how to tell my GP?

[barclay]

my swelling hasnt gone down, but he did tell me it could take months, plus i think i started pushing myself too hard too early which has hindered it. i dont believe my swelling would have been any different had i gone private or through the nhs. after the op, prior tot he swelling i was extremely flat chested.
I was also told that both sides may not look even after the op, he told me one nipple may be lower than the other due to one side being a lot worse pre op. this hasnt been the case though but I get the feeling he wasnt trying to gloss anything over, he was giving me the hard truth and wasnt trying to promise me miracles but promised he would do his best.

ive just found this

http://www.cosmeticsurgery-boston.com/gynecomastia.html

read that, it mentions that its not possible or desirable to remove ALL gland, just the excess.

[WXYZ]

barclay, when it comes to gyne it seems that some surgeons leave some in and some remove all (such as Levick). But I remember reading on this board a while back that all glandular tissue must be removed to prevent it from recurring. I remember seeing a documentary (I think it was Boys with Breasts) where a guy complained his grew back because his surgeon didn't remove all of it.
It doesn't seem great when the surgeon says they will be uneven, because we've seen pics where some gyne sufferers have had a good job done and both sides appear to match perfectly. Maybe it's the price you pay with an experienced private surgeon and the NHS.

Is there any scarring with yours?

[barclay]

no, i havent had any scarring, in fact ive had my top off around people and some think im lying about the fact i had an operation which is very reassuring. he made an incision around the nipple, and also there was an incision on my side where the drain was fitted. I expected mine to be uneven to be honest, one side was a lot larger than the other and when he said uneven, he suspected one nipple would be lower than the other due to the size of one side, he didnt mean one would still protrude further than the other. This hasnt been the case though, although there is still swelling on my right side which may be holding the nipple higher, it may be a few months yet before i see the final results
ive got a check up with him in a few weeks, ill be asking him then exactly what he removed and what he left behind.

[DrBermant]

he explained to me that if he removed the whole gyne it could cause my nipple to die, he mentioned something about it being how it gets the blood supply (cant remember too well, its about 5 months since i saw him for the consultation) I was apprehensive, like yourself when he told me about leaving some in, but he seemed very knowledgable about it, and the nurses and other doectors on the ward told me he was very experienced in it and one of the nurses sons had actually had it done with him.
now nearly 2 months post op im very happy.
he said he would be leaving a small amount in. im sure ive read it else where in here, ill try and find it


edit : cant find it on here, but i havent spent that long looking. i have found searching with google that some surgeons will leave some behind, some wont. I was having a look on dr bermants site too and there was mention of only removing "some" of the gland, although i may have read into it wrong. But what i picked up is that sometimes its necessary to leave some to prevent the concave look if there is insufficient fat to build up the breast area if all the gland is removed.

Actually I prefer to target the gland first with my Dynamic Technique for Gynecomastia. This permits me to remove almost all of the firmer distorting gland and reserve the remaining tissues as a resource for reconstruction.  I feel that getting most of the gland is a major factor in helping my patients minimize their chances of recurrence.  Yes, it does take skill to preserve the nipple with such surgery.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[barclay]

when you say you reserve the remaining tissue, are you referring to left over gland? Does some need to be left in to preserve the nipple, or can it be preserved if ALL of the gland is removed?

[WXYZ]

That's what I need to know, exactly what is left under the nipple? I've heard the glandular tissue needs to be removed completely or else regrowth may occur.

[DrBermant]

when you say you reserve the remaining tissue, are you referring to left over gland? Does some need to be left in to preserve the nipple, or can it be preserved if ALL of the gland is removed?

Although I target gland first, shreds of gland typically remain behind with any technique.  It is an issue of the anatomy of the gland / fat.  However, what leave is so trivial that I am able to have such a low recurrence rate.  I use my Fat Flap Sculpture and other elements of my artist's pallet to contour the tissue under the nipple.

That's what I need to know, exactly what is left under the nipple? I've heard the glandular tissue needs to be removed completely or else regrowth may occur.

Yes, that is why I target gland first.  Less breast cells can mean less for hormones and other factors to stimulate. 

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[barclay]

i just read this wxyz

http://www.gynecomastia.org/smf/index.php?topic=13938.0

jim says benito also sometimes leaves some gland behind

[Jackd]

It took me a couple of attempts to tell the doctor about my problems as well. More serious than  just gyne but all connected.... first couple of times I felt like I was wasting his time which then put me off going back to actually tell him, I got the feeling he thought I was a timewaster, but as soon as I finally told him he was very understanding, extremely helpful and I've started various treatments, got an endocrinologist and he is saying about surgery on the NHS, but I think I am going to bite the bullet and pay for it via Dr Benito as all his cases I've seen so far look very very good work, you only get 1 chance at this sorta thing IMO. I'd rather pay and have a greater chance of being happy.

So, just tell the doc, its all good news from there on....

[BullsEye]

I had problem of facing my GP with gynecomastia but I saw him on Wednesday. I was surprised at his reaction and he said he was going to refer me straight away to a surgeon. I was expecting him to send me for blood tests and to see a psychologist. Does the blood tests etc come after you see a surgeon? And just to see the surgeon can take months I believe..

[Jackd]

You should see an endocrinologist first I think! A lot depends on your age and circumstances... from what I gather, if you're young it's in your very best interests to go to the endo FIRST.. as if you have a hormone imbalance and go ahead with surgery you risk the gyne coming back, whereas if you fix the hormone problems first then get surgery after, you're more likely to be successful.

I saw the endo almost a year ago, I have been on treatment ever since , I should have spent the time training and getting fit and saving for surgery, but I didn't.. I've just started now and I'm going to wait until I'm around 15% Bodyfat before getting surgery.. so I'd reccomend getting fit now or you will regret it later...

Just my thoughts on it anyways.

[SortIt2008]

I have also been refered to a specialist via my gp but he has mentioned a drug that is accesable called Danazol. From the info the GP was giving i seems like this can somehow reduce gyne ive not had chance to do much research ....anyone else come across this Danazol?

[Jim1985]

From what I've heard on here, drugs don't normally help gyne. I've heard they can help if you have a hormonal imbalance, but normally if you've had your gyne since puberty, surgery seems the be the best, if not only, option. That being said, there are new developments all the time. Best to do some proper research into it.