Author Topic: surgery options  (Read 2580 times)

Offline chrisdemarco

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Hey guys, I want to know what my surgery options are because I'm hearing some mixed info.  Some guys go for the pera-aereola incision and then have the lipo and scraping, while others (more severe cases) undergo a bi-lateral mastecomy in which all breast tissue is removed.  The results are awesome for the mastecomy, but the scars are huge and the nipple incisions can still leave some sagging.  What do you think?  I'm 33 and I've been wearing compression vests for a while.  But I can't stand it anymore.   I'm gonna get surgery by next year, but I don't know which...

Offline Grandpa Bambu

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Chris...

Full mastectomies are not necessary. Unless of course, cancer is involved. Bi-lateral excision is more than adequate for the majority.

Do you have any pics posted?

GB
Surgery: February 16, 2005. - Toronto, Ontario Canada.
Surgeon: Dr. John Craig Fielding   M.D.   F.R.C.S. (C) (416.766.8890)
Pre-Op/Post-Op Pics

Offline chrisdemarco

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I don't have a digital camera, but I would guess, in terms of size, its probably a B cup.  Your surgery resutls looks great!  No scars, that's awesome.      Did you have your nipples grafted?  Did you have the bi-lateral incision done with lipo?

Offline Grandpa Bambu

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Your surgery resutls looks great!

No scars, that's awesome.

Did you have your nipples grafted? 

Did you have the bi-lateral incision done with lipo?

Chris....

My chest is not perfect but I am happy with the results. It has made my life much more manageable...   :)

There are scars, however they are almost undetectable. If you look real close you can see them. If you weren't looking for them, you'd never know they're there.

No, nipples were not grafted.

I had Bi-lateral excision and Lipo.

GB

DrBermant

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Hey guys, I want to know what my surgery options are because I'm hearing some mixed info.  Some guys go for the pera-aereola incision and then have the lipo and scraping, while others (more severe cases) undergo a bi-lateral mastecomy in which all breast tissue is removed.  The results are awesome for the mastecomy, but the scars are huge and the nipple incisions can still leave some sagging.  What do you think?  I'm 33 and I've been wearing compression vests for a while.  But I can't stand it anymore.   I'm gonna get surgery by next year, but I don't know which...


Options depend on the problem(s) to be treated.  I prefer for almost all of my patients a single small incision at the edge of the areola and chest skin interface.  This is a great place to fool the eye and hide the scar.   

You can see actual pictures during excision of the gland during Gynecomastia Surgery at the bottom of this page.  Excision is one of the tools of my artist's palette for my Dynamic Technique Male Chest Sculpture.

An incision at the edge of the areola opens up for me an artist's palette of tools not available when using the armpit approach.  That is why I prefer my Dynamic Technique.  I let what I find during surgery help evolve what needs to be done.  What subset of this pallette of tools will vary from patient to patient and sometimes from one side to the other.

I have also seen patients from other doctors with channel problems between remote access sites and the areola / nipple.  Scars, adhesions, and depressions can look terrible.  Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexion here to see what I mean. 

Here is another example on this forum of other incisions:
http://www.gynecomastia.org/smf/index.php/topic,3736.msg29322/topicseen.html#msg29322 The result posted are not mine and are early after surgery.  Here are typical early after surgery pictures for my techniques. In general, the extra incisions just do not look natural to me and I try to avoid them when possible.  I do need to use an extra incision for the rare patient of mine that needs a drain.

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat. 

The areola chest skin interface is a great place to hide a scar.  Check out the many before after pictures of this Areola / Nipple Gallery here, here, and here.  These results are typical for my sculpture of my patients.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture
« Last Edit: December 31, 2006, 09:30:59 AM by DrBermant »


 

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