I need revision advice

[Jt1856]

Hello all,
 I received liposuction to treat gynecomastia about 7 months ago. Since there was no tissue excision my results were less than extraordinary (nipples are still puffy). I have talked to my original (board certified) plastic surgeon about the disappointment with my results and he has agreed to follow up with a revision to remove the glandular tissue behind the nipple under local anesthesia at no cost to me. 
  However, I received a second opinion from a another plastic surgeon who is a well known gynecomastia specialist in CA. He informed me that if i wanted to get optimal results he would perform the entire procedure over including lipo and excision because just excising the tissue only, could lead to a crater deformity.
Just curious if any other doctors agree with the gyne specialist or if i should let my original doctor perform the revision (excision only.) Could do a revision with excision only lead to crater deformities?

[Litlriki]

While most gynecomastia surgeons perform simultaneous excision and liposuction for most of their procedures, some plastic surgeons do liposuction first and later gland excision and still get good results with a staged approach.  If your surgeon always uses a staged approach, and he can show you nice results in other patients using that approach, then you may be at low risk for complications if you feel he is otherwise a competent surgeon and you are comfortable with your interactions. On the other hand, if he avoided the excision part for fear of getting "yet another" crater deformity in his series, then perhaps the total re-do is the way to go, so that further salvage of your procedure isn't required.  Correction of a botched result is much more challenging than completing a staged procedure that was started by another surgeon.  
Good luck.
Rick Silverman

[Dr. Elliot Jacobs]

Totally, totally agree with Dr. Silverman.

Dr Jacobs