Scheduled for surgery next week, doctor is adamant that only lipo is needed.

[gunburg]

The doctor is pretty insistent that he can remove fat AND tissue with lipo suction and that no areola incision will be necessary.  He does of course say that that could change during the procedure if he finds more tissue than he is estimating is present but hes fairly certain that only lipo is necessary.

As with most patients, I am a bit worried that I wont be satisfied with just lipo.  I'm sure most guys feel this way before surgery but I've lived with this for so long that I want it completely removed and gone forever in 1 shot.  Think this is reasonable if I am willing to pay the money and go through the procedure.

From my pictures, is there anyway to get a 2nd opinion on this?

[Dr. Elliot Jacobs]

There is no way to know ahead of surgery whether lipo alone will suffice or if additional excision will be needed.  After having performed thousands of gyne operations, I never tell a patient that I will do only one thing:  lipo.  I always state that I will do whatever is needed to get the optimal result -- including excision if need be.

Some surgeons have a philosophy that if they make your gyne 50 or 80% smaller, that you should be pleased.  I am not in that camp.  I always go for 100% -- ie a smooth, contoured, muscular appearing chest.  In truth, mother nature doesn't always cooperate in the healing process, and I don't always hit 100% -- but I sure as heck would not settle for 50 or 80% improvement.

You should have a heart to heart talk with your surgeon prior to surgery to make sure he understands exactly what you want.

Dr Jacobs

[Litlriki]

I am in complete agreement with Dr. Jacobs.  I have revised a number of patients over the years, who simply didn't have their gynecomastia fully resected at the time of their primary procedure.  Afterwards, they will think it's "recurred," but in most cases, it was only corrected "50 or 80%."

You should be very clear that you want complete removal of the tissue, and that he should feel free to make that incision if it's required.

Rick Silverman

[gunburg]

Thanks for the replies doctors.  My doctor did state that if he deemed necessary he will make the incision and excise tissue.  He was just fairly certain that it would not be necessary. 

He stated that he must leave some layer of fat/tissue there to avoid a concave or totally flat, unnatural look. I explained that while I am overweight, I do have a decent later of muscle under there as I have always been fairly active in chest exercises through the years (in an attempt to get of my moobs) and that I am still in fairly good shape as far as strength goes.  I also explained that my biggest concern if having to do a revision because I am unhappy with results. 

He understood but was very re-assuring that he understands my requests and will excise if necessary but will only do the lipo if he feels he can achieve my desired results without excision.

Is it possible to remove the excess tissue using just lipo?   Or will that ONLY do fat and excision is required for tissue?

 

[Dr. Elliot Jacobs]

Yes, it is possible to remove some tissue using lipo along -- but extremely rarely.  Most of the time the breast (gland) tissue is fairly firm and dense and it requires special instrumentation which some doctors may not have available in heir operating rooms.

Dr Jacobs

[DrPensler]

You will most likely need to have glandular tissue excised,the likely hood is in excess of 95%.

[gunburg]

Thanks again for the info.  The procedure is complete at this point and it does seem that the tissue has been removed without an incision in the areola.  As Dr. Jacobs mentioned, usually the tissue is dense and firm but I must say, my moobs and areola area were always extremely soft.  In fact, I wondered if it was just purely fat although 2 separate doctors indicated that it was in fact gynecomastia. Anyhow, I guess time will tell if indeed everything has been taken care of but so far I'm pretty confident it was a success. 

Again, I can't thank you enough for your input!

Thank you doctors.