Questions for Dorctors, is it important to do lipo first, followed by excision?

[rich19007]

I read on bodybuilding.com that the correct order during surgery is to do the lipo first, then follow it up with excision.  It stated something about the gland is easier to get to, or something along those lines.  Is this common knowlegde among all doctors or just one surgeon's way of doing it?  My surgery date is coming up in the 23rd of Jan, and I want to ask my doctor if that is what is doing.

[fresh_start]

   I'm having surgery in two weeks and my doctor told me he was going to remove the tissue first and then do lipo after to improve the contour. 

[headheldhigh01]

both sound plausible depending on the case.  in the first, he can't really tell the layout till after the lipo, and in the second, excision is the primary op and the lip evens it out. 

[rich19007]

Thanks for the feedback. 

Fresh start, are you nervous. My surgery is in a couple of days and I am totally climbing the walls.  Last night I got so worked up over it I fainted.  I really got to relax.  How do you feel?  Who is doing the surgery and where? 

[fresh_start]

  Hey man

  Don't be so nervous.  I realize that's easier said than done when your in a moment of anxiety, but still their is just no reason to worry yourself.  It is natural to be a little nervous b/c surgery is probably something you've never done before and the unknown can get the imagination running wild.  But just recognize that it will only be a few hours of your life and then afterwards you will be free of the stupid useless gyne that has ruined so many precious summers.  I'm sure you picked a board certified plastic surgeon and that he/she is more than capable of performing the operation safely. I'd say next time you start imagining anything negative about your surgery you should immediately stop yourself and start to imagine something positive that will result.  I know I'm looking forward to going swimming and wearing new clothes.  So decide what kind of thing you'll be able to do a month from now that you are too self conscious to do now and you'll feel excitement instead of nerves. 
  I am really f'ing excited man.  I have let this useless gyne make me so uncomfortable for way to long and I can't wait for that surgeon to slice me open, chop off my gyne and set me free.  Your going to feel more confident after surgery and be bangin' lots of hot babes I'm sure who are going to be drooling to be with the new, improved you!  We're getting are breasts removed b/c we're NOT WOMEN so I say along with it improve your attitude and be a MAN.  Men don't worry about little surgeries and pain after recovery, they worry about wars, world affairs, justice & being the best person they possibly can.  You are taking a big step in becoming that new and better person that YOU KNOW is lurking just beneath the surface and is about to roar.  You are strong, your a man, you can handle any little pesky doubts and nerves, I know you can. 
   I don't really want to disclose my surgeon for privacy reasons but I will tell you that I am from the philadelphia area so if you happen to be from there too maybe I'd be more willing to disclose.  But chances are your not and knowing who my surgeon is won't help you anyway. 
  I really hope this helped you in your moment of need.  This board has been such a valuable resource for me that I am happy to be able to give back and maybe help a fellow sufferer.  If you have any other questions/comments/concerns feel free to post 'em and I'll make sure to check back within the next day or so.  Hang in there bro. 

[rich19007]

Actually, believe it or not, I am from Philadelphia.  That's quite a coincidence, huh?  I am using Dr. Benjamin Lam from Bucks County Plastic Surgery in Langhorne, PA.  Dr. Lam is partners there with Dr. Skalicky.  All of my doctors state that they are some of the best in the state.  Supposedly they are the first surgeons in the country to perform breast augmentation on the web, or something like that.  I am not sure what board they are certified with, but eveidently they are supposed to be good surgeons.  I am getting the procedure done at St. Mary's Medical center in Langhorne.  It's nice to meet u.  Thank you for the pep talk, it actually did inspire me to tell myself to stop being such a b!tch.  When it comes to medical stuff, I really wind myself up. 

[DrBermant]

I read on bodybuilding.com that the correct order during surgery is to do the lipo first, then follow it up with excision.  It stated something about the gland is easier to get to, or something along those lines.  Is this common knowlegde amongall doctors or just one surgeon's way of doing it?  My surgery date is coming up in the 23rd of Jan, and I want to ask my doctor if that is what is doing.

I prefer to start with and target the gland first. By concentrating on gland, I target the tissue that compresses the least and reserve the remaining fat as a potential tool for my reconstruction. 

Liposuction is fine for fat.  However, all forms of liposuction preferentially remove fat over gland.  When fingers of fat are between fingers of gland, liposuction alone tends to suck out the fat condensing  the gland behind making a mess.  I prefer my Dynamic Technique where liposuction is but one of many tools of my artist's palette for surgical sculpture. 

• Excision,
• Liposuction,
• Microliposuction,
• Nipple Sculpture,
• Mastopexy Male Chest Lift,
• Skin Reduction,
• and other techniques.

My Fat Flaps can bring fat into a crater.  A flap is tissue moved with a blood supply.  Adjacent fat transfered with a blood supply tends to survive, much better than a graft.  When carefully done, fat flaps tend to look like normal fat, feel like normal fat, and move like normal fat.  There are limitations to what fat flaps offer since fat still connected to its blood vessels will move only so far.

Try to go through the entire section about male chest sculpture on my site to learn what my techniques of surgery have to offer.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture