confused: is gland one unit or a type of tissue?

[ThatMethD1guy]

Some posters even go so far as to show photos of THE GLAND removed as if it is a single unit being removed (like an appendix)

a doctor on this site describes it more like a type of tissue that is intermingled with the fat and other tissue (like when you see fat marbled in a piece of beef)

I ask becase I am curisous as to how GYNO can come back after surgery if THE GLAND is gone (understainding of course that someone sould simply "gain weight"

I would think it could only come back if remiments of the gland were left behind after surgery

[DrBermant]

Some posters even go so far as to show photos of THE GLAND removed as if it is a single unit being removed (like an appendix)

a doctor on this site describes it more like a type of tissue that is intermingled with the fat and other tissue (like when you see fat marbled in a piece of beef)

I ask becase I am curisous as to how GYNO can come back after surgery if THE GLAND is gone (understainding of course that someone sould simply "gain weight"

I would think it could only come back if remiments of the gland were left behind after surgery

I prefer to target the gland first with my Dynamic Technique. This permits me to remove most of the gland and then sculpt the remaining tissue to minimize contour problems.  Any surgery technique, even radical breast mastectomy for male breast cancer can leave gland behind.  The problem is that there are fine fingers of gland that dissect between fingers of fat and can extend quite far into the chest.

You can see what I mean by fingers of gland here.

By concentrating on the gland first I am able to minimize the chance of breast regrowth.  It is very rare for my patients to have recurrence.  With my techniques and red flag before surgery evaluation system, I have only a few patients over the many years I have been doing surgery that I know have regrown.  However, gynecomastia surgery does not stop breast regrowth.  For patients having breast growth, I have advised for many years that they should get their problem under control before surgery.  There are exceptions, such as young men with massive breasts that have not stopped growing.  That is why each case needs to be individually evaluated. 

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[mizuno]

Dr. Bermant,
After, making the incision can you see that gland ? Or do you a scope to see how far the gland extends?
I have always wondered how doctors can see how much gland their is with such a small incison.
Is it possible for the gland to spread half way to the nipple to the side halfway to the armpit.



And also wondering about your in office exam can you most of the time determine if a patient has hormonal problem?
"With my techniques and red flag before surgery evaluation system, I have only a few patients over the many years I have been doing surgery that I know have regrown"

Thanks.

[ThatMethD1guy]

ok. so looking at the diagram on DrBermants site it would seem that becase we need to leave the nipple and skin on top in tact - it is not as simple as removing THE GLAND the way we would remove AN APPENDIX. IT would seem as though these photos that guys submit, of the removed gland, is perhaps the "lions share of the gland" but not 100%. I would think that if it took someone say 40 years of genetics, drugs and lifestyle, to aquire B-cup sized MOOBS, then after surgery it would be a safe bet that it would be quite some time before the residual "gland" could get itself back to MOOB like status....i would think I will die of old age long before this became an issue. Is that a coorect analysis? OR can a tiny amount of gland.... sense the reduction, and quickly replicate itself in an attempt to restore it's previous MOOB size?

[DrBermant]

Dr. Bermant,
After, making the incision can you see that gland ? Or do you a scope to see how far the gland extends?
I have always wondered how doctors can see how much gland their is with such a small incison.
Is it possible for the gland to spread half way to the nipple to the side halfway to the armpit.



And also wondering about your in office exam can you most of the time determine if a patient has hormonal problem?
"With my techniques and red flag before surgery evaluation system, I have only a few patients over the many years I have been doing surgery that I know have regrown"

Thanks.

Gland is white, fat yellow and is fairly obvious visually.  When I have wide access visual nature of tissue helps.  For most of my small incision male chest surgery, I start with how the tissue feels with my Tumescent Infiltrating Cannula.  Fat tends to be soft, gland firm.  This is part of my Dynamic Technique Male Chest Surgery.  I then use my finger to feel the firmer glandular tissues.  Although I target gland first, fingers of gland remain behind with all techniques.

My plastic surgery practice brings me patients from around the world giving me a very nice exposure to a wide range of Endocrinologists.  My lectures about gynecomastia also gives me the opportunity to discuss this condition with many Endocrinologists specializing in the treatment of gynecomastia.  I have been speaking with Endocrinologists about gynecomastia for over 30 years.  Almost all have told me that good screening by history and physical examination is the standard of care for a gynecomastia patient considering surgery.  Over the years, a number of Endocrinologists specializing in the treatment of gynecomastia helped me set up a series of Red Flags for evaluation instead of automatically sending each gynecomastia patient for testing.  For some, an endocrinology evaluation helps set their mind at ease and is a great idea.  For others I mandate it before surgery because of my findings during my evaluation of the patient.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[Gyno 44]

Dr. Bermant,

So in other words  when you see a paitent in person you can tell wether or not they should see an endo? ,

can you also decide when patients of yours choose the remote picture option you offer (for out of state people).

Dr. Bermant,
After, making the incision can you see that gland ? Or do you a scope to see how far the gland extends?
I have always wondered how doctors can see how much gland their is with such a small incison.
Is it possible for the gland to spread half way to the nipple to the side halfway to the armpit.



And also wondering about your in office exam can you most of the time determine if a patient has hormonal problem?
"With my techniques and red flag before surgery evaluation system, I have only a few patients over the many years I have been doing surgery that I know have regrown"

Thanks.

Gland is white, fat yellow and is fairly obvious visually.  When I have wide access visual nature of tissue helps.  For most of my small incision male chest surgery, I start with how the tissue feels with my Tumescent Infiltrating Cannula.  Fat tends to be soft, gland firm.  This is part of my Dynamic Technique Male Chest Surgery.  I then use my finger to feel the firmer glandular tissues.  Although I target gland first, fingers of gland remain behind with all techniques.

My plastic surgery practice brings me patients from around the world giving me a very nice exposure to a wide range of Endocrinologists.  My lectures about gynecomastia also gives me the opportunity to discuss this condition with many Endocrinologists specializing in the treatment of gynecomastia.  I have been speaking with Endocrinologists about gynecomastia for over 30 years.  Almost all have told me that good screening by history and physical examination is the standard of care for a gynecomastia patient considering surgery.  Over the years, a number of Endocrinologists specializing in the treatment of gynecomastia helped me set up a series of Red Flags for evaluation instead of automatically sending each gynecomastia patient for testing.  For some, an endocrinology evaluation helps set their mind at ease and is a great idea.  For others I mandate it before surgery because of my findings during my evaluation of the patient.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[DrBermant]

Dr. Bermant,

So in other words  when you see a paitent in person you can tell wether or not they should see an endo? ,

can you also decide when patients of yours choose the remote picture option you offer (for out of state people).

Dr. Bermant,
After, making the incision can you see that gland ? Or do you a scope to see how far the gland extends?
I have always wondered how doctors can see how much gland their is with such a small incison.
Is it possible for the gland to spread half way to the nipple to the side halfway to the armpit.



And also wondering about your in office exam can you most of the time determine if a patient has hormonal problem?
"With my techniques and red flag before surgery evaluation system, I have only a few patients over the many years I have been doing surgery that I know have regrown"

Thanks.

Gland is white, fat yellow and is fairly obvious visually.  When I have wide access visual nature of tissue helps.  For most of my small incision male chest surgery, I start with how the tissue feels with my Tumescent Infiltrating Cannula.  Fat tends to be soft, gland firm.  This is part of my Dynamic Technique Male Chest Surgery.  I then use my finger to feel the firmer glandular tissues.  Although I target gland first, fingers of gland remain behind with all techniques.

My plastic surgery practice brings me patients from around the world giving me a very nice exposure to a wide range of Endocrinologists.  My lectures about gynecomastia also gives me the opportunity to discuss this condition with many Endocrinologists specializing in the treatment of gynecomastia.  I have been speaking with Endocrinologists about gynecomastia for over 30 years.  Almost all have told me that good screening by history and physical examination is the standard of care for a gynecomastia patient considering surgery.  Over the years, a number of Endocrinologists specializing in the treatment of gynecomastia helped me set up a series of Red Flags for evaluation instead of automatically sending each gynecomastia patient for testing.  For some, an endocrinology evaluation helps set their mind at ease and is a great idea.  For others I mandate it before surgery because of my findings during my evaluation of the patient.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

Yes, I have evolved my Preliminary Remote Discussion such that it typically helps me select which patients should start out with an Endocrinologist.  There are rare exceptions when the added information from the in office examination reveals Red Flags that can be important.

Hope this helps,

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