Fat Flap vs leaving gland - techniques

[rubystar]

Hi all,

i just registered after seeing two surgeons who had differing
ways of surgery,


surgeon 1 : Wants to remove as much gland as possible then sculpt the chest area
by using a fat flap method similar to Dr Bermant that posts on this site,

surgeon 2 : Wants to remove part of the gland and leave a piece of gland to fill the crater
that is left once he removes the major part of the gland,

I have searched the site and could not find much

could people help by stating what type of surgery they had?
and how successful they thought it was.

If any doctors could give a pros and cons of each type that would be great.

from what I've seen this is a great site, just wish i found it earlier

thanks
james

[Dr. Elliot Jacobs]

Either method will work -- there is no right or wrong in this matter.  What does matter is that you will be left with a trim and contoured chest after surgery.  Deciding on a surgeon is difficult -- ask lots of questions, look at the surgeon's before and after photos, check the surgeon out on this site and any others, and sometimes you have to go with your gut instinct.  But please, please, do not choose a surgeon based on fee alone -- that is the wrong way to go about it.

Dr Jacobs

[DrBermant]

Hi all,

i just registered after seeing two surgeons who had differing
ways of surgery,


surgeon 1 : Wants to remove as much gland as possible then sculpt the chest area
by using a fat flap method similar to Dr Bermant that posts on this site,

surgeon 2 : Wants to remove part of the gland and leave a piece of gland to fill the crater
that is left once he removes the major part of the gland,

I have searched the site and could not find much

could people help by stating what type of surgery they had?
and how successful they thought it was.

If any doctors could give a pros and cons of each type that would be great.

from what I've seen this is a great site, just wish i found it earlier

thanks
james

Fat Flap Sculpture is a component of my Dynamic Technique that permits me to target gland first, and then use remaining tissue to contour the chest. 

I see many patients who complain of residual Puffy Nipple Gynecomastia after another doctor's surgery.  There are many possible problems causing such a deformity.  The most common is remaining gland behind the areola as seen in these Anatomy of Puffy Nipple Drawings.  Check out the images with the link for remaining gland after surgery to see what I mean.  Options depend on the problem to be treated which we help patients explore during a consultation or a Preliminary Remote Discussion.

However it is not just technique, each surgeon has his or her own skills and methods.  Each doctor is an artist.  Review the quality of each doctors' work. Images should be from multiple angles for each example instead of seeing only the "best" before and after view.  Checking the results of the different types of gynecomastia can also make a difference.  Each doctor also often has their own "passions" that they specialize in.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

[moobius]

i'd go with surgeon 1 in a heart beat...

[Dr Kapoor]

The end result is the most important no matter how you get there. Having said that, I usually start with liposuction of the surround fat and also somewhat through the gland. After this, I will usually make an incision at the border of the areola and remove whatever glandular tissue I need to to give a smooth contour (without giving a crater deformity). Following this, I usually will do a little more with liposuction to feather the surrounding tissues. This technique has worked well for me.

[Grandpa Bambu]

Does surgeon #2 intend to perform lipo also?

Or is it Excision only?

GB

[headheldhigh01]

i admit i prefer bermant's approach, i wouldn't want anything left if i could help it. 

[rubystar]

Thanks everyone for the responses,

I am still uncertain who to go with,
might make a second appointment for some follow up questions,


surgeon 2 didn't mention lipo just excision only then sculpt fat flap for
definition,

neither surgeon mentioned anything about the process being dynamic as per
Dr Bermant but i guess the process is variable depending on what they find.

i have another appointment with a different PS in a few days
and will post his recommendations ,

thanks again
this forum has helped ease my mind already,

[DrBermant]

Thanks everyone for the responses,

I am still uncertain who to go with,
might make a second appointment for some follow up questions,


surgeon 2 didn't mention lipo just excision only then sculpt fat flap for
definition,

neither surgeon mentioned anything about the process being dynamic as per
Dr Bermant but i guess the process is variable depending on what they find.

i have another appointment with a different PS in a few days
and will post his recommendations ,

thanks again
this forum has helped ease my mind already,

We see patients from around the world who prefer my techniques.  To minimize travel to Virginia, many of our patients start with our Preliminary Remote Discussion.  Jane is my office manager and can explain the process.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Hope this helps,

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