Only lipo in this case? need advice

[sin2numeros]

Hello,

I’m from Lima Peru, 25 years old, 170cm (66.9 in) and 68kg (149lb). I have been diagnosed with gynecomastia and planning to go for the operation. I have some doubts though and need some advice. (Sorry for my english, I’ll try to do my best, let me know if something isn´t clear.)
 
First: I had an interview with two plastic surgeons already, both mentioned lipo only but no gland removal (with the possibility of doing so if they feel it would be necessary while in surgery). They said I have more fat tissue rather than big glands.

Second: I’ve always notice that when I get cold my nipples “shrinks and get tight”, seems like no gyne anymore. The opposite thing occurs when I get warm, the nipples and areola get pointy (puffy nipples?), pics attached. Why this happens and what does it mean? I talked about these with the doctors but they didn’t understood to much what I was talking about. One of them said that without fat it would not protrude...

So, my question:  Is lipo only, in my case, going to resolve the pointy nipples I’ve mentioned?

Note: as you can tell in the pics, I put the “warm stage” on the left side with the “cold stage” at right.

 











Ecography:


Thanks a lot!

[sin2numeros]

Please, anyone?

[DrPensler]

You have gynecomastia. I often tell patients if you could tape an ice cube to your nipple you would not need surgery,however that is not possible.You are a thin guy in good shape and I would suspect the majority of your tissue is glandular  as opposed to fat. I would recommend lipo and excision.In cases where lipo only is performed there is swelling postoperatively and everything looks good for a while then as the swelling  dissipates the glandular tissue is once again apparent.

[sin2numeros]

Thanks for your reply Dr. Pensler. I had a new appointment with other doctor today. He told me there is both fat and gland, and be necessary lipo and excision as you said. I’m a little bit concern now about how much gland is enough: He said after surgery I would get a slightly depression around the areola, but in some time it would fill up and look normal… is that right?

[Litlriki]

I agree that you'll most likely need excision and liposuction.  A properly executed procedure should not leave you with significant depression around the areola.  It should be fairly evenly contoured even at the end of surgery.

Rick Silverman

[DrPensler]

I think both glandular and adipose ( fatty ) tissue should be removed.As far as a depression after surgery that would not be typical.

[sin2numeros]

Thank you a lot doctors, things are much clear now. I'll go for the lipo and incision