Had my consultation with Mr Hamed on Friday (7 September). He was very honest with me, but didn't really say what I wanted to hear.
Basically, his view was that my condition is "within the range of normality". I had trouble accepting this, as I've seen plenty of similar cases on this website and others that appear to have been successfully operated on. My pics are here (sorry about the large image sizes):
http://www.gynecomastia.org/smf/index.php/topic,11004.0.html. Basically, puffy nipples and a bit of gyno.
My chief concern is the big dome shaped nipples, which do actually go flat if it's cold. Mr Hamed explained that the nipple works like a muscle (he may have said it is a muscle, can't quite recall). When it's tensed, it contracts, and lies flat. When it's relaxed, I get the dome effect.
He said he can remove the tissue below the nipple, but isn't sure if that's going to achieve the result I want. He said I could consider lipo, which would suck out the fat but not the supporting tissue, meaning the nipple might lie flatter anyway. Might.
Then he showed me a pic of a previous case similar to mine, which was a bit more encouraging. He removed a fair bit of tissue, and the nipple appeared to have shrunk to about two-thirds its usual diameter, and was flatter, though still a little convex.
Mr Hamed also pointed out that, post op, the nipple would not expand as much when relaxed because of the scar, and because some nerves would have been removed. Which made me think (later), why not simply snip through all the nerves?
I asked about the gland, and he said if it fell within the area of tissue he was targetting, it would come out. Not definite though. He didn't seem to think it too important and said he couldn't feel it when he examined me. He also said I should beware the "doughnut effect", which might occur after removing too much tissue.
When I asked what result he expected to get, he said sometimes he surprises himself, and the patient ends up 80%+ happy with the result, which would suit me. But it's hard to predict. If I was unhappy with the result, he would operate again for free, though I'd have to pay hospital fees.
I have to say Mr Hamed was very thorough throughout the consultation, which lasted one hour, and the fact that he was hesitant about operating rather than just grabbing my money made me trust him.
But it's left me in a real quandry. I could go ahead with Mr Hamed, but I'm starting to think I need a second opinion. The reports on Levick are glowing on here, and although it would be a hassle for me to get to, I'm thinking that may be the most sensible option.