First surgery-Excision only?

[Tiredofittoo]

Had gyno for years, grew with prohormone use when I didn't pct correctly. My breast area is very perky, with hard and sensitive tissue behind the nipple on both sides. They do not sag at all when standing up straight.

Went to 2 plastic surgeons for consults, not happy with either. Neither touched my gyno, just looked and described their process. I was disappointed with those local doctors and quit looking for a bit. Both did excision plus lipo.

I asked my GP about another local doctor, who I went to see Thursday. He's a board certified general surgeon with a speciality In mastectomy and other breast issues. He doesn't work for the hospital, but is affiliated and has multiple credentials regarding breast speciality doctor.

I was extremely happy with the consult. He took his time, answered all questions, explained that he leaves a little bit of breast tissue in but would do whatever I want in Regards to amount of tissue  removal.He doesn't do lipo as a general  surgeon, but believes excision only would get my chest flatter. Is it possible excision only can be done with good results for someone with primarily breast tissue?

[Miguel Delgado MD]

Tiredofittoo,
Unfortunately, the plastic surgeons did not relate to you well. However, going to a general surgeon is not a good plan.  You really need a plastic surgeon who has specific skills in gynecomastia surgery. 
 It may seem like a simple procedure but it is far from it.  Forty-five percent of my cases these days are revision surgery for men who are not happy with the first surgery performed at other places. The doctors on our panel of experts all perform many revision surgeries for this reason.
My suggestion to read this blog of how to find a gynecomastia surgeon- 7 tips.  This will offer some valuable information. Good luck.

[Dr. Elliot Jacobs]

Totally agree with Dr Delgado.  Most gyne surgeons utilize gland excision plus lipo to sculpt the surrounding tissues.  A general surgeon is usually not familiar with lipo and hence may not want to do it.

Many of the patients I have seen for revision gyne surgery have been done by general surgeons.

Would strongly advise you to continue to seek help from plastic surgeons and preferentially those who have considerable experience in gyne surgery.  If there is no one available in your local area, then consider traveling for such expertise.  An experienced gyne plastic surgeon can save you a second operation for revision surgery.

Dr Jacobs

[Dr. Schuster]

I think that every good qualified gynecomastia surgeon should be able to perform excision of the gland as well as liposuction / UAL for every case. If you read these forums and see the unsatisfactory results, they are frequently because only excision, or only liposuction was performed. Most general surgeons do not perform liposuction so if that's the case with your general surgeon, I suggest that you keep searching for the right surgeon.

[Dr. Cruise]

I would encourage you to keep searching for a board-certified plastic surgeon who specializes in gynecomastia surgery. I hear from countless men who are unhappy with their results after having surgery with a general surgeon or a plastic surgeon who didn't truly specialize in male breast reduction surgery. The two most common issues I see: not enough breast tissue removed or over dissection. 

[Dr. Schuster]

I think the best results are gotten by surgeons who are prepared to use both excision and liposuction / ultrasonic liposuction techniques. They need to be combined in the vast majority of cases. if you read about unhappy patients, many times they have chosen surgeons who use only one. Be careful and select wisely. better to have it done right the first time.