Trust the doctors? Please help.

[rockymnt]

Hello, first off thanks to everyone. This site has been a great resource. My question is should I trust these doctors?

I have done extensive research on doctors and spoken to offices from San Fran to Denver.
I have had two examinations locally and both doctors recommend a primarily lipo approach. Based on my readings here this worries me a great deal. When I feel em they feel like there is more hard gland tissue than soft breast tissue. But I have never felt man boobs before. So what do I know?
I have told both about my fears about lipo only.

Although both doctors said I should see great results with ultrasonic lipo. There were some differences.

Doc 1 does 2-3 per year works at a major medical center locally and recommends general anesthesia. Says he will perform lipo with one incision under breast then while I am under make a judgment about excision.

Doc 2 does 2-5 per month works at a clinical setting and recommends sedative twilight anesthesia + local. He will perform in office with physician anesthetician.  Says he will perform lipo from small incisions both under and to the side of breast and remove fat in a criss-cross pattern. Says he recommends this because its less invasive and if I should decide later that I want the excision the gland would be significantly smaller, requiring only a small areola incision and minimal down time. If I have excision now it will require a large incision in the areola, possible wider than my nipple. Larger scar plus lots of down time. He feels after talking that I am realistic about expectations and I should be happy about what he can do with lipo only. I am generally more comfortable with this doctor.

Other options: I have a 3rd local consultation in a few days. I have spoken to people with both Dr. Albin in Denver and Delgado in San Francisco. But costs are significantly more (Delgado) plus I will incur travel expenses and hassle. But I am willing and able to do this if needed.

Sorry for the long read, please help if you have any experience with this.

[MSJ108]

Doc 2 because of his experience. I hear good things about Delgado as well though but it will cost you much more to travel

[rockymnt]

"Doc 2 because of his experience."

Even though he is also suggesting lipo only?

"I hear good things about Delgado as well though but it will cost you much more to travel."

But is is worth it? Getting lipo now and excision later might cost almost as much and be more of a
pain.

Bottom line..... has anyone been happy with lipo only? I haven't been felt up by Delgado or Albin but it seems that each do both excision and lipo. I am just worried that the doctors I have seen are too confident in the machines they have paid so much for. But if I can get good results with just lipo that would be great. Doc #1 said that excision is how they treated gynecomastia 15 years ago and rarely its done anymore. Reading on this board suggests otherwise.

Thanks for the reply.....

[Twin Peaks]

Doc 2 doesn't seem like his procedure is the best.  I've seen pictures of HUGE amounts of gland removed from an incision that was cut around less than half the nipple. I can't imagine how the scar would looked if it was made outside the areola . Also, making 2 puncture wounds for lipo does not seem necessary at all.  If the doctor does do lipo only and you decide that you want an excision, there isn't going to be any less gland after the lipo so doing an excision isn't going to be any easier.  Lipo cannot remove gland.  Maybe I'm not understanding his procedure completely, but it just seems excessive. 

[MSJ108]

Doc 2 doesn't seem like his procedure is the best.  I've seen pictures of HUGE amounts of gland removed from an incision that was cut around less than half the nipple. I can't imagine how the scar would looked if it was made outside the areola . Also, making 2 puncture wounds for lipo does not seem necessary at all.  If the doctor does do lipo only and you decide that you want an excision, there isn't going to be any less gland after the lipo so doing an excision isn't going to be any easier.  Lipo cannot remove gland.  Maybe I'm not understanding his procedure completely, but it just seems excessive. 

I have read of some lipo techniques that can remove some gland.

[Twin Peaks]

Doc 2 doesn't seem like his procedure is the best.  I've seen pictures of HUGE amounts of gland removed from an incision that was cut around less than half the nipple. I can't imagine how the scar would looked if it was made outside the areola . Also, making 2 puncture wounds for lipo does not seem necessary at all.  If the doctor does do lipo only and you decide that you want an excision, there isn't going to be any less gland after the lipo so doing an excision isn't going to be any easier.  Lipo cannot remove gland.  Maybe I'm not understanding his procedure completely, but it just seems excessive. 

I have read of some lipo techniques that can remove some gland.

That is correct, and that is actually the type of procedure that I am having myself tomorrow. The doctor uses a large cannula with a small grinding tool at the end to chop up the gland in addition to other tools.

However, the original poster just mentioned "ultrasonic lipo" and not any other specific kind so that's what I was basing my response on. 

[rockymnt]

"That is correct, and that is actually the type of procedure that I am having myself tomorrow. The doctor uses a large cannula with a small grinding tool at the end to chop up the gland in addition to other tools.

However, the original poster just mentioned "ultrasonic lipo" and not any other specific kind so that's what I was basing my response on.  "

The doc did mention a cannula but didn't detail the grinding tool. I will follow up with him about that. I said Ultrasonic lipo but I am not completely familiar with all the terms. Thanks

[MSJ108]

Doc 2 doesn't seem like his procedure is the best.  I've seen pictures of HUGE amounts of gland removed from an incision that was cut around less than half the nipple. I can't imagine how the scar would looked if it was made outside the areola . Also, making 2 puncture wounds for lipo does not seem necessary at all.  If the doctor does do lipo only and you decide that you want an excision, there isn't going to be any less gland after the lipo so doing an excision isn't going to be any easier.  Lipo cannot remove gland.  Maybe I'm not understanding his procedure completely, but it just seems excessive. 

I have read of some lipo techniques that can remove some gland.

That is correct, and that is actually the type of procedure that I am having myself tomorrow. The doctor uses a large cannula with a small grinding tool at the end to chop up the gland in addition to other tools.

However, the original poster just mentioned "ultrasonic lipo" and not any other specific kind so that's what I was basing my response on. 

gotcha brother.

[rockymnt]

*update* just talked to the his office. They said they use saline assisted lipo and that it will not remove glands. He is happy to do the excision as well however he wont be able to be as aggressive with the lipo. He does excision often but in my case thought I would see enough improvement with just aggressive lipo.

So it is either aggressive lipo or excision with lighter lipo. They are holding an appointment for me to have Excision + lipo under general anesthesia at my request. Sound wise?

I think I will still see the local guy in a few days just for another opinion. Do you guys think I should still pursue the travel option? Dr Albin is about $800 more +travel and Delgado is $2800 more +travel. Does anyone think this is worth the extra expense? I just want this done right.
 

[MSJ108]

doc 2 if you got gland and need it removed

[George Pope, M.D.]

Rocky,

You mentioned in your initial post on this thread that both docs said they would use ultrasonic lipo.  In theory, the ultrasonic energy can break up (melt with heat) glandular tissue, in addition to melting fat.  In reality, though, when I used ultrasonic lipo in gyne cases, I often had to directly excise gland tissue anyway.  I eventually abandoned ultrasonic lipo.  Laser lipo is the latest craze, but I have no experience with it.  Maybe they initially meant that lipo alone was sufficient for that reason (use of U/S).

If it were me, I'd go with Doc #2 and excision of gland with lipo.  Is he the one who has you scheduled?

Dr. Pope, M.D.

[rockymnt]

[quote author=Dr. Pope link=topic=14211.msg99278#msg99278 date=1211417638]
Rocky,

You mentioned in your initial post on this thread that both docs said they would use ultrasonic lipo.  In theory, the ultrasonic energy can break up (melt with heat) glandular tissue, in addition to melting fat.  In reality, though, when I used ultrasonic lipo in gyne cases, I often had to directly excise gland tissue anyway.  I eventually abandoned ultrasonic lipo.  Laser lipo is the latest craze, but I have no experience with it.  Maybe they initially meant that lipo alone was sufficient for that reason (use of U/S).


If it were me, I'd go with Doc #2 and excision of gland with lipo.  Is he the one who has you scheduled?

Dr. Pope, M.D.
[/quote]

I miss typed when I wrote ultrasonic lipo. Later today I called and was told he used saline assisted lipo. Any experience with that? He says he is willing and very able to do the excision as well so that is how I booked the appointment. I insisted on excision because in my own uneducated opinion the tissue behind my nipple seems firm and glandular. He thought that it was soft enough to be helped a great deal by lipo alone. That is why I am so confused.

Yes I put a $100 deposit with him because he had a very convenient opening. Also I am almost sure I will get it done with him but am willing and able to do what is needed to get this done right.

Do you think I should just go with his recommendation of starting with saline assisted lipo and then moving on from there? Or stay with my insistence that the excision be done?

HAHA what is with all this doc 1 doc 2 crap? The doc I am considering is Dr. York Yates in Layton, UT (http://www.yorkyates.com/). I didn't post his name earlier because he is not in the holy elite of gynecomastia.com but he seems very qualified. 

Anyone have any experience with him?

Dr. Pope thank you for this post and any future help.

[MSJ108]

[quote author=Dr. Pope link=topic=14211.msg99278#msg99278 date=1211417638]
Rocky,

You mentioned in your initial post on this thread that both docs said they would use ultrasonic lipo.  In theory, the ultrasonic energy can break up (melt with heat) glandular tissue, in addition to melting fat.  In reality, though, when I used ultrasonic lipo in gyne cases, I often had to directly excise gland tissue anyway.  I eventually abandoned ultrasonic lipo.  Laser lipo is the latest craze, but I have no experience with it.  Maybe they initially meant that lipo alone was sufficient for that reason (use of U/S).

If it were me, I'd go with Doc #2 and excision of gland with lipo.  Is he the one who has you scheduled?

Dr. Pope, M.D.
[/quote]

ultrasonic energy can break up, melt with heat glandular tissue huh. Interesting. Thanks Doc!

[rockymnt]

First of all thanks to everyone for the help.....

I have narrowed my options down to two. I would appreciate any thoughts on my situation.

Option one Dr. York Yates "Doc #2": After consultation he suggested that he perform only saline assisted lipo with local anesthesia and then go from there. I went against his suggestion and tentatively booked for lipo + excision under general anesthesia.
Pros: he is local and experienced. Also about $800 cheaper ($ is not my main concern).
cons: What he suggested goes against what I have come to understand is the main source of my problem, the gland. He is "willing and comfortable" doing either.

Option two Dr Richard Albin: After reviewing my pics he automatically is convinced that I need the excision under general anesthesia + ultrasonic lipo. My uneducated opinion agrees with this.
Pros: Seems exceptionally experienced with this procedure.
Cons: Have only communicated via phone and e-mail. He is in Denver and a little more expensive.

Right now I am leaning towards the Dr. Albin just because I think he is more experienced and he is recommending the correct course of action instead of being "willing". He will end up costing about 1500 more with travel included but that is negligible because I am confident that I will never need a revision.

Think I am making the right choice?

[MSJ108]

tough choice but think you are in good hands either way from your feedback and posts