Surgery technique?

[Tonyp1]

Had my consultation with the surgeon I plan on using today.  His technique is sonic liposuction followed by excision through the same hole he did the lipo through.  He said he just basically pulls out what is left behind from the lipo, through the hole. Does this sound possible?  It seems like everything I read says that excision through the cut under the nipple is the only way to get everything out.  He does over 200 hundred surgeries a year, and his before after galleries all seem good.  I'm just curious if this method would actually get everything out.  Any opinions?

[macman213]

Every surgeon has his/her own techniques. As long as he actually excises the gland and undermines the surrounding skin, you should be OK. It also seems reassuring that he's done over 200 gyne surgeries a year. Make sure you are seeing before and after pictures that are close to your body type/condition. That said, it seems good...

[Dr. Elliot Jacobs]

Agree with Macman -- what counts is the final result.  Every surgeon has his own method of treating gyne.  If that particular method works in his hands, then go for it!

Dr Jacobs

[rhyno18]

This sounds very similar to what my PS did.   He went in through a small incision under the arm and did excision and lipo with a cunnula (sp) style tube get the tissue and fat.  This was actually a revision surgery. I had a pretty severe case and the original PS did a direct excision.   The results of the direct excision were very uneven and lumpy.

The revision that was done under the arm was fantastic.  No drainage tubes, no new scars on the nipple and I was very pleased with my results.  I just wish I would've went to the second doctor first!!!

[MammaryMan]

I'm wondering if this technique works in the severe case where the breasts are large and sag down. It seems to me that there would be a lot of skin left after the fat/gland removal that has nowhere to go but noticeably flop down. A regular incision type surgery could take care of this.

[Dr. Elliot Jacobs]

In cases of severe overweight or major weight loss, the skin loses its ability to tighten by itself and the nipples end up droopy and the skin is very floppy.

In these cases, more major surgery is required to achieve a trim and contoured chest with the nipples placed at the appropriate position on the chest.  Every case is different and must be evaluated individually.

There are several different techniques available for treatment of such cases -- each with its attendant pros and cons.  Many plastic surgeons attempt to treat this as if it were a female breast reduction -- and the scars are usually an inverted T or "anchor" scar.  These are definitely not acceptable for a man -- different techniques must be used.

These are difficult procedures and you should look for an expert in gyne surgery for an opinion.

Dr Jacobs

[rhyno18]

Even after my original surgery, there was quite a bit of tissue left.  My PS was a bit concerned about loose skin, especially given I was in my early 40s.

Fortunately my skin was still very elastic and tightened up really well.   We were both pretty excited about it.  It's gotten even better as I've lost another 20 lbs (I was about 30 lbs overweight).  But after my surgery I felt a lot less conscious in the gym or running (used to bounce a lot.) 

[Tonyp1]

Thanks to all for the replies!  I should add that he said that in a small amount of cases, between 5 to 10% direct excision through the nipple is needed.  Not sure what the criteria is?  I'm still just trying to figure out how the gland becomes detached from the underside of the nipple when removed through the lipo hole.  In all the videos I've watched, it looks like it needs to be directly cut away.  Whatever he does it, it seems to work.  None of the pics in his before/after shots have the puffy nipple look to them, so it must be gone.  I also found a recent post on here, with pics, of someone who used the same surgeon with great results.  Having someone on this forum that had a successful surgery is a big confidence booster for me.  He also said he usually doesn't use a drain, which I was hoping to avoid if possible.  He called it an open stitch, that fluid can still escape from.  It all sounds a little different from the norm...  Hope all goes well!