excision only?

[jinlian]

So I'm scheduled to get surgery soon and the plastic surgeon plans on doing excision only. I work out and have an athletic build; 6', 155lbs. My chest has almost no fat, just muscle and gland, giving me the notorious 'puffy nipples'. I have read on this site that liposuction is a critical part of the surgery but if i have very little to no fat is it OK to exclude lipo? My doc did not suggest this to get around insurance as i am paying for the whole thing myself.

[snugglebandit]

Usually its necessary to do lipo, even if you are very lean because of the gland defect left behind after its removed. Lipo smooths the contour out gives a better result. You should post some pics up though, because every case is different. If you are super, super lean, or your gland isnt that big then you might not need any lipo. Its all relative, though usually some lipo is done.

[Paa_Paw]

Your height/weight indicate that you are leaner than most young men these days so the procedure your surgeon recommended may be all that is needed.

Contrary to what has been said previously, I think that Lipo is the coarse tool while the scalpel is used for refinement.

Presuming that you have done the appropriate homework and selected your surgeon with care you should have a good result.

[Dr. Elliot Jacobs]

The problem with doing excision only is that the surgeon will only operate in the localized area beneath the areola.  Once the tissue is removed, there is a space which can potentially fill up with fluid (blood or serum).  Further, the stretched out skin has nowhere to go.

I find that lipo is necessary for virtually every case.  Sometimes, if there isn't a lot of surrounding fat, I will use the lipo cannula but without suction.  This allows for re-draping and re-distribution of the skin surrounding the areola -- and provides some room for the areola to settle down.

Snug compression with or without drains may be very useful as well.

Dr Jacobs

[jinlian]

Thanks for the replies guys. Here are some photos that can explain what i cannot.

Here's some when I am most puffy:





















Here's some when i am less puffy:

[snugglebandit]

If i were you, i would save my money man. No one is gonna notice anything weird about your nipples unless they are educated on gynecomastia. And even then, they probably wouldnt say anything its such a mild case.

[canadianmoobs123]

If i were you, i would save my money man. No one is gonna notice anything weird about your nipples unless they are educated on gynecomastia. And even then, they probably wouldnt say anything its such a mild case.

I beg to differ. Yes, it is a mild case, but the nipples do look larger, and are somewhat noticable. And honestly gynecomastia is a condition where people look down upon, and bully you, but for the MOST part(for me anyway) I find its more of a self-image problem. Watching the Arnold Schwarzeneggers and all the men at the pool with the perfect chest make you feel like you less than them, and it really hurts you the most, in my opinion. But honestly I doubt its gonna be noticable. Your not gonna be called names, or be bullied by anyone at all with your shirt on, and even without you shirt on someone would have to take a close look at your nipple before judging you. So I say get the surgery, and forget gyne. Just do it to cure any social anxiety, or any sadness you have because of it. However, it is an EXTREMELY mild case. If the doctor does not diagnose gynecomastia, and you just have slightly over sized nipples, then I guess your going to have to deal with it  .