Nipple reduction - plastic surgeon

[cowboy100]

Ok so right now I have already had surgery and my chest is ok at best but I have bit time protruding nipple especially in cold temperature or if I'm running around, etc. I am looking into have nipple reduction surgery, the one were they just cut a piece of the top of the nipple of because the look funny and get chafed so much. Does anyone know of a surgeon that does this in Canada more specifically near toronto and if you have done it can you share you experience or know anything about it share...side effect, etc, etc...thanks you

[Grandpa Bambu]

Give Doc Fielding a call...

416.766.8890

GB...

[Darth Menace]

I am quite a ways from Ontario at the moment, but have family there and am going there for the summer.  Does a patient usually have to go in for a consulation before nipple reduction surgery or can we just book an appointment and slap them the cash?  Also, whats the going rate for this nipple reduction surgery?

[Grandpa Bambu]

Darth...

Yes, JCF requires you to have a consultation with him. OHIP covers the cost of the consult.

If it is just gland removal only that you need, there should be no cost to you as OHIP pays for excision of the gland and all hospital fees...

GB...

[Darth Menace]

I do not have OHIP exactly.  I did as I was once an Ontario citizen, but I moved to Saskatchewan (not by choice!!)  I am now an employee of the Canadian Government, and have a Canadian Government Employee Health Card instead of a Provincial Health card.  Hopefully that doesn't matter

[Grandpa Bambu]

You should be okay with your CGEHC dude...

GB...

[cowboy100]

just to clarify I'm talking about nipple reduction for protruding nipples...like the tips, not gyno removal, not surgery that requires lypo just reducing the ends of the nipples because I have already have gyno surgery and revision which makes my nipples sensitive to the smallest breeze and they protrude a lot...not puffy. Looking for a cost and surgeons for that. 

[DrBermant]

just to clarify I'm talking about nipple reduction for protruding nipples...like the tips, not gyno removal, not surgery that requires lypo just reducing the ends of the nipples because I have already have gyno surgery and revision which makes my nipples sensitive to the smallest breeze and they protrude a lot...not puffy. Looking for a cost and surgeons for that. 

Long Nipple Reduction Surgery alone is possible when the anatomic nipple itself is the only problem. It can be combined in stages with gynecomastia surgery when there are deforming elements under the areola.

Nipple deformity comes in many different forms as you can see in this Puffy Nipple Picture Gallery

Hope this helps,

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

[cowboy100]

actually those pictures for long male nipple pretty much show exactly what I have when my nipples are erect, so that essentially is the surgery I would need. Now my nipples would have to be erect during surgery though so I hope that isn't a problem but I think they would easily be with my shirt and being operated on the whole time.

[DrBermant]

actually those pictures for long male nipple pretty much show exactly what I have when my nipples are erect, so that essentially is the surgery I would need. Now my nipples would have to be erect during surgery though so I hope that isn't a problem but I think they would easily be with my shirt and being operated on the whole time.

That is the exception where plastic surgery does not work well. When the relaxed nipple areola muscle contour is flat, nipple reduction does not work. Some men tend to have this thin muscle protrude the nipple when stimulated. This is a normal function of presenting the nipple for breast feeding in mammals (both men and women). If the contour returns to being flat after the muscle relaxes, reduction tends to leave a deformity. Theoretically paralyzing that muscle with botox could be an answer, but then you would need to keep returning for more treatments as this costly option wears off. In addition you have major risk of the poison migrating an paralyzing the near pectoral muscles. That is a treatment I do not offer nor recommend.

Anatomic long nipple reduction is for the person with long nipples when the areola muscle relaxed. That means surgery does not require stimulation (the local anesthetic would paralyze the muscle anyway making stimulation irrelevant.

Hope this helps,

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

[cowboy100]

well they do stick out when relaxed just not as much, I think they would be able to be cut down when relaxed no problem so that in the future it doesn't look so funny and pointy when not relaxed. Also what kind of deformity are we talking here like indentation or a concavity or something? cause I would much rather that then what I have right night, yes it is natural for people to have pointed nipples when cold and such but they are almost allllllllways pointed, they are sensitive to everything and they are 3-4 times more pointed/long then your average male.

[DrBermant]

well they do stick out when relaxed just not as much, I think they would be able to be cut down when relaxed no problem so that in the future it doesn't look so funny and pointy when not relaxed. Also what kind of deformity are we talking here like indentation or a concavity or something? cause I would much rather that then what I have right night, yes it is natural for people to have pointed nipples when cold and such but they are almost allllllllways pointed, they are sensitive to everything and they are 3-4 times more pointed/long then your average male.

When there is a deforming component behind the areola Nipple Reduction Surgery Also is effective for men. This case was done in 2 stages: the tissue behind the nipple, then the anatomic nipple beyond the areola.

Your options depend on many factors. We are glad to help patients explore their concerns during a consultation or a Preliminary Remote Discussion. If interested, Jane is my office manager and can explain the process.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Hope this helps,

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

[cowboy100]

Just wanted to say I had the nipple reduction its now been about 4 weeks, nipples sticking out are less of an issue but my chest still has scar tissue which I obviously had not been messaging for about 2-3 weeks while my chest healed and it's has become an issue again is soarness and sensitivity. Funny thing is I think the freezing solution my doctor used relaxed my scar tissue and it actually looked fairly flat for those 2 weeks, but now it sticks out again a bit so I may go for a small dose of kenalog and hope that works.

[DrBermant]

Just wanted to say I had the nipple reduction its now been about 4 weeks, nipples sticking out are less of an issue but my chest still has scar tissue which I obviously had not been messaging for about 2-3 weeks while my chest healed and it's has become an issue again is soarness and sensitivity. Funny thing is I think the freezing solution my doctor used relaxed my scar tissue and it actually looked fairly flat for those 2 weeks, but now it sticks out again a bit so I may go for a small dose of kenalog and hope that works.

Injured sensory nerves result in numbness. Injured motor nerves result in diminished / lost muscle function. That thin under areola muscle, if it is the cause of projecting nipples, tends to not work well while those motor nerves are out of action. As nerves recover, sensation and muscle function tend to recover and the problem returns. Kenalog can help with scar tissue to a degree, but does not help with the shape of nipple from areola muscle contraction.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

[cowboy100]

so what can I do exactly other the kenalog, like I think getting ride for the most part of the scar tissue will help it flatten, but will the sensitivity eventually decrease so my nipple are not always so pointy, cause it would be way to expensive for me to get a cortisone shot and relax my chest ever few months.