to come up and take me there and back and look after me for a few days.  She was somewhat worried about being the only one who knew, and the fact that she lives a hour or so away from me (she is currently going to a different school working on her masters.)  So, to eliminate her fears, and to make me feel better about putting such a burden on her in case something went wrong.  I set up an emergency power of attorney and a plan of action should something happen.  This certainly isn’t a necessary step, but admittedly it made be feel better knowing that if something should happen my girlfriend wouldn’t be in the horrible situation of trying to explain everything to my family members, and cope with any medical or financial issues that might occur.  I would definitely suggest looking into such an arrangement for individuals not wishing to tell anyone, or are traveling for their operation.
I did have an awkward issue with the prescriptions, as apparently I didn’t receive an antibiotic for the evening before (which I only knew about from this site).  I had only received my pain medication, and an anti-nausea drug to take the evening before.  I called the office, and they said it wasn’t a big deal, and that the nurse would have one for me the day of the operation (which I found out she had no idea about, and thought that perhaps the pharmacy didn’t have that particular antibiotic and just didn’t fill it without informing either I or Dr. Pensler, which I found very odd.)  Regardless, the night before I ate a pretty healthy “last supper” and took my anti-nausea medication.

The Big Day:
   
SNOW STORM!  It started the evening before, and I made the decision that we wouldn’t get a hotel room in the city, since it would have been worse (so I thought) driving at night before the plows were out.  I intended on leaving by 6:00, and I think we got on the road around 6:05 so we did pretty good.  What usually took an hour and a half ended up taking around 3 hours.  I called the office at 8:30 (my scheduled time) and let them know I was going to be 20 minutes late and that I had just gotten into the city.  They were very understanding and in fact one of the assistance couldn’t make it as well due to the weather.

When we finally arrived, an assistant got my information and payment for the procedure, and took down my girlfriend’s phone number etc. (they don’t allow people to wait in the waiting room which my girlfriend found odd, but I found very reassuring and purposeful, as I didn’t want someone and their family waiting out there when I came out of my operation) Dr. Penslers office is about 4 blocks from Michigan Ave. (major shopping district in Chicago) so my girlfriend took off for Borders, and was told she would get a call when she should come back.

Soon I was taken in by the Nurse/Surgical Assistant, and asked if I had taken my antibiotic (see pre-op), which I never got, so she gave me one right away, took my weight,  then had me take off my shoes, shirt, and eventually pants (track pants, and button up shirt as requested) and get into a gown.  Then Dr. Pensler came in, took a marker and marked my chest.  I was then shown to the bathroom to try and go before the procedure (no test just so I didn’t soil myself I assume).  I made sure I was ready to go, then was taken into the operating room, where Dr. Pensler administered an IV, and began prep with his assistant while making small talk.  Then they told me they were going to give the sedation medication, and I was out.

I think I woke up a just a bit earlier than expected (I’m sneaky like that) I do remember very clearly the thought “Oh yeah I’m getting my mobs chopped off, and seeing and feeling some interesting things, but then I was right back out”

I’m guessing just a few minutes later I woke up to just the assistant in the room wearing my favorite fashion accessory (that damn vest).  “I think” few things about my liver and something about drinking habits (I rarely drink) and something about wakening up was mentioned, but I was still out of it and didn’t really care to pay attention.  Then she said she was going to either call my girlfriend or go get her, regardless the next thing I remember she was standing over me and my girlfriend was in the corner.  After that everything was a blur for a little bit.  I remember getting dressed and the nurse rattling off instructions which I really wish she would have written down b/c I was freaking swimming.  Lucky enough my girlfriend (I think the instructions were more for her benefit anyway) got most of it, but she even said, man I wish she wrote some of that stuff down.

The nurse asked me if I was ready to try standing up.  I’m always ready to try anything  ;D.  So I got up ok, she pointed me toward the bathroom (IV and all I think it was at least a liter) and I remember thinking “this is fun” and when I was getting to the bathroom I was thinking what if I slipped and cracked my head open after finally getting this done (Which my girlfriend told me later I must have found funny b/c she asked me why I was giggling when I was going into the bathroom).  Anyways, I remember getting into a wheelchair, and showing up at my car.  I don’t remember anything in between very well.  The nurse helped me into the car and positioned some ice packs on my chest and away we went.

While on the way home, I was in considerable discomfort.  My chest felt strange but not painful, but the incisions by my armpits were sore, and my arm movement was very limited.  When I moved my arm, I was worried I would tear something, and there was a bit of pain from the armpit incisions.  I was really worried about how bad revoery would be if it was going to feel like that.

We got home, I crawled into bed, and my girlfriend ordered some subs for us (I was starving).  I took a quick nap, then went to change into cloths so that we could go to the store and get some ice packs, and to get me walking a little bit.  Getting into the car was a pain in the ass, well really it wasn’t that bad, but reaching out to close the door blew, and so did putting on my seat belt.  After that I felt pretty good, I was leaking a but from the incisions in my arm pits, but nothing major, I just threw some new gauze around the area so I didn’t make a mess and spent the rest of the day lounging around.
   
Sleeping was difficult since I usually sleep on my stomach or side, but it really wasn’t that painful just a little uncomfortable (the nurse said sleeping on my stomach was fine).



Day 3:

My first shower, and look at my chest.  I was shocked.  It looked perfect.  I mean my nipples were in the right place, my chest was flat and the incisions in my armpits were scabbed up.  I had bruising of about every shade, but I was very happy with what I was seeing.  My right nipple however was an ashy grey, almost like black with white dead skin on top, and this had me extremely worried, but after reading the site a bit I found that most people have some concerns about it.  I took a flashlight just to be sure and moved the nipple just a bit and saw pink between the natural creases in my nipple so I knew blood was there and figured everything was ok.  At this point I had regained 100 mobility in my arms without any tearing feeling or pain from my incisions so I was very happy with that.

Day 6:

My ~1 week post op with Dr. Pensler.  I brought up the concerns about my nipple and he said things seem to be just fine, I also had a concern about a “concavity” on my right side above the nipple toward the armpit.  Originally there were two minor concavities (at the corner of my gauze under my vest for the first 3 days) on both sides, and the left one had all but disappeared.  That was where the muscle is, and she showed me my pre-op photos  where it is very evident.   Other than that he said I was fine and that I need to return for a 1 month post op.

Day 9: (today)

Right side “concavity” equal to the left and almost invisible.  I am very happy with my results at this point.  The last few days I’ve been having issues with itching and a little burning (years of sports injuries told me that was coming) which is extremely annoying!!  Really no pain.  I never had any pain related to my chest, just my armpits really so looks like I got away easy.  My right nipple is brown and pink, with deep black at the incision, but it looks 1000 times better than day 3.  My left nipple has some sensation returning, I think it reacts to cold as well, which is sort of a pain as it is scabbing.   The swelling isn’t too bad, but its evident.  I think that days 3 and 4 seemed to be the worst as far as swelling.  I might take some pictures but I doubt it, The only pre-ops Dr. Pensler has, and I wont be seeing him for a while, and I really have no need of reminding myself of this anymore than I have to  ;).   



Ok, that was my experience so far.  Here is a quick outline of the cost.  I’ll post from time to time if things change, but other than that I don’t think I’m long for this board anymore. 

125.00  Consult
500.00  Scheduling Fee
4425.00 Balance
------------------------
5050.00 Total.

I know someone else had just started posting with pics that had gone to Pensler just prior to me, and everything on his posting is very similar to my experience.  As of right now I would certainly Recommend Dr. Pensler  I am very satisfied.  However I’ll keep updates and reserve the right to retract that if my nipples fall off  :D.


Linkback: https://www.gynecomastia.org/smf/index.php?topic=12952.0

Re: Surgery Experience, Dr. Pensler Chicago, IL
« Reply #1 on: February 11, 2008, 04:42:53 PM »
Congrats on the surgery man!  Excellent report of the whole process.  I had my surgery performed with Pensler at the end of December and had a very similar experience.  The way you described your nipples sounds familiar.  The scabbing really didn't entirely go away until about one month post op.  Also, I can definitely tell the scar tissue has been continually going away; something else you have to look forward to.  Keep us posted on how the recover goes!  Again, congrats!

Re: Surgery Experience, Dr. Pensler Chicago, IL
« Reply #2 on: February 11, 2008, 06:20:19 PM »
Awesome, thanks man, its good to know things worked out for you.  Like I said right now I'm pretty happy but its still early and its good to know there are still people around that will be able to let me know whats going on if I hit a pitfall.

Re: Surgery Experience, Dr. Pensler Chicago, IL
« Reply #3 on: February 13, 2008, 05:10:42 AM »
Day 13:

Get me out of this god damned vest!  :).  Its amazing how having this procedure done can just change your life momentum.  I have been a little bit more reserved actually since I got the operation that when I had my moobs, but I think that’s just the way I look at it.  I would much rather have someone notice my moobs (mind you I have never been made fun of as others have), then have someone see the vest and think I am some kind of a vein not a nice person... I suppose that makes me a hypocrite when I look at my opinions of women with breast implants etc.

Anyways.. the nuts and bolts of it :).  No more purple bruising, there are a few (and I mean few and small) spots that are deep red.  The scabs have fallen off the lipo incisions near my armpits, and I will begin using scar cream on them.  They would certainly not be noticeable at all when they fade to normal skin color (pink right now).   My nipples are falling off :) just kidding, but they scabbed over and are now starting to peel leaving the pink skin underneath.  The left nipple is perfect!  Like pre-op with an ice cube, perfectly round etc.  The right nipple seems a little wider than tall, but its hard to tell as there is a ton more scabbing on the nipple, and I think the Dr. needed to make a much wider incision on that nipple so hopefully its just the butchers spreading it out.  I can already tell that scarring will not be an issue on my left nipple, but I think it will be more noticeable on my right, but time will tell.

I have been waiting to go to the gym, for the whole vest reason, and due to my current gut situation it bunches up making it noticeable.  So, I plan on waiting a few more days to ensure that the incisions below my nipples are healed pretty well, and will probably change into an underworks compression vest (997 I think I have) when I go to the gym.  I just want to make sure the nipples won’t be scraped off when I put it on :).

On another note, my sister is having a beach wedding this summer, and I remember her telling me earlier this year and I just thought "Oh shit that’s going to be miserable and hot.."  Now I realize I won’t have to wear two shirts or a compression vest and am actually excited!

I can tell by feel what is swollen, and it seems that if the swelling reduces things will look excellent.  I'm holding out hope that my right nipple shapes up like the left and if that’s the case I'd be on cloud nine (shirtless of course)

Re: Surgery Experience, Dr. Pensler Chicago, IL
« Reply #4 on: March 24, 2008, 07:45:57 AM »
Week 7 Update:

Well, Things have been going pretty well.  My chest overall looks great and I am very satisfied with its overall appearance.  The only problems are my nipples.  My right side has some harder tissue extending from the right top quarter of the areola and then about a half inch toward my armpit.  This distorts my right nipple/areola into what some people would call a "puffy nipple," but only on the right side of my right areola (the left side of the areola is flat).  My major issue with this is that the puffed out portion is visable through a t-shirt (but not enormously noticeable).  However when compared to my left side it looks a bit odd.

My left side nipple/areola looks great, with the exception that where the incision was made at the bottom seems to be pulled in more sort of allowing a bit of the areola to hang down above the scar (I don't know if that makes sense.. I think some people refer to it as folding, but its not that extreme).  Under a T-shirt my left nipple looks like a happy normal nipple, but hopefully the incision will evolve and even out with the rest of the nipple for a more natural nude appearance.

During my 1 month post op, Dr. Pensler mentioned that it would take about 16 weeks to get to a point where more decisions could be made.  He also mentioned that he might have to just "go in and release some of the tissue"  It makes me nervous that he brought up a revision, but then as I think about it I'm happy he didn't say... "good enough later man."

Overall, 90% improvement.  My goal was to have "normal looking" (of course I didn't expect natural nipple appearance, but you know round same size symmetrical etc.) nipples after the operation, if my chest was a little big or a little uneven thats fine, but nipples that look odd through a t-shirt and non symmetrical is what I was hoping to avoid.

That being said, things do look very good!  Hopefully the nipples issues will resolve (there has been some improvement over the past two weeks), and if not.. Dr. Pensler did an excellent job and if some cosmetic work needs to be done to my nipples/areola it should be minimal.  I am just thrilled I don't have a hole in my chest or one nipple in my armpit :).

I will post this question elseware, but if someone reading this has used Pensler, does he still do free revisions?  The way he said "just release some of the tissue" so nonchalantly it lead me to believe he still does, and his price was quoted as "all inclusive" but after reading this site I just assumed that was his practice based on other people saying so and forgot to ask him in person (read my above post about writing questions down and not assuming you know everything due to this site) :).  This might be premature, but I would just like to know if for some reason things dont resolve on their own.

I was scheduled for a 2 month post op, so hopefully next week things will have improved.  I am still very pleased with Dr. Pensler.  He listend to my concerns about how I'm healing and doesn't seem hesitant to discuss options regarding my concerns.  I was very nervous that at my one month I would have gotten some song and dance about how things look fine and waiting is the cure for everything.  It's very comforting to know that even if things dont resolve naturally there are solutions.. it makes the ups and downs of revoery a little easier.


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