Author Topic: Decided on surgery  (Read 6001 times)

Offline hungry.tides

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Hi all,
After 5 months of endo hunting and asking if my hormones are not off the track, I have finally decided. Now i have two options for surgery, I'm confused between them:
1) I do the surgery in Bangalore, India (Where i work)
2) I do it in Mumbai (my home)

i met a PS in Bangalore, Dr Susheel Celitus, I met him only once and he suggested me to go for Gland excision + Lippo: So according to most of threads here, this is what is expected. He sounded very professional, though he was giving this impression : im a PS i remove things, I dont know if it comes back (considering my tricky hormones -though all 4 endos said the same thing:go ahead with surgery)

I havent done much as far as PS in Mumbai is concerned. Can you ppl please suggest a good PS in mumbai, I want to interview few more PS before zeroing on one....
Also i feel being at home (taking a week off from office) would be great....

Ciao
~~~~~hungry tides~~~~~
Surgery Date: 25th June 2007
Age: 24 years
Lipo + Excision (<100% removal around nipple)
Plastic Surgeon: Dr. Ananteshwar, Manipal, Bangalore
pre & post pics link:
http://s191.photobucket.com/albums/z236/hungrytides/
Know more @ :
http://www.plasticsurgery4u.com/procedure_folder/male_breast/index.html

Offline hungry.tides

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hi all,
I met Dr Anand today at Mallya hospital,Bangalore. He came across as a very friendly person, He first felt my gynecomastia, and said i will have to under go liposuction and gland excision, its a day surgery, and there will be no drains, no bleeding, also when i asked if there would be any blood tests i have to do before goin under knife, he said absolutely NO, you are a healthy person, you wont bleed 2 Liters on the table, i found him too confident a surgeon, He didnt have his laptop today so cudnt show me any pics, one on his mobile was a case of puffy nipples, So ppl wat do u make of this?
I want to get this operated as soon as possible.....
kindly reply...

~~~~~~~~hungry tides~~~~~~~~~

Offline hungry.tides

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He sounds good to me. Lipo plus excision is often the way to do it. I'm very glad I had both.
  yeh one of the way we say a surgeon is good r bad...  :)

But i would like to do my surgery at my home town, so i have thought abt the surgeon i met the first time, Dr Bimal Mody: I called him up today and he said he will do a manual liposuction and not PAL, (obviously glandular tissue removal) is this fine
I want you response urgently, plz reply back.... if a Manual lipo is good as PAL?

it costs me much less if i go for Manual. I forgot to ask abt revision surgery policy....

ciao
~~~hungry tides~~~

Offline hungry.tides

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hi all,
I discussed over email with a surgeon and this is what he wrote:

"I do liposuction only for most cases of gynaecomastia. Even glandular tissue can be removed by that technique in most cases. Only if it very hard would open surgery be required. Chances of revision surgery are very low by the first technique. If at all required I would generally do it 6 months later."

my question to ppl here is can glandular tissue be removed using lipo, what do u mean by lipo + gland excision?

waiting for your reply..


Offline Mr_Nip

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...my question to ppl here is can glandular tissue be removed using lipo, what do u mean by lipo + gland excision?

waiting for your reply..




I could go into a lengthy explanation of why you should probably get an opinion from a different surgeon, but this recent thread sums it up pretty well:  http://www.gynecomastia.org/smf/index.php/topic,10233.0.html
MR. NIP

I come from nowhere
And you should go there.
Just try it for a while.
The people from nowhere always smile.  -  Frank Zappa

Offline hungry.tides

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thanks alot Mr_Nip that was helpful

How abt the other question, diff between manual and PAL - power assisted Lipsuction?
The other surgeon said he will do Manual or PAL, but Manual is what he said first, when i asked PAL then he said - I can
do it, but will cost more (Double the amount)

What say ppl?

Offline Mr_Nip

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thanks alot Mr_Nip that was helpful

How abt the other question, diff between manual and PAL - power assisted Lipsuction?
The other surgeon said he will do Manual or PAL, but Manual is what he said first, when i asked PAL then he said - I can
do it, but will cost more (Double the amount)

What say ppl?


Glad you found that helpful.  Now for your other question - If you'll go back to the link I gave you before and read Dr. Bermant's entire post at the bottom of that thread, then you'll get a very detailed description of those methods of lipo.  He also gives you the insight as to why he prefers doing things the way he does.  Dr. Bermant is one of the most respected and experienced gynecomastia surgeons in the world.  Take his comments seriously.   ;)   

Also, do a search on this site for those methods and "lipo only" and you'll get more information than you'd believe.  Unfortunately, you'll also find that almost everybody here who's had the lipo only (in whatever form) is very unhappy and has to have a second surgery to finally do what didn't get done the first time. 

Offline hungry.tides

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i had a look at Dr. Bermant's comments there, but he doesnt talk abt Manual Liposuction
My surgeon said he will do a Manual Liposuction and Gland excision, so my question is is it better if i go for Manual Lipo or Power assisted lipo ( Gland excision is always there as mine is a Glandular gyne)

hope i didnt confuse
Dr. Bermant : if you too can guide me over this

ciao

Offline abbey

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Hi,

I am also planning for surgery and have met following doctors in Mumbai,

Narendra Pandya
Shantanu Nagarkatti
Mohan Thomas

Dr. Pandya & Nagarkatti are of the opinion that I will need excision as well as Lipo, but Mohan Thomas says he can remove glands through lipo alone. Dr. Pandya & Thomas are both very experienced doctor.

I suggest you meet both Pandya & Thomas in mumbai.

All the best.

Offline Mr_Nip

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...( Gland excision is always there as mine is a Glandular gyne)

hope i didnt confuse...


I may be confused, indeed.  Are you saying that you expect one of the forms of lipo to remove gland, or are you saying that you are expecting to have lipo for fat AND excision for gland?

DrBermant

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i had a look at Dr. Bermant's comments there, but he doesnt talk abt Manual Liposuction
My surgeon said he will do a Manual Liposuction and Gland excision, so my question is is it better if i go for Manual Lipo or Power assisted lipo ( Gland excision is always there as mine is a Glandular gyne)

hope i didnt confuse
Dr. Bermant : if you too can guide me over this

ciao

Actually, I do.  All of my patients are done with "Manual Liposuction," (which is probably just your doctors term for liposuction that most of us use.)  However, it is not the tool that gives the results.  It is the skill of the sculptor who works on the chest.  This is like saying I picked Da Vinci to paint for me because he uses this type of paint brush!

Here is the original post:


Liposuction Is Great for Sculpting Fat

Various types of ultrasonic and power assisted liposuction (UAL and PAL) have been around for quite sime time.  Each surgeon uses the tools and techniques he / she prefers.

There are studies claiming that ultrasonic liposuction does not break down gland cells, these were done to justify the safety in female liposuction breast reduction surgery.  Ultrasonic energy cannot be both ways, good for gland breakdown and safe not harming gland unless there is a difference between male and female breast gland tissue which has not been proven to my knowledge.

Tumescent liposuction is a form of anesthesia where fluid is placed in the tissues to be sculpted.  You can see very graphic pictures of the tumecent technique here.

Liposuction such as ultrasonic, VASER, power assisted, and sharp cutting cannula preferentially remove fat over gland.  Gland tends to exist under the nipple areola region.  When fingers of fat extend between fingers of gland, breast reduction can come from removing the fat and leaving gland behind.  On animation such as flexing the pectoral muscles or putting the arms over head, gland does not compress or move like fat.

When gynecomastia is from fat, liposuction works very well for contouring the chest.  I have seen many patients from other doctors who tried to use liposuction alone techniques that left gland behind that the patients just did not like for Revision Gynecomastia Chest Sculpture.

Here is an example of Revision Surgery after Liposuction alone.   Here is another revision after liposuction alone.

The problem is picking the right method for what actually is that patient's problem.  That is why I prefer my Dynamic Technique that permits what I find during surgery to guide my sculpture.

I have also seen patients 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.

Ultrasonic liposuction uses energy to help emulsify fat.  Power assisted liposuction uses mechanical vibrating devices to rapidly move the cannula back and forth.  Both PAL and Ultrasonic methods have been around for several years.  Many do not prefer what they do to the tissue.  Others like what they offer.  Both still preferentially remove fat over gland.  Both make the work of the surgeon easier.  Some feel ultrasonic liposuction can cause more swelling, bruising, and the increase the need for drains.

For me however, they also both remove the feel of the tissue sculpture.  I like the much better control I get with my cannula selection and personally I do not like either ultrasonic nor power assisted techniques.  None of the cases on my website used either PAL or Ultrasonic techniques. 

As any artist, I take my cannula selection very seriously and have evolved what permits me to achieve my results.  I have considered and evaluated many, many technologies.  The many different types of cannula I use have their own advantages and qualities.  I pick a subset of these cannula that varies for the many different types of gynecomastia male chest sculpture that I see.

Gland removal by any technique can still leave a depression when  a major part of the problem is from gland.  For gland removal, I prefer the greater precision of removal under direct visualization and feel.  This also give me access to many more elements for my artistic palette of my Dynamic Technique to sculpt the remaining tissues.

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat.  How tissues move is important.  The human body is beautiful in animation.  That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views.  Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor.  It is like an artist selecting a paint brush.  The results are what matters, not with what tool they sculpt.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

Offline hungry.tides

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thats a relief to know that Manual Lipo is quite prevalent, that was helpful Dr Bermant

I have a suggestion for guys in the future who search for Plastic Surgeons, can we make a questionnaire that would make PS hunting more easier, we can also have a similar one for Endocrinologits

As for my case I would take appointment with my surgeon, he would be out of India for some time this month, Will do the procedure once he returns....

ciao

Offline hungry.tides

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I am also planning for surgery and have met following doctors in Mumbai,

Narendra Pandya
Shantanu Nagarkatti
Mohan Thomas


hi there abbey,
How is Narendra Pandya? I read on net about him, he is one of the foremost in India i believe. What is the cost he says? Are you thinking abt geting operated by Narendra Pandya at Breach Candy Hospital?? What is the cost he is quoting?

Quote
but Mohan Thomas says he can remove glands through lipo alone.
Even one doc, Dr Sameer said similar thing, But i isnt it better to go for Excision straight away, that is what is the out come frm this thread, Mr_Nip am i right

Sorry If i confused you Mr_Nip thing is even i was confused by the fact that Gland can be removed by Lipo  >:(

abbey i think we shud also post at Asia-India thread so that people can be informed there....
When are you planning to go under the knife?

Ciao

Offline abbey

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Narendra Pandya seemed to be a good doctor. He is infact considered the father of plastic surgery india.  The expenses for surgery would be a little over 1 lakh.

I am planning for next month. Hope to get over this curse this year.  :)

Offline hungry.tides

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Did u consider Dr Bimal Mody ?
hes a consultant at Hinduja
over a Lac!! must be a very good surgeon, did u speak abt policy on revision surgery?
Ciao


 

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