Scar placement for skin excision

[Titswiggle]

I have grade 4 gynecomastia and believe it will require skin excision.  When I lift the breasts up by placing my hand above the breast and pulling up, they move up into a “normal” position and don’t look too bad.  Has any doctor removed the glands plus lipo and then made the horizontal incisions above the breasts and then stitched it in a way to lift the breast up into a normal position instead of making the cuts below the breast?  Seems like there will be scarring either way but I thought the other option might work. Thoughts?

[Miguel Delgado MD]

No, that is not a natural placement for the scar and would look terible. Go with the "gold standard" placment. Good luck.

[Titswiggle]

If someone has pseudo gynecomastia where gland removal isn’t required, but still needs skin excision, wouldn’t the ability to make the cut above the breast eliminate the need for the nipple free graft?  The scar placement isn’t optimal but not having to relocate the nipples seems like a decent trade off.  

[Titswiggle]

Here is a pic of a guy who had skin excision with the scar placed above the     nipples.  Seems like a good alternative to the “gold standard “ where the free nipple graft wouldn’t be required.  I would like some of the doctors on this site to provide their opinions on using this technique.  

[Miguel Delgado MD]

It certainly can be used for someone who wants to maintain nipple sensation.  You must maintain a moderate amount of tissue underneath the tissue so not as flat as the free nipple procedure. The photo is right after surgery. I would like to see how it looks in 6 months.  This technique can be used but not main stream.