Gyno? Puffy nipples?

[Stevew87]

I'm not sure which images will come up first but i think it's quite clear which image shows the gyno issue. The one with me standing up is when my chest was cold and as you can see despite a bit of fat on the chest the nipples looks quite good. The other image of me lying down shows what my chest looks like when it's not cold. I seem to have a hard pea sized ball under my nipple. I do have a fair bit of fat on my chest and have always even when i cut down to 11 stone (and for 6'1 that is quite skinny considering i had no muscle).
This issue has stopped me from going to the gym. I mean the nipples is quite prominent despite having 0 muscle... if i was to hit the gym i believe i would just look worse.

Also, to get a good masculine look say they removed the gland underneath or what ever is causing the issue... would having a areola reduction be a good idea? 

Thanks all,

[Stevew87]

Can anyone help me out please?

[Dr. Elliot Jacobs]

You appear to have puffy nipples, which react to cold temps or stimulation precisely as you describe.  Unfortunately, they revert to the puffy state all the time.

The only permanent treatment would be surgery -- but it can be tricky.  You should consult with a gyne expert in your area.  Appropriate surgery would also result in spontaneous decrease in diameter of your areolas.

Good luck!

Dr Jacobs

[Stevew87]

Thanks a lot for the reply! When you say tricky... would it be more tricky than most gyno operations? Would they need to remove the gland? My gland only feels like a hard pea.

When you say appropriate surgery do you mean there is a certain way they should do it or should i get a areola reduction added on during the operation.

Thanks again

[Dr. Elliot Jacobs]

Yes, even though this might seemingly appear to be easy, it is tricky to remove sufficient gland to reduce the puffiness but not over-do it and produce a crater.  I sometimes spend as much time on these "small" cases as I do on much larger ones.

As for the areolar diameter, it will decrease spontaneously (thanks, Mother Nature) once the excess tissues beneath the areola are removed.

Dr Jacobs

[Stevew87]

Thanks again for your help!
A place I'm thinking of getting it done remove the whole gland as far as i know to prevent further gyno re-occurrence. They said 1 in 10 to 20 have indentation and 1 in 100 come back for another surgery. I think they use lipo or something to prevent the indentation etc.

[font=verdana, geneva, lucida, "lucida grande", arial, helvetica, sans-serif]I'm looking to get it done in Poland due to costs (x2-x3 cheaper). -- which have a surgeon that does gyno surgeries every day apparently. I was wondering what you think about their supposed 'surgical process' of removing the whole gland. [/font]


The surgical process: 

• In many cases only excision of the glandular tissue is needed. This will result in a flat chest and a satisfying appearance of the chest. In these cases the skin is cut on the lower border of the areola (to minimize the visibility of the scars). We have a policy of removing all glandular tissue at -- (as opposed to gland reduction which is sometimes used at other clinics).
• In cases of lipomastia (pseudogynecomastia) a good result is achieved by liposuction of excessive fat tissue in the chest area. This is done via two stab wounds (3 mm) on each side of the chest and therefore leaves very little external scarring.
• Very often both of the above methods are used and liposuction (or “liposculpturing”) is performed followed by excision. This is used when the glandular tissue is surrounded by additional fat tissue which grows to keep the shape of the chest. In these cases if only glandular tissue was removed then a step-up would be seen from the space where the gland was removed to this fat tissue. Aesthetically, therefore, sometimes liposculpturing is very necessary.

[Dr. Elliot Jacobs]

Actually, their surgical approach is very similar to mine.  I remove virtually the entire gland, which usually requires removal from under the skin of the areola down to the muscle fascia.  I perform liposuction as needed to smooth the entire chest.

Often there may be a depression where the gland was removed.  I then reconstruct it immediately with fat flaps so that there is a smooth contour.  With virtually all of the gland removed, there is minimal chance of a recurrence.

Good luck!

Dr Jacobs

[Litlriki]

I agree with Dr. Jacobs. The mild cases of gynecomastia are perhaps more challenging than moderate cases and they require precision in the surgical approach.  I also use a combination of excision of the sub-areolar tissue with liposuction to contour the surrounding area, which helps to avoid a crater deformity.  Only a small remnant of the tissue is left under the areola, and while this can be the source of recurrence if the condition is related to medication or steroid use, for cases arising in puberty, the good news is that you only go through puberty once.  So you shouldn't have recurrence in that instance.  Some "recurrences" are the result of inadequate removal in the first place, so you want a surgeon who is skilled in this technique.  
Good luck.