Armpit rather than areola incision

[bosco]

Dr. x a local surgeon in the New Orleans, LA  area makes incisions in the armpit rather than the nipple area. This seems to me to be a much better way to avoid obvious scars around the nipple. How common is this type of incision and why don't I read more about other doctors doing this?

[DrBermant]

... a local surgeon in the New Orleans, LA  area makes incisions in the armpit rather than the nipple area. This seems to me to be a much better way to avoid obvious scars around the nipple. How common is this type of incision and why don't I read more about other doctors doing this?

Each surgeon used the tools and techniques he / she prefers.

The problem is that gynecomastia comes in so many different forms.  I prefer to let what I find during surgery help guide what needs to be done.  An incision at the edge of the areola opens up for me an artist's palette of tools not available when using the armpit approach.  That is why I prefer my Dynamic Technique.

I have also seen patients with channel problems between remote access sites and the areola / nipple.  Scars, adhesions, and depressions can look terrible.  Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexion here to see what I mean. 

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat. 

The areola chest skin interface is a great place to hide a scar.  Check out the many before after pictures of this Areola / Nipple Gallery here, here, and here.  These results are typical for my sculpture of my patients.

How tissues move is important.  The human body is beautiful in animation.  That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views.  Limited view demonstrations can pick the best angle to hide deformities and problems.  Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor.  It is like an artist selecting a paint brush.  The results are what matters, not with what tool they sculpt.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture