Best place for incision?

[SOAD]

Okay, so cosmetically, what is the general consensus on the best place for the incision/cut? I've heard it is at the armpit, but I'm not sure.

I ask this as I was told my surgery may be done straight across the bottom/front of my chest, which sounded about the WORST place to do it, so I want to be able to discuss this with knowledge on what can and can't be done.

Thanks a lot in advance.

[jc71]

I'd say under the armpit for lipo and around the areola for glandular excision.

I think most PS's only cut across the bottom front in extreme cases of gyne.

Good question, maybe Dr. Bermant will weigh in on this.

[DrBermant]

Okay, so cosmetically, what is the general consensus on the best place for the incision/cut? I've heard it is at the armpit, but I'm not sure.

I ask this as I was told my surgery may be done straight across the bottom/front of my chest, which sounded about the WORST place to do it, so I want to be able to discuss this with knowledge on what can and can't be done.

Thanks a lot in advance.

I prefer for almost all of my patients a single small incision at the edge of the areola and chest skin interface.

You can see actual pictures during excision of the gland during Gynecomastia Surgery at the bottom of this page.  Excision is one of the tools of my artist's palette for my Dynamic Technique Male Chest Sculpture.

An incision at the edge of the areola opens up for me an artist's palette of tools not available when using the armpit approach.  That is why I prefer my Dynamic Technique.

I have also seen patients from other doctors with channel problems between remote access sites and the areola / nipple.  Scars, adhesions, and depressions can look terrible.  Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexion here to see what I mean.  

Here is another example on this forum of other incisions:
http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=1;action=display;num=1144655789;start=2#2  The result posted are not mine and are early after surgery.  Here are typical early after surgery pictures for my techniques. In general, the extra incisions just do not look natural to me and I try to avoid them when possible.  I do need to use an extra incision for the rare patient of mine that needs a drain.

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat.  

The areola chest skin interface is a great place to hide a scar.  Check out the many before after pictures of this Areola / Nipple Gallery here, here, and here.  These results are typical for my sculpture of my patients.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture