Author Topic: Could gland have been missed or is it excess skin causing gyne  (Read 3399 times)

Offline april24th2007

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Would like to ask the respected surgeons, when you perform gland excision, nipple flattens but does the skin adjust to the new "reduced" chest or do you cut skin as part of the operation and stitch it back so its tighter.  The reason I ask is because it still looks like I have gynecomastia after more than a year of surgery.  I went to the surgeon as a consultation and he informs me that he removed the gland (I have hardly any fat 150 lbs, 5' 9") and he said that the reason I have pointy nipples is because I needed the skin to be cut?? I'm quite confused..  Surgeon's first language isn't english and he is from a different country and he spoke through a translator.

I would be grateful to anyone who could shed some light on this matter.   Thank you.

Offline Litlriki

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After removal of the gland, the skin of the nipple and areola will retract to a certain extent.  Sometimes, however, this is not enough, and if the patient is still unhappy with the appearance, then excision of the skin (peri-areolar skin reduction) can be performed.  This can be done in the office with local anesthesia at a fairly nominal cost.  This is something I discuss with my patients at the initial consultation.  In those patients with nipples and areolae that are "borderline" large, doing the reduction in a delayed manner is reasonable, particularly since some will avoid the skin removal (and associated scarring) completely.  In those for whom later skin reduction is required, the cost is the same as if I had done it at the initial surgery--It's just the difference in the surgical fee for gynecomastia surgery with skin removal and without skin removal.  There is no facility or anesthesia fee in the office.  The delayed option is also safer, in that risk of nipple loss is less when skin removal is done at a second setting.

Rick Silverman
Dr. Silverman, M.D.
Cosmetic and Reconstructive Plastic Surgery
29 Crafts Street
Suite 370
Newton, MA 02458
617-965-9500
800-785-7860
www.ricksilverman.com
www.gynecomastia-boston.com
rick@ricksilverman.com

Certified by the American Board of Plastic Surgery

Offline DrPensler

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If you have some photos it would be helpful.More often than not the contraction of the skin  is rapid after surgery.
Jay M. Pensler,M.D.
680 North Lake Shore Drive
suite 1125
Chicago,Illinois 60611
(312) 642-7777
http://www.gynecomastiachicago.com

Offline april24th2007

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Thank you for informative answer.
What type of test, x-ray etc do I need to do in order to know exactly whether it is fat, left over gland or nothing (just skin excision needed).
When cold, nipples go hard and chest looks very flat (if this info helps).

i will put up pictures tomorrow for your review and further opinion.

If it is case of skin excision, are the results permanent?  Is recovery swift or compression vest and rest needed for weeks?

Offline april24th2007

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To be more helpful for your input/feedback, I should add to my initial query that I did not have liposuction.  Only gland excision.

Offline april24th2007

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my pics.  pls see if they help you analyze.  thank you.



Offline april24th2007

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Doctor, any input you can provide after seeing these pics?

Offline Litlriki

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It looks like there's still glandular tissue and/or fat present.  Skin actually looks okay, and I wouldn't anticipate a need for skin removal.

Rick Silverman



 

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