Doc says I need trans surgery

[Denman]

I had a consult with a highly qualified gynecomastia doctor. He said that for my severe case, I would need what amounts to the same procedure that a female to male transgender gets, where the breast is removed and the nipple repositioned as necessary. This whole thing results in a scar across the bottom of each breast, not just a small incision as is commonly used for breast reduction. He said the reason for this is that the elasticity of my skin is not strong enough to retract and tighten if regular techniques are used, and the breast will sag, thus necessitating a more radical approach. Perhaps one of the reasons for this approach is that the doctor is known in my area for trans surgery and has this perspective on things. The procedure is also akin to a mastectomy. I guess this all has me a little freaked out due to long scars and potential problems such as the nipple dying. I also don't like the thought of feeling as though my starting place is as a female who is getting top surgery.

The doctor also proposed a lower abdomen reduction, he used the term abdominoplasty and this would be done at the same time.

I just revisited the Gynecomastia 101 section, and it does mention this procedure for more severe cases. I don't know what I am asking for here, perhaps just to register some concern. I would like to read about the experiences of other men who have gone through this.

I am 60, 6', 205. The gyne was caused by hypertension meds. 

[Miguel Delgado MD]

Denman,
This is a common technique for men with grade 4 gynecomastia and sometimes grade 3. If the skin is insignificant excess there is little option other than and double incision mastectomy with a free nipple graft.  Men who need the procedure and understand their condition are quite happy with the outcome.  There is also a two-stage procedure that can be performed in some cases if the skin laxity is mild to moderate.  A photo of your chest and your age would be very helpful to give you my opinion. Good luck.

[Denman]

This and the next reply are two pics from different angles. Your opinion is welcome. 

[Denman]

Another pic.

[Miguel Delgado MD]

You are a Grade 3 gynecomastia and age 60.  This is not a good combination for a minimally invasive gynecomastia technique.  At age 60 your skin will not contract well and have redundant skin.  Two-stage surgery is another option but would not be adequate for a good outcome.  I agree with your doctor.

[Dr. Elliot Jacobs]

And I agree as well.

Dr Jacobs

[Dr. Cruise]

Based on your photos and age a minimal technique (minimal incisions) would not suffice in correcting your chest and obtaining a result you would like. To tighten your chest, you need breast tissue removal, fatty tissue removal, skin tightening, and re-positioning of the areolas. Simply put, gynecomastia surgery/male breast reduction surgery will correct your problem. If you are a good candidate for a tummy tuck, then it would make sense to have it done at the same time. One surgery, one recovery.