Best Surgeon? (Special Case)

[craZ]

Hey all,

I never quite realized how widespread this was, though I was pleasantly surprised to find that there were more than a few people I could ask a couple questions.

I'm trying to decide on a surgeon, and am located in Burlington.  Toronto, Hamilton etc. is fine, but as a university student I can't really make it much further due to time and money issues. 

The issue is, I don't have gynecomastia.  I have enlarged and asymmetric nipples.  As far as I can tell, it's hereditary, or whatever caused it happened when I was very young: always been this way.  Nutshell is, I'm an athlete, I swim a lot, and I'm very fit otherwise, so it's really very annoying not being comfortable taking my shirt of. 

Reason I'm here is that surgery for gynecomastia seems to normally involve surgery on the nipples, which means that someone experienced with one would tend to be experienced with the other.  It's a much smaller surgery, but you don't tend to see it performed on it's own.

Does anyone know if there's a surgeon in the area who's particularly experienced with this kinda thing?  I can upload a photo if that will help....ok, wait, I actually did find one.  Note: This is one side.  No, the nipple is not erect, it's always that way (hence part of the problem) and is soft to the touch.  The other (right) side is significantly (at least two to three times) larger, and the shape is different.  (As I mentioned, asymmetric.)  I'd upload a picture if I had one, but I don't and it's way too late here for me to go fiddling around with cameras.  Again, if it would help I'll give it a try maybe tomorrow.

Thanks for your patience, and hopefully someone will be able to help!

[DrBermant]

Hey all,

I never quite realized how widespread this was, though I was pleasantly surprised to find that there were more than a few people I could ask a couple questions.

I'm trying to decide on a surgeon, and am located in Burlington.  Toronto, Hamilton etc. is fine, but as a university student I can't really make it much further due to time and money issues. 

The issue is, I don't have gynecomastia.  I have enlarged and asymmetric nipples.  As far as I can tell, it's hereditary, or whatever caused it happened when I was very young: always been this way.  Nutshell is, I'm an athlete, I swim a lot, and I'm very fit otherwise, so it's really very annoying not being comfortable taking my shirt of. 

Reason I'm here is that surgery for gynecomastia seems to normally involve surgery on the nipples, which means that someone experienced with one would tend to be experienced with the other.  It's a much smaller surgery, but you don't tend to see it performed on it's own.

Does anyone know if there's a surgeon in the area who's particularly experienced with this kinda thing?  I can upload a photo if that will help....ok, wait, I actually did find one.  Note: This is one side.  No, the nipple is not erect, it's always that way (hence part of the problem) and is soft to the touch.  The other (right) side is significantly (at least two to three times) larger, and the shape is different.  (As I mentioned, asymmetric.)  I'd upload a picture if I had one, but I don't and it's way too late here for me to go fiddling around with cameras.  Again, if it would help I'll give it a try maybe tomorrow.

Thanks for your patience, and hopefully someone will be able to help!

Evaluating a single side for gynecomastia, especially for asymmetry, makes no sense. Posting Standard Gynecomastia Pictures can help others better understand your concerns.

Options depend on if the problem is one of Long Nipples in Men or uneven Puffy Nipple Gynecomastia.

I see many Gynecomastia Patients from Canada and around the world who prefer my techniques.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[craZ]

As I said, that just happened to be the picture I had at the time.  Here's a much better one taken today which shows both sides.  I hope that works ok.

Many Thanks!

[craZ]

Arms Over Head

[craZ]

Left Side

[craZ]

Right Side

[craZ]

Right Oblique

[craZ]

Left Oblique

[craZ]

Hands on Hips

[craZ]

Hands on Hips (Flexed)

I believe this is all the pictures that you suggest on your website.  This is the natural state of the nipples, and both are soft to the touch, it's quite warm here.  I hope this helps.

[DrBermant]

Hands on Hips (Flexed)

I believe this is all the pictures that you suggest on your website.  This is the natural state of the nipples, and both are soft to the touch, it's quite warm here.  I hope this helps.

The images posted look like a case of  Long Nipples in Men. A nipple length of 2 mm is normal. Longer can push out a shirt. However, there is nothing wrong with much longer nipple length. My reduction for just the anatomic nipple is typically done under local anesthesia alone. In picking a surgeon, make sure you can see before / after surgery examples. If there is a component under the

Here is a rare case of Big Nipple Gynecomastia that had gland in the anatomic nipple itself. This needed more extensive local anesthesia with sedation.

And here is a more typical case of combined behind areola and long nipples that required a 2 stage surgery. The first under local with sedation. The second under local to reduce the anatomic longer nipple done about 6 days later or longer.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[craZ]

That's what I figured was the case.  It's not something that appeared at puberty, it's simply been that way since I can remember and the chest is firm when flexed (no fat). 

I'm a university student, and this would be a much less drastic surgery so it's likely not worth (or budgetable for) my making a trip down to Virginia to see a specialist such as yourself, but do you happen to know if there are any surgeons in Ontario (particularly Toronto and the surrounding area) who have particularly good reputations for performing this kind of surgery?  This is something that's pretty important to me, and has impacted particularly my sexual confidence, so if I'm going to have it dealt with the last thing I want is for something to go wrong.

Finally, at least to give me some perspective and a point to compare things to, what would you generally expect to charge if you were to perform a reduction on both the left and right sides, including some shaping to restore symmetry?  I know you can't give me a full quote from a few grainy pictures, but if everybody up here quotes me a number that's 1k higher then it might suddenly become profitable to find an excuse to go to Virginia.

Thank you so much for taking the time to help!

[DrBermant]

That's what I figured was the case.  It's not something that appeared at puberty, it's simply been that way since I can remember and the chest is firm when flexed (no fat). 

I'm a university student, and this would be a much less drastic surgery so it's likely not worth (or budgetable for) my making a trip down to Virginia to see a specialist such as yourself, but do you happen to know if there are any surgeons in Ontario (particularly Toronto and the surrounding area) who have particularly good reputations for performing this kind of surgery?  This is something that's pretty important to me, and has impacted particularly my sexual confidence, so if I'm going to have it dealt with the last thing I want is for something to go wrong.

Finally, at least to give me some perspective and a point to compare things to, what would you generally expect to charge if you were to perform a reduction on both the left and right sides, including some shaping to restore symmetry?  I know you can't give me a full quote from a few grainy pictures, but if everybody up here quotes me a number that's 1k higher then it might suddenly become profitable to find an excuse to go to Virginia.

Thank you so much for taking the time to help!

Cost of Gynecomastia Surgery depends on the problem to be treated. It would be different for just an anatomic nipple reduction vs. a two stage sculpture. Jane is my office manager and can better discuss typical costs and fees.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.  To minimize travel and better define the problem our patients often start with our Preliminary Remote Discussion.


Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction