NHS Advice

[SOAD]

Let me tell you my story so far, then ask my questions. Cheers all.

I am pretty certain since january my gyne has got a fair bit worse. This has coincided with a fair bit of muscle hypertrophy in my chest. My right hand side chest is still perfectly fine, albeit now with more muscle.

Visited GP in June before my holiday. She examined my chest then referred me to Leeds' "breast clinic." She decided it was severe enough and assymetrical enough to warrant that.

Got there and was examined by a doctor who simply repeated my GP's words saying that I have gyne, and said I could have a "scan" on the thursday of that week, and a repeat appointment to discuss the findings the next week. The "scan" merely confirmed it was definitely gynaecomastia, and the week after I was told it was gynaecomastia... again. A different doctor spoke to me on my appointment. He told me the scans showed I have gynaecomastia. He then said the options are usually to:

Lose weight - he said I can't lose any more bodyfat realistically - I have low body fat % and have had gyne at times while being ultra skinny.
Exercise, specifically weight training. - being going to the gym for the past year 3 times a week, so again, not an option. (put on a good twenty pounds of muscle in this time.)

SURGERY - he asked if I would be willing to do this. I certainly am, but am wary of an NHS surgeon cocking it up. He said he would give me a month to discuss it with whoever I wished - family, etc, before a return to discuss it with them, with the option of potentially having the surgery in december.

Now I am totally FOR doing the surgery, but like I say, wary of an NHS surgeon. Let me say, I feel very fortunate to have this opportunity on the NHS as others haven't been as lucky.

Now the question is, what should I ask on my discussion about surgery appointment?
e.g. what about seeing an endocologist (SP)? This has yet to mentioned - I will mention it at the appointment.
- The doctor mentioned cutting into my chest, and pointed ACROSS my lower chest... now that sounds pretty flimsy, and I'm sure I've heard of better techniques, EG cutting at the armpit - which ways are considered best? (As a side note, he was NOT the surgeon and way well have not known the exact surgical procedure.)
- What else should I ask?
Note - I will ask whether gland removal AND liposuction will be done, as I know doing only ONE is a bad option - I'd imagine with my low bf% liposuction will be less important though? I don't know how much of it is fat, and how much gland though, but I know for sure that I have a hard mass of gland that is a large bulk of it.

Also, I've yet to tell my family about ANY of this... should I...? I'm really not sure whether I should, I think it would be AWESOME if I could get the surgery done privately, and then let them know, as it would be a great thing to do indepently - however, if this is not the best idea, I'll talk to them. They are aware of it as they have seen me with my top off of course, though this year at the beach I couldn't bring myself to take it off, which was hell, and my family hasstled me about, but I wouldn't explain why.

On the off chance, has anyone dealt with a Doctor Musa? He is my doctor, but NOT surgeon for this. I am yet to confirm surgery - that is what I am doing at the end of this month.

Thanks in advance everyone.
I'm aware I tend to rant on these, need to get it all out... I am so emotional about this all the time at the moment, it is rediculous. I need to play it down in my head a little - none of it is life threatening or hurting anyone genuinely.

[SOAD]

bump due to appointment being in 3 days.

[phantom]

Hello SOAD

I really am hard pressed to think of another example from this forum where the NHS has got it oh so wrong!  You didn't need to be referred to a frickin breast clinic to determine you have gynaecomastia!  All the breast scan did was prove you had breast tissue.  Irrespective of breast and fat composition, if you have 'woman-like breasts' visually, then you have gynaecomastia!

From what you say, it sounds like your GP could do with finding out the protocol for hormonal/breast issues in men is.  Your first referral should have been with an endocrinologist to run a few tests just to rule out any chronic hormonal issue such as hypogonadism (low testosterone).  Once you have the all-clear in that department, then you can decide on surgery.

I'm not going to go through all the pros and cons of NHS vs Private and what to ask.  Take time to go through the UK section of this forum where just about ALL your questions will be answered.

The NHS is much more of a mine field in terms of finding the right surgeon.  Personally, I would not be happy to proceed with anything less than a PLASTIC surgeon that has significant experience in male chest procedures.  I would NOT want to be seen by a breast surgeon, that spends all day lopping off women's' breasts or a general surgeon who is the 'jack of all trades' in human cutting.

A surgeon that knows his stuff would only use the 'crescent cut' around the edge of the areola or an incision via the crease near the armpit.  Anything else is sooo last century.  A good surgeon will aim to remove as much breast tissue as possible and sculpt the fat tissue accordingly.  I'd walk away from anyone that just removes fat only.

There have been some excellent results via the NHS and all done in a matter of weeks and there have been some really sh*t results where patients have had to wait more than a year.

For the reasons above and some others, I bit the bullet and went private.  I chose the surgeon that has done literally 100s before me at a time that suited me.  He work carried a guarantee and I felt confident that NO ONE was capable of achieving a better result for me - a result I will now live with for the rest of my life.

£4,000 might seem a big financial blow, but that kind of money only really effects the here and now, not the longer future.  I'll check this forum over the next day or two in case you have any more questions before your appointment.

Hope that helps.