Full gland removal or most of it?

[buddenfan]

Hello everyone. Yesterday I went for a gynecomastia consultation. I do not have any hard lumps and have had puffy nipples ever since I was a chubby teenager. Currently I am dieting down to single digit bodyfat and will be ripped come summer time. I told the doctor at my consult that I do not want lipo (im in fairly muscular but gained some fat over the last few years as well) I only want my puffy nipples to look normal. When they get cold like after a cold shower they look normal temporarily.

The doctor told me that he has to make a small incision under the nipple and remove most of the gland but not all of it. He said that if he fully removes the gland then theres a chance my chest will indent inwards. I want to get the surgery done asap and other doctors have a 3 week wait for consultations. (I wanted to get a second opinion)
Since there are a few well known gynecomastia experts on this forum please answer me this question. Is full gland removal necessary or not? I do not need nor want any lipo or contouring, I want to naturally get my chest lean through diet and exercise as I already have a muscular chest. I just want my puffy nipples to be flat and look normal and masculine.

Thank you for your time in advance.

[Dr. Elliot Jacobs]

Welcome to the forum!  Hopefully you will get a lot of your questions answered.

As for your circumstance, every doctor has a different approach to gynecomastia surgery and puffy nipples (mostly, they do go together).  What counts is the result -- not the means by which the result was obtained.

All men have a certain amount of breast tissue -- which is usually concentrated under the areolas.  It is only when that tissue grows that it becomes objectionable.

In my experience, puffy nipples usually go along with some amount of excess tissue beyond the confines of the areolas.  Trying to remove just enough to reduce the puffiness without creating a crater and while leaving the anticipated surrounding excess tissue present is a difficult surgical procedure.  That is why I virtually never attempt it.

Rather, I remove all excess tissues as welll as the concentrated tissue under the areolas. The results are a much more defined chest with areolas that lie flat and flush with the surrounding skin -- all the time.  Yes, I use a liposuction instrument as part of the surgery -- sometimes with suction applied and sometimes not.

I think it is a wrong impression on your part to tell your surgeon to be that you do not want lipo as part of the procedure -- that should be his decision and recommendation.  After all, he is the doctor, not you, and presumably he has a lot more experience doing gynecomastia surgery than you do.

Listen to your doc!!

Dr Jacobs