Questions about surgery for MILD Gynecomastia

[nutella]

Please help me better understand the potential risks involved in surgery.

I have had a case of unilateral Gynecomasta for about 11 months. It is a mild case but can be seen through t-shirts and when I have my shirt of. This has effected my esteem greatly and I am nearly dead set on getting corrective surgery. Yesterday I had my first consultation with a surgeon in my area that was recommend to me by my endocrinologist. He looked me up and down, felt my nipple, agreed that there was some glandular material in there and then told me that he wouldn't preform the corrective surgery on me. He said that the possible risks involved in the surgery (scaring, nipple indentation, loss of nipple sensation... etc) out weighed the potential gains, in my case. He told me that my Gyno is mild enough that under most circumstances a person wouldn't even be able to tell I had anything. Also, he told me that because this particular type of surgery is considered a "gross surgery" (as opposed to a "fine surgery") he cannot guarantee any kind of result. Due to the conditions in his examination room both of my nipples were contracted and the Gyno was not fully apparent. I let him know that he wasn't getting a chance to see the full Gyno in it's entirety. As I left he told me that I could send him some pictures of it when it was dilated and he would review them, which I did.

Today I got an email back from him. He conceded and told me that there was definitely apparent asymmetry and told me that the surgery was "my call" but I should be familiar with the risks. He told me that the chance of a satisfactory outcome would probably be 80/20.... To me, in the state that I am now, I feel like the risk is probably worth it. However, what I am wondering is this: does 80/20 seem like an accurate appraisal in a surgery like this ? I know how complicated this surgery can be.... Tell me what you think.

[DrBermant]

Please help me better understand the potential risks involved in surgery.

I have had a case of unilateral Gynecomasta for about 11 months. It is a mild case but can be seen through t-shirts and when I have my shirt of. This has effected my esteem greatly and I am nearly dead set on getting corrective surgery. Yesterday I had my first consultation with a surgeon in my area that was recommend to me by my endocrinologist. He looked me up and down, felt my nipple, agreed that there was some glandular material in there and then told me that he wouldn't preform the corrective surgery on me. He said that the possible risks involved in the surgery (scaring, nipple indentation, loss of nipple sensation... etc) out weighed the potential gains, in my case. He told me that my Gyno is mild enough that under most circumstances a person wouldn't even be able to tell I had anything. Also, he told me that because this particular type of surgery is considered a "gross surgery" (as opposed to a "fine surgery") he cannot guarantee any kind of result. Due to the conditions in his examination room both of my nipples were contracted and the Gyno was not fully apparent. I let him know that he wasn't getting a chance to see the full Gyno in it's entirety. As I left he told me that I could send him some pictures of it when it was dilated and he would review them, which I did.

Today I got an email back from him. He conceded and told me that there was definitely apparent asymmetry and told me that the surgery was "my call" but I should be familiar with the risks. He told me that the chance of a satisfactory outcome would probably be 80/20.... To me, in the state that I am now, I feel like the risk is probably worth it. However, what I am wondering is this: does 80/20 seem like an accurate appraisal in a surgery like this ? I know how complicated this surgery can be.... Tell me what you think.

To better understand the risks of what a surgeon offers, look for before and after surgery pictures for how he / she sculpts that particular problem. Subtle gynecomastia is in itself an art form. That is why I have a Puffy Nipple section on my website and another section for unilateral and uneven gynecomastia. Many years ago I found that a cold exam room did not permit a true evaluation of gynecomastia nor the results of the surgery. That is why I not only maintain a warm room, but also document the temperature of my examination and measurements made on each patients. It is the same issue for picture taking for the before and after surgery results, a constant warm temperature removes that variable. You will find that statement in my published instructions for each of my Standard Pictures for Documenting Gynecomastia.

Although no surgeon can "guarantee" results, they are required by our Plastic Surgery Societies to demonstrate typical results for their patients when putting up their work on the internet or showing photos in the office. So if you are looking for the risks of how any particular surgeon manages that variation of the many forms of gynecomastia, look for such documentation.

Hope this helps,

Michael Bermant, M.D.

[nutella]

The surgeon I went to see only has a couple "before & after" pictures on his website, all of his cases are more extreme than mine. Also, a few of his patients still have visible breasts after surgery...... This photo is the most 'mild' case I could find on his online profile....

[nutella]

This is the after photo

[DrBermant]

The surgeon I went to see only has a couple "before & after" pictures on his website, all of his cases are more extreme than mine. Also, a few of his patients still have visible breasts after surgery...... This photo is the most 'mild' case I could find on his online profile....

Unfortunately a single image does not say much about the problem nor the solution. Fairly major issues can be hidden on limited views. Check my Standard After Gynecomastia Picture set that I designed to better demonstrate contour issues that are better shown from different angles, arms up overhead, flexing muscles and for an even more critical analysis the Standard Videos.

Going to a surgeon that has no or just a few examples is a gamble. Going to someone who shows results that you do not like makes no sense to me. Anyone that then end up with similar results shown by a doctor, has nothing to complain about.

Hope this helps,

Michael Bermant, M.D.