Gynecomastia Surgical Techniques

[May87]

I'm questioning whether or not I should see another plastic surgeon.  Just today, I went to a consultation in Maryland about getting surgery for my puffy nipples. Liposuction was added to the fee and so was PARTIAL REMOVAL of the "subareolar gland."  I asked the doctor about why he was only wanting to remove some of the gland and he said it was because he didn't want to leave a creator in my chest.  Is this part of good technique? I'm afraid of it coming back and as I've read on forums, everyone says that in order for it to never come back, the whole gland has to be removed.  I've also seen on videos as well as other forums, surgeons removing the whole gland leaving nothing behind w/ out any indications of creators in the chest.  It seems like there are more cons than pros w/ partial removal of the gland under the areola.  I don't want to pay $5,140 for it to come back, or for there to still be puffiness after surgery.  I live in the Northern Virginia area, I'm 145lbs, and I'm about 5ft 8in.

[Dr. Elliot Jacobs]

Techniques vary with every surgeon.  And experience varies as well.  You might do well to get at least one or even two other opinions.  Do your homework and then decide.  Hint -- do not let the price be the deciding factor.  You might even consider traveling to see a surgeon with significant experience in gyne surgery.

Dr Jacobs

[May87]

Thank you very much for the reply Dr. Jacobs.  From your experience, is it in your technique to leave some of the gland under the areola behind (in order to not have the crater like inward dent)?  The more I do research, the more I see mixed opinions; but, most of them all say that complete removal of the gland is the preferred way.  I also hardly/never see the end result to see if there is that crater like dent due to complete removal of the gland like my surgeon told/warned me about today in my consultation.

[Dr. Elliot Jacobs]

Although it appears simple, gyne surgery can be quite difficult.  The problem is that the thickest portion of the breast tissue lies directly under the nipple.  I try to remove as much of the breast tissue as possible while still leaving a smooth contour.  I achieve this with primary liposuction and then near-total removal of the gland.  If there are any contour irregularities (ie potential crater deformities) I will attend to it immediately, usually with a combination of fat flaps, sutures, etc.

The result is a smooth chest contour with nipples that are smaller in diameter and which lie flat and flush with the surrounding skin.

Dr Jacobs