Dr. Fielding Consult Questions/Concerns

[854clc]

A few days ago, I went to Dr. Fielding for a consult. I have a few concerns.

I noticed that he doesn't explain things in too much depth, and he is somewhat brief. Is this ok? It seems like he knows what he's doing.

But I was also feeling very tired (didin't get any sleep on the red eye from Vancouver). I forgot to ask him some questions, so I'll ask here.

My situation: I do have gynecomastia. I am not overweight (according to BMI), but most think I'm 10 pounds overweight probably because I don't have much muscle tone (I look like I'm 100% covered in fat), I'm very short, my face is naturally round, and my gynecomastia makes me look fat. Still though, I would like to lose about 10 pounds (just to have less of a belly and to look skinny, not average).  My gynecomastia is a pretty bad case - Dr. Fielding did say I have quite a bit of extra skin, but it will likely go away (my skin is elastic).

Dr. Fielding showed me with his hands how much the surgery will reduce my gynecomastia. However, I don't know if he meant that just the excision will remove that much, or that both will remove that much.  I was not really impressed - it seemed like whatever he was describing (either just the excision, or both excision and lipo) would not make my chest much flatter. It seemed like I would get an end result like this:

http://www.rsplastic.com/wp-content/uploads/2008/06/gynecomastia-119081.jpg

Ignore the before in the picture above - my gynecomastia is much larger than his was.


If you look at this person's after picture, his chest still isn't flat. I don't want to end up like him - I want a more flat chest!

I talked to Dr. Fielding about this (still not having a complete chest), and he said don't expect to be 100% satisfied with the surgery. Is he purposely going to still leave some fat in my chest just because he possibly thinks I'm overweight, and that having a chest with a bit more fat will look proportional to the rest of my body? There was a doctor who posted on these boards before who said that he does leave in a bit more fat for overweight people so that their chest looks proportional to the rest of their body, and to give them an incentive to lose weight. I don't want Fielding doing this to me - and I'm not even overweight! (but I admit, I do look overweight to most because of the reasons listed above). It feels like a punishment for being overweight (even though I'm really not, but he thinks I am).

Another concern of mine was the fat above my breasts. I do have some fat above my breasts (coming down from my shoulders towards my breast), and Fielding said that it is subcantaneous fat, meaning that it can go away through weight loss, and that for gynecomastia surgery, he typically doesn't ahve to remove fat in that area. But he also said that there is a bit more fat there than he would expect for someone with the same weight/height as me. I've lost many pounds over the past few years, and fat was NEVER lost in that area. I told him I wanted that fat removed, and he agreed. He told me he can't remove all of the fat in that area b/c it would look "not natural". What does he mean by this? Does this mean he'll leave enough fat so my chest looks proportional to someone overweight? He told me that he can't remove all the fat b/c he said EVERYBODY has SOME fat in that area. Still...I have my doubts. He seemed to be getting a little annoyed at my concern about having a flat chest. But really...I didn't mean to annoy...I just want this surgery to be well worth the money and I want a good job to be done in the first time. I was hoping he would be a bit more empathetic.

However, my surgery now comes to $2400 plus GST, which is WAY more expensive than what most here have paid! And I'm a full time student! Do you think he's giving me a break because I'm a full time student, or not? Is he charging me more as a punishment for supposedly being overweight (even though I'm not)?

Is he just saying that my chest won't be 100% flat just so I don't complain after just in case it doesn't turn out the way he planned? I've seen many before/after pictures for Fielding, and it looks like he always does a good job regardless of whether or not the patient is overweight (makes everyone's chest flat!). For those of you who were overweight when you had the surgery - were you satisfied in the end? How flat was your chest afterwards? Was it like the picture posted above, or flatter than that?  I really don't think having a completely fat chest would look disproportional on me b/c I'm not overweight!

[Grandpa Bambu]

Dude post some pics...

Full body shots (minus your head, as I'm sure you'll want to remain anonymous...) Front, LHS and RHS...

I'm just curious as to the extent of all this 'body fat' that you say you have...

GB...

[Travelbum]

Well if it makes you feel any better, I have now had 5 consultations with PS from Montreal to San Francisco and $2400 is the lowest price I have heard of.  The doctors in California and Montreal want between $7,000 - $8,000.  I am ending my search next week with a consultation with Fielding myself.  Apparently my biggest problems are age (61) and the fact that I live half the year in the sunbelt where I get tanned often.  I was given rather disappointing news from a couple of the doctors for that reason.  The skin is not very elastic when you get older.  I am waiting to hear what Fielding has to say before I will make my final decision as to who I pay.  Right now, without Fielding's opinion, I am leaning toward a guy in Newport Beach, California.  He offered solutions for all the drawbacks without my even being aware that these factors were drawbacks.  From what I have read and researched on this I don't think you will go wrong with Dr. Fielding.  Good Luck!   

[Grandpa Bambu]

However, my surgery now comes to $2400 plus GST.

Looks like JCF's fees are on the rise again...

GB...

[chaps69]

I think that all doctors are only preping you for disappointment, meaning that they don't want you going under thinking you are going to have the perfect chest, ready for a magazine.  Dr Lista told me to expect 80% improvement.  I would be happy with the post pic that you posted.  I would go for it but I would stress to him this is a jump start to your loosing 20 lbs to make your torso to look thiner, that way he may take more.  Also, I have read on here that many guys who have had Fielding gets a flatter look due to the incisions around the areola, where Lista only does one incision. 

I think if you can swing it, do it.  Lista is charging $5150 +$100 for a physical, $30 for meds, and $55 for blood work for mine.  My main reason for going with him is that I scar easily and want to keep the cuts to a minimum...and I am not tight for funds. 

I would do it, hope for the best and get er done!  BTW, post some pics.

Best of luck.

[854clc]

I'm actually going ahead with the surgery in August. Dr. Lista is well above my budget. Plus, after seeing the results of many people on this board, I'm pretty comfortable with Fielding. Nevertheless, I do have concerns still. Are you suggesting that I tell Dr. Fielding that this surgery is the beginning of loosing 20 lbs so he’ll take out more fat? Would that work, or would it backfire - would he take out less fat, in hopes that the fat he leaves in will give me an incentive to loose weight through diet/exercise (even though I’m not overweight)?
During the consult, Fielding asked me if I'm happy with my weight, and I told him that I do want to lose 10 pounds. I hope he takes out enough fat to make my chest look flat. I’m still really curious whether my result will be like the one I posted above (with the end result not being a flat chest), or completely flat. I was looking at Grandpa Bambu’s before/after pics, and the results look excellent (very flat chest!).

And another question:

I forgot to ask Fielding what the exact distribution/proportion of fat/gland was in my case. My breasts are both big and very cone shaped. From what I could gather from Fielding (not sure if my interpretation is right), the gland is out in front (so towards the tip of the cone/nipple), and the fat is a layer behind the gland. Is this a typical gynecomastia situation?

If that is the case, will Fielding first remove the gland (from the top of the breasts via the areola incision), and then do lipo at the bottom of the breasts? Is that how it is typically done. If he does it this way, then why do some (like the situation pictured above), not end up with a completely flat chest? Why can’t the doctor remove all the fat at the bottom of the breasts to create a completely flat chest?

[willy27]

I spoke to Fielding and he said the prices have increased over the past 2 years.
When he does gynecomastia surgery, hes in there to do that specifically; removing the gland and remove some of the fat to properly shape the chest as if you were the same person without the gyne.

I totally understand what you mean. I want a flat chest too and im not overweight at all. After my surgery+revision surgery, I still wasn't happy.
He told me I looked normal, like an ordinary person without the condition. Instead I had a pointy chest, which showed when I wore a a tshirt and people could clearly see this. I do not feel normal.

So I asked him for a lipo, to shape my chest. He said this not part of the first procedure an would cost me another surgery. It was double my initial fee which I had 2 years ago for (excision+lipo), while this time it was only the lipo.

[chaps69]

They can't take out too much because you could end up with concave pecs, which I think would look awful.  Lista told me that this is the reason he doesn't remove all the fat.  I told him that I will be loosing wieght and he said that my chest would end up looking flatter once I lost more weight. 

I think the most important this is don't go expecting perfection.  Dr Lista has a video on his site which shows you how he does the surgery.  I would make a point of telling him that you are going to loose more weight so he may have a better idea of porportions for the end result.

I don't know if they would know how much gland/fat % is until they do the surgery.  Lista tells you how much is removed after the surgery, there's really no good reason for them not to share that info.