How to tell if 100% of gland was removed?

[762MMFMJ]

Well looking around, Ive seen a lot of people saying that most docs don't remove all the gland because it leave a concave nipple which i don't have. however when i lift my arms my nipples go concave. is that what they mean by concave nipples? or do they mean when you are relaxed with your arms down to your sides? i was just wondering because I believe i remember my doctor saying he was going to remove all of both glands which i believe he did i just want to know for sure.

Thanks

[iFlow]

Dunno, besides a flat chest? I personally want 100 percent out, but if it's bad, then perhaps 98 percent or so.

[DrBermant]

Well looking around, Ive seen a lot of people saying that most docs don't remove all the gland because it leave a concave nipple which i don't have. however when i lift my arms my nipples go concave. is that what they mean by concave nipples? or do they mean when you are relaxed with your arms down to your sides? i was just wondering because I believe i remember my doctor saying he was going to remove all of both glands which i believe he did i just want to know for sure.

Thanks

No surgery removes 100% of the gland, that is just not anatomically possible.  Any surgery technique, even radical breast mastectomy for male breast cancer can leave gland behind.  The problem is that there are fine fingers of gland that dissect between fingers of fat and can extend quite far into the chest.

I prefer to target the gland first with my Dynamic Technique. This permits me to remove most of the gland and then sculpt the remaining tissue to minimize contour problems. 

You can see what I mean by fingers of gland here.

By concentrating on the gland first I am able to minimize the chance of breast regrowth.  It is very rare for my patients to have recurrence.  With my techniques and my Red Flag Evaluation System before surgery, I have only a few patients over the many years I have been doing surgery that I know have regrown.  However, gynecomastia surgery does not stop breast regrowth.  For patients having breast growth, I have advised for many years that they should get their problem under control before surgery.  There are exceptions, such as young men with massive breasts that have not stopped growing.  That is why each case needs to be individually evaluated. 

Prevention of gynecomastia, when possible, is much better. We help patients explore such issues during consultations or preliminary remote discussions.

Hope this helps,

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

[mattmando]

Dr. Bermant,

  I have had two surgeries and the last one about two years ago.  and recently i feel a gland getting bigger and nipples getting bigger. I take no drugs (legal and illicit) and before i got my first surgery my gyneo was the same size for years until i got it removed.  The reason i got my second surgery is not because there was regrowth but just the fact that the first surgeon didnt meet my expectations.  What am i to do? i don't have insurance until august so i cant go an endocrinologist.   And i am up for getting another surgery but am scared that this may happen again

[DrBermant]

Dr. Bermant,

  I have had two surgeries and the last one about two years ago.  and recently i feel a gland getting bigger and nipples getting bigger. I take no drugs (legal and illicit) and before i got my first surgery my gyneo was the same size for years until i got it removed.  The reason i got my second surgery is not because there was regrowth but just the fact that the first surgeon didnt meet my expectations.  What am i to do? i don't have insurance until august so i cant go an endocrinologist.   And i am up for getting another surgery but am scared that this may happen again

We see many patients from other doctors unhappy with what has been done.  Realistic expectations are key to a successful outcome.  For many, Revision Gynecomastia Surgery is an option.

For some problems, an endocrinology evaluation can be very important for a better understanding of reasons for gland growth or stimulation.  We are happy to help patients explore their concerns during consultations or Preliminary Remote Discussions.  If interested, Jane is my office manager.  She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery