Advise on nipple graft, keep them or no...?

[Coastman]

Have any of you drs had a patient who chose to have his nipples removed during gyno surgery? I am working towards surgery and the drs I have consulted with both have said they include a free nipple graft. Yet the placement always looks wierd to me. I do not particularly like having them anyhow and am strongly considering not having them put back on. I have been classified as severe gyno with a good amount of skin that will need removed. I plan to get tattoos across my chest after all is said and done. What are your thoughts on it? 

My stats, 38yo male, gyno since teens, 350lbs

[DrPensler]

Never been a fan either.Why don't you post some photos.

[Coastman]

Can admin please help, it will not allow me to upload pics. Says error 500

[Dr. Elliot Jacobs]

If indeed you weigh 350 lbs, then you have much more significant problems than your gynecomastia.  My best advice, which you may not like, is that you should lose significant amounts of weight (either diet/exercise or thru bariatric surgery, which is now safer than ever) and then consider appropriate gyne surgery when you are at your best and most stable weight.

Any surgery done when you weigh 350 lbs has significantly iincreased risks because of your obesity alone.

Think about it.

Dr Jacobs

[Coastman]

Thank you for the truth dr Jacob's, that is what I was hoping for here. I have several times in my life, dropped 50-70lbs and have done so with minimal trouble. It is my intention to get down to about 270 which is the wieght I have carried most of my life. 270-260lbs. My ideal wieght is 240 after surgery and I am able to finally be able to go to the gym without being embarrassed. I can only do so much from my home weight set. I have been thinking about gastric sleeve surgery because it would be nice to stop yo yoing with my wieght. Even tho, I feel the surgery will allow me to exercise much more and will be a large contributing factor to my overall wieghtloss.

[Dr. Elliot Jacobs]

If you could get down to 240  (that's 110 lb weight loss from 350), you would be in much better shape to have the surgery done in a safe manner, the surgery would be better and the results would be longer lasting.

Good luck!

Dr Jacobs

[Dr. Schuster]

I reserve the nipple graft method for the most severe type of gynecomastia. This is when there is too much skin that will simply not shrink alone nor with a peri-areolar technique. I think the the nipples can come out looking normal but I can understand if there are guys who don't like the look. I don't think it is unreasonable not to have them put back on. But if this becomes your choice I would suggest looking into 3D nipple tattoo. This is done for women after having mastectomies for treatment of breast cancer. 3D tattooing is a specialized type of tattoo performed by limited numbers of experienced tattoo artist - so you need to do your homework, preferably before you do your surgery. Good luck.