Unrealistic expectations? Or just inept surgeons? :-)

[Shane_591]

Hi I am not entirely new here as last year I tried to describe my postop experiences when I had a liposuction last year.

To make a long story short: I am a 41 year old guy based in Denmark in Europe and have a degree of gynecomastia that can be defined as mild (I saw many pictures in this site which depict situations far worse than mine).

As I said, I underwent 'liposuction only' in May 2008: my surgeon claimed that taking out the gland tissue would cause cavities on my chest (so he said) and this is why he went only for the lipo.

11 months postop: I did have a small improvement, but I certainly expected much more. In my opinion the result I obtained does not justify the price of the surgery.

At the time of the operation I concluded that only liposuction does not work; as a matter of fact I simply blamed myself for not doing my homework properly: I knew virtually nothing about gynecomastia and just trusted this surgeon because he is working in a very well-known Danish hospital.

One year later I decided to see 4 other different doctors and - to my great amazement - 3 out of 4 still maintained that removing gland tissue would make my chest deformed (with cavities). In other words they would have done exactly like their fellow surgeon ...

The 4th doctor is indeed willing to perform a revision by removing more residual fat (I am not overweight and I doubt there is much fat left after last year lipo) plus gland tissue. This is why I am quite reluctant to go ahead .. I wonder what would happen if there is no gland and/or fat at all left between the skin and the underlying muscle. brrrr :-) Skin hanging? Huge holes? Who knows ...

Now some questions arise..

1) are my expectations simply unrealistic? I was told that, seen my mild gyno, the results I got are the best possible results from a 'cosmetic' point of view even though I still 'feel' the gland tissue. Obviously, for guys suffering from severe gynecomastia having a bit 'weird looking' chest with small cavities where the nipples are placed is a small price to pay compared to having very large breasts.

2) Can I conclude that most surgeons here in Denmark really do not know very well this particular field of plastic surgery (this relates to one of the topics I saw around here, that is to say how specialized should a surgeon be for gyno related operations).

I especially would like to hear some of the good doctors' opinion ...


Thanks in advance!

   

(here's my post from last year: http://www.gynecomastia.org/smf/index.php?topic=14083.0)

[Ben2cat]

THAT IS GREAT INFO. i AHVE NO CLUE WHO TO ADDRESS MY CONDITION WITH.
i AM NOT CERTAIN YOU ARE BEING UNREALISTIC, AS i HAVE NO PHOTO TO GIVE MY OPINION.
I DO KNOW I OBSESS BECAUSE MY GYNO IS HORRIBLE. I AM OVERWEIGHT AS WELL...
I HAVE STARTED "AGAIN' IN MY LIFE REBUILDING MY CHEST..20 YEARS AGO, IT WAS AT LEAST ACCEPTABLE, AND SOME WHAT O.K TO FACE...
KEEP THE FAITH & KEEP LOOKING FOR THE RIGHT ANSWERS AND RESULTS.
I WOULD HAVE MINE DONE RIGHT NOW IF i COULD AFFORD IT.

[Paa_Paw]

Both very good questions. And you pose more good questions in your post as well.

With respect to the qualifications of the surgeons, the field is very wide. A general surgeon may perform Gynecomastia surgery but the outcome may not meet your expectations. Even a very good general surgeon is not the best for specialized surgery. Cosmetic surgeons who usually perform facial surgery likewise may not be the best. Specialized surgery requires a specialized surgeon for the best outcome.

Whether your expectations were unrealistic or not is something that I am not in a position to judge. I do agree that this is a legitimate question to be asking, but in a more introspective way as it would be very difficult for anyone to answer that objectively.

The chest area is a normal place for fat to accumulate in men. Even in men who are otherwise quite lean. So it is possible that there could be sufficient residual fat in the area to give contour the the breasts.

The opinions of three out of four surgeons that a concave deformity would result from gland removal is a rather compelling argument against gland removal.

What you have not provided are the comparative credentials and experience of the surgeons.

Even when gland is removed, it cannot be removed entirely without leaving a deformity. The fact that you can still feel gland there does not bear as much weight as would the overall appearance of the result.

I think you would be wise to try and get some totally unbiased opinions prior to seeking revision surgery. To be unbiased,  the people would have to be in no position to gain or lose anything as a result of giving their opinion. In this regard, a surgeon might have difficulty being completely unbiased while a medical professional in an unrelated field would be more neutral.

[Shane_591]

Thanks for your replies guys .. I appreciate it ..

Grandpa Dan ..
the surgeons I talked to were all very experienced and had performed many gyno operations before, but, and this is probably the huge difference, they performed mostly on patients that had severe cases of gynecomastia. Obviously their opinion is quite discouraging because they certainly had everything to loose by saying that a concave deformity would result from gland removal. (no money to be made on me!)

The point is that I can't figure out whether their are simply talking about their own limitations (plastic surgery for gyno is just starting here in Europe if compared to the US) and I need to keep on searching for the right surgeon or, as you are saying, accept the fact that what counts is the overall appearance of the result, even though I both see and feel the gland in there!

Speaking of unbiased opinions prior to seeking revision surgery: I am quite athletic and was always able to 'somehow' mask my gyno with muscles: I can wear t-shirts, go to the swimming pool etc without people noticing it at all. To the inexperienced eye, one sees huge pecs especially with clothes on.
This is probably the biggest problem about unrealistic expectations, my own and other people's 
Once I went to ask a normal MD, and not only he told me that a certain degree of gyno is normal, but he even maintained that his own gyno was far worse than mine! 

I tried to upload some pics, but could not do it because they apparently have too big a size ..

regards
Shane

[mrpower33]

Well, you should probably post photos and get opinions from people here as to whether you really have gyne.  There are a surprising number of people that come to these boards and they don't have gyne at all.  The reality is that most men have some breast tissue.  If you have read Dr. Jacobs' posts, it's only a problem when you have EXCESS tissue.  As for surgeon's in Denmark, I would definitely not restrict your search to Denmark.  There are some highly recommended surgeon's in England, it is really not that for.  I traveled from California to Virginia to get mine done with Bermant and the results are excellent.  This is definitely a specialty field and most specialists will be able to remove all the gland without cratering or other deformities.   Choose wisely and don't limit your options!

[Shane_591]

yeah ... that's right ... sometimes you gotta go the extra mile ... literally 

I can't seem to be able to upload any pictures in these posts as the maximum attachment size which is allowed is 128 KB...  does somebody know how to do it ?

[mrpower33]

You can't.  What you need to do is open the photo in Windows Paint or some other photo editing program and shrink it.  Resave the file and right click to check the properties tab to see whether it is smaller than 128 kb.  It's a pain, but that was the only way I could do it.

[Shane_591]

Hey mrpower33 ..

no matter what I do, I can't upload the pictures ... anyway your piece of advice about not restricting my search to Denmark is good .. that is the only thing to do I guess ..

thanks man ..

shane

[don_joe]

You need to have gland removed as well. When selecting a surgeon, be sure he's done some male breast reductions before. You are in Denmark ?  Take a look at the Swedish board on this site.

[Shane_591]

yeah .. I will get the gland removed.
Honestly I will not even try to go to any other Swedish or Danish surgeons: a revision operation is always much more difficult than a surgery with "virgin" breasts and if I want to gamble with its final results I'd rather do it with a surgeon who knows what he is doing .... 100% .. I do not need to make an experiment on my own skin!? Do I?
 
I contacted dr Bermant and dr Jacobs and decided to fly to NYC to see Dr Jacobs because of several reasons....  the good doc has been very friendly and understanding from the very beginning .... plus it is much harder (and more expensive) to fly to Richmond from europe ....
(you need to be on a plane for ever!!)
 
I hope I will not regret it but judging from what I read here on the site, I won't.  Even a 20% improvement - bear in mind I have a mild GYNO and a lot of muscle underneath - would make me happy.

Dr Jacobs' fee really hurts!!! (around $7500) ..... and my girl-friend is now mad at me because I want to use so much money for a Gynecomastia operation (plus plane tickets, hotel etc) that 'I do not need'  ....
Gee ... she could have used that sum much more wisely in shoes, designer cloths and makeup products !! 
As far as I am concerned I am doing it ... I have been waiting for this so long that I am surprised she does not understand it ...
She can always take a walk if she still finds it silly    But this is another story!!

[Sheldon]

Dump ur gf if she cannot understand how we suffer under gyno :p gyno= physical, metally, and emotionally= priceless!

[Shane_591]

Hi there,
I was in this forum during the last 2 years trying to describe my postop experiences when I had both a liposuction (June 2008) and gland removed (July 2009).
 
I had a long break from this site (basically 10 months), simply because I needed to get away from the whole matter for a while: I really feel that my gynecomastia problems always played a very dominant role in my life and now that the (t)issue  is 'gone' (or at least greatly minimized) it was time to get completly away from it!
Now, one whole year since my last operation has passed; its results are pretty much stable and most satisfactory, so it is time to share my experiences with others.
More importantly, I would like to give some words of advice so that, those of you that are considering a GYNO operation right now, would not make some of the same mistakes I made.

Let me start writing down the things I have learnt..

1) doing a liposuction only is (maybe) not a good idea if you both see and feel the gland in your chest. You will be disappointed by doing the lipo only and such small improvements (if any at all) do not justify the price of the surgery. Believe me.
2) do your homework properly: find a specialist in the field, who has performed many gyno operations before (I went to DR Jacobs in NY: he's great, but maybe there are other docs located closer to where you live): 'normal' plastic surgeons, though experienced, might have limitations especially in those cases where liposuction is not enough and you need to remove the gland as well.
3) the right specialist is extremely important especially when you are dealing with situations that are not so bad to begin with and only small improvements are necessary. You want to have those improvements without nasty side-effects like extra skin hanging, cavities etc. Basically, you gotta go the extra mile, financially and, sometimes geographically: as I said, I went to Dr Jacobs in NYC, but I am based in Europe! Spending a big bucket of money once (and for all), is better than doing 1 or 2 revisions afterwards, in terms of time, pain and saved money!!
4) do not have highly unrealistic expectations: it all depends on your degree of gyno; the worst your initial situation is, the most difficult it would be to get what you might perceive as the 'perfect result'. Within the boundaries of  reason huge improvements can be obtained, but miracles are not possible.  


more details here:

http://www.gynecomastia.org/smf/index.php?topic=21128.0