Question to docs: Do you remove all glandular tissue?

[outofshape]

During the first consultation my surgeon told me all glandular tissue would be removed and to avoid deformity of the nipple some liposuction would be done to redistribute the fat.

1 day After surgery i told the surgeon i felt a few hard bumps under and around my nipples. He assured me he removed all glandular tissue "it's impossible to be glandular tissue".

During the first check-up, approx. 10 days later i asked him again about the glandular tissue and he was 100% sure he removed everything. I shouldn't worry.

Now 2 months later i contacted him by email to make an appointment for a follow-up on monday and told him i feel a bump in the shape of a disc, just like glandular tissue.
He told me he left some glandular tissue to avoid deformity.

Also, since scars are quite a big issue to me i wanted minimal scarring. I told him the better surgeons in the USA usually don't create any incisions larger than 2cm, he told me his practice was the same.
I measured the scars and they are about 3.8cm in length, almost double in size as he promised!

My question to the surgeons on this forum are:
1. Do you always remove all glandular tissue, or do you sometimes leave some on purpose. If you leave some, do you inform the patient about that?

2. Do you often create incisions at the size of 3.8cm? If you do create an incision larger than 2cm, do you inform the patient about that? Would there be a reason to create an incision larger than 2cm in length?

[xelnaga13]

Surgeons always leave a small amount to avoid deformity. I had surgery twice because my first surgeon left way too much.

Also scar tissue may be an issue as well.

[outofshape]

I'm not so sure about that, i've read some surgeons really remove all glandular tissue so i'd like to hear from the docs on this forum if that's true.

[cms5402]

My understanding is that it is normal to leave in a small amount.  If 100% is removed, the nipple will look caved in and unnatural.  It is possible your surgeon did not remove enough, but I think it's more common than not to leave a small amount present to maintain a natural look.

[Dr. Elliot Jacobs]

Agree with the previous posters -- in most cases, a little bit of gland is often retained to prevent crater deformity.  I always inform my patients that I will deliberately leave some tissue to support the nipple.  Remember, this is not a cancer operation -- we are dealing with normal healthy tissue which, unfortunately, if present in excess amounts.  A surgeon's job is to remove the excess tissue to achieve a more normal appearance.

Remember, all the "normal" guys in this country also have a bit of gland beneath their nipples -- that is the normal condition.

As for the length of the incision, that is truly a moot question.  The surgeon makes an incision as long as needed in order to properly perform the operation.  Incision length varies with each operation and in no way reflects on the ability of the surgeon.

Dr Jacobs