Areola VS armpit incision

[tmb82]

Hi,

Serious confusion! I have been to two surgeons now for gland excision and lipo. The first one said he would make an incision around the half the areola - and that the armpit was too far away to enter from. The second says he does everything from the armpit. I dont know why I didnt sort this out with the surgeons right there right then, but now I just don't know which way to go for! PLease, I would be so grateful of some information on the pros and cons of each procedure, and why some surgeons prefer one or the other.

Thankyou a hundred times!

Tim

[DrBermant]

Hi,

Serious confusion! I have been to two surgeons now for gland excision and lipo. The first one said he would make an incision around the half the areola - and that the armpit was too far away to enter from. The second says he does everything from the armpit. I dont know why I didnt sort this out with the surgeons right there right then, but now I just don't know which way to go for! PLease, I would be so grateful of some information on the pros and cons of each procedure, and why some surgeons prefer one or the other.

Thankyou a hundred times!

Tim

Each surgeon used the tools and techniques he / she prefers.

The problem is that gynecomastia comes in so many different forms.  I prefer to let what I find during surgery help guide what needs to be done.  An incision at the edge of the areola opens up for me an artist's palette of tools not available when using the armpit approach.  That is why I prefer my Dynamic Technique.

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.

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat.  

The areola chest skin interface is a great place to hide a scar.  Check out the many before after pictures of this Areola / Nipple Gallery here, here, and here.  These results are typical for my sculpture of my patients.

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

[Paa_Paw]

You may want to check the credentials of each Doctor. A Plastic/Reconstructive Surgeon is not necessarily the same as a Cosmetic Surgeon, you want the latter. You may want to get yet a third opinion as a tie breaker.

Cosmetic Surgery is still a comparatively new specialty and what Dr. Bermant said is valid that the Surgeon may limit their surgical options by the surgical route or method they choose. Just as one artist may choose to work in clay while another uses oil paints; a cosmetic surgeon is also an artist and may choose one medium over another.

Also, you are an individual, what is best for you may be very different from what is best for someone else.

Ultimately the decision is up to you.  Get all the information you can to make a truly informed decision.