Confused on type of surgery

[cymro]

Hey guys, I have been to a GP, an endo and have had 2 consultations for gynecomastia surgery and I'm kind of confused with the type of surgery I should go for. I have puffy nipples. I know this is a broad term but this is the best I can think of. Basically everything outside the areola seems fine, the areola itself protrudes and is a lighter colour than normal. When cold, the whole thing shrinks and flattens but the nipple is really big. I know that the nipple is meant to be erect but it its larger than average. Btw I'm 20 years old and live in the UK.

To start with the endo, he concluded that I was healthy and surgery was a good option if the gyno was bothering me. I  also have had blood tests and the results are coming on Friday. He referred me to a breast surgeon which happened to be the one just down the corridor from him (which I find a little concerning). The surgeon specializes in female breast surgery and has done a few gynecomastia surgeries. What seemed to concern me the most is that when I took off my shirt he immediately said they were really bad that they were one of the worse cases he has seen. He sort of seemed a little shocked and said that they were a lot like female breasts. I was a little insulted about this because I have seen the pictures of gynecomastia on many plastic surgeon's websites and I have not got an extreme case by any means. It's a little larger than a a lot of guys with gyno but its only puffy nipples.

He concluded that there was excess skin, gland and fatty tissue and that he would need to do a donut incision. He also said that it was like treating droopy breasts on women. I didn't know if I this is the right type of incision for me because he is the only one to say that my gyno was really bad, all of the other doctors said it was a bit larger than normal but they have seen much worse cases.

I also saw another doctor which offered a vaser treatment. He was highly reccomended, situated in Harley street and works with the top modelling agencies in London. He said there was a little gland there and he could offer at least 80% reduction in the gynecomastis but not quite a 100% because of the gland. All of the people of the doctors and surgeons I saw said it was mostly fatty tissue and a small amount of gland. However, this guy is not a surgeon. I'm not sure if that matters that much because its not really a surgery, more of a treatment done under local anesthetic and he is very experienced and highly recommended.

Therefore I have a bit of a dilemma. I'm not sure if the surgeon is right about the techniques and whether he has the experience in doing a good job. He also didn't seem to show any sympathy about my problem and was kind of rude about it. The good thing he offered is that if he takes out the gland, I could probably get a better result. The doctor seemed to be more professional, he didn't refer to them as boobs or comment on how bad they were and seemed to take the matter more seriously. He was also more sympathetic. He cant guarantee 100% but said he could make them flat and that all there might be left will be a small hard lump which would barely affect how they would look. The advantages of this is that its a lot cheaper and minimum recovery time.

I have the full support of my parents (financial and general) and they think I should go for the noninvasive option with the doctor and if I'm not happy with the results, find another surgeon to do it the conventional way. Can anyone give an opinion or advice? (sorry for the long post!)
Thanks

[DrBermant]

Hey guys, I have been to a GP, an endo and have had 2 consultations for gynecomastia surgery and I'm kind of confused with the type of surgery I should go for. I have puffy nipples. I know this is a broad term but this is the best I can think of. Basically everything outside the areola seems fine, the areola itself protrudes and is a lighter colour than normal. When cold, the whole thing shrinks and flattens but the nipple is really big. I know that the nipple is meant to be erect but it its larger than average. Btw I'm 20 years old and live in the UK.

To start with the endo, he concluded that I was healthy and surgery was a good option if the gyno was bothering me. I  also have had blood tests and the results are coming on Friday. He referred me to a breast surgeon which happened to be the one just down the corridor from him (which I find a little concerning). The surgeon specializes in female breast surgery and has done a few gynecomastia surgeries. What seemed to concern me the most is that when I took off my shirt he immediately said they were really bad that they were one of the worse cases he has seen. He sort of seemed a little shocked and said that they were a lot like female breasts. I was a little insulted about this because I have seen the pictures of gynecomastia on many plastic surgeon's websites and I have not got an extreme case by any means. It's a little larger than a a lot of guys with gyno but its only puffy nipples.

He concluded that there was excess skin, gland and fatty tissue and that he would need to do a donut incision. He also said that it was like treating droopy breasts on women. I didn't know if I this is the right type of incision for me because he is the only one to say that my gyno was really bad, all of the other doctors said it was a bit larger than normal but they have seen much worse cases.

I also saw another doctor which offered a vaser treatment. He was highly reccomended, situated in Harley street and works with the top modelling agencies in London. He said there was a little gland there and he could offer at least 80% reduction in the gynecomastis but not quite a 100% because of the gland. All of the people of the doctors and surgeons I saw said it was mostly fatty tissue and a small amount of gland. However, this guy is not a surgeon. I'm not sure if that matters that much because its not really a surgery, more of a treatment done under local anesthetic and he is very experienced and highly recommended.

Therefore I have a bit of a dilemma. I'm not sure if the surgeon is right about the techniques and whether he has the experience in doing a good job. He also didn't seem to show any sympathy about my problem and was kind of rude about it. The good thing he offered is that if he takes out the gland, I could probably get a better result. The doctor seemed to be more professional, he didn't refer to them as boobs or comment on how bad they were and seemed to take the matter more seriously. He was also more sympathetic. He cant guarantee 100% but said he could make them flat and that all there might be left will be a small hard lump which would barely affect how they would look. The advantages of this is that its a lot cheaper and minimum recovery time.

I have the full support of my parents (financial and general) and they think I should go for the noninvasive option with the doctor and if I'm not happy with the results, find another surgeon to do it the conventional way. Can anyone give an opinion or advice? (sorry for the long post!)
Thanks

Puffy Nipple Gynecomastia is an art form.  You should review cases of this specific problem and how that surgeon sculpts them.  Check out this Puffy Nipple Gynecomastia Gallery to see how my Dynamic Technique manages this deformity.  Look at many before and after pictures to see that doctor's skills.

Puffy Nipple Anatomy consists of gland, fat, and skin. The liposuction will not manage the gland. Here is one of the many cases I have had to Revise Puffy Nipples After Another Surgeon's Liposuction Alone.  Skin reduction is normally not needed for this problem.

Hope this helps,

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

[cymro]

Thanks, I found those links very helpful. Does the surgery decrease the nipple size? Also do you know of any reputable surgeons in the UK?

[DrBermant]

Thanks, I found those links very helpful. Does the surgery decrease the nipple size? Also do you know of any reputable surgeons in the UK?

Actually I see many UK patients with gynecomastia who prefer my techniques. 

Puffy Nipple Gynecomastia can be distressing to live with.  With my Dynamic Technique I target the gland first and this flattens the nipple areola projection.  Areola diameter also typically shrinks nicely as you can see in the collection of before and after surgery nipple areola galleries links below.

Puffy Nipple Areola Picture Gallery Before and After Male Breast Reduction

Nipple Areola Reduction Picture Gallery Before and After Surgery

Male Areola Reduction Picture Gallery

Nipple Areola Reduced with Surgery Gallery

Hope this helps,

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