Excess skin removed from around the nipple? Is this a common technique?

[gyneco7]

I went to see a local surgeon the other day and he says that I would have quite a bit of excess skin after having the gyne/fat removed and therefore he would want to remove some of the excess.  He's not confident that the skin would simply retract nicely on its own.  I'm going on 37 so maybe he has a point there.  On the one hand I was happy that he seemed to want to take a more aggressive approach than a couple of the other surgeons I've talked to (who basically thought no skin removal was needed), on the other hand I'm a little worried about nipple symmetry, scarring, etc. 

And the technique he says he'll use... while I'm sure it's nothing new, is not one I've read much about, so just curious if anyone else had it done like this and result.  Basically what he wants to do is leave the nipple fully intact (i.e., leave it connected to tissue so I'll retain sensitivity) but cut circular all the way around it, completely remove about 3/4' or 1" of skin all the way around it (envision the piece of removed skin being in the shape of a donut or tire), then get in there and remove all the gyne/fat (which i'd think one good thing about this is he'll definitely have more room to move around in there!), then close the skin up around the nipple.  Obviously they'll be some scarring around the nipple, but that does seem like an easier place to hide it than having marks under or around the sides of the breast, which I'm not crazy about.  I definitely wouldnt want a large scar line under each breast where excess skin had to be removed.  Plus one of my breasts is slightly larger than the other so I'd think he would need to remove perhaps slightly more skin from one side than the other, which that also worries me a little.

Thoughts?  Thanks in advance for any feedback.   

[Paa_Paw]

You want to check out the qualifications of the surgeon, and how often they perform this type of surgery.

You may find that opinions vary somewhat, go with the surgeon having the greater experience with this specific type of procedure.

[DrBermant]

I went to see a local surgeon the other day and he says that I would have quite a bit of excess skin after having the gyne/fat removed and therefore he would want to remove some of the excess.  He's not confident that the skin would simply retract nicely on its own.  I'm going on 37 so maybe he has a point there.  On the one hand I was happy that he seemed to want to take a more aggressive approach than a couple of the other surgeons I've talked to (who basically thought no skin removal was needed), on the other hand I'm a little worried about nipple symmetry, scarring, etc. 

And the technique he says he'll use... while I'm sure it's nothing new, is not one I've read much about, so just curious if anyone else had it done like this and result.  Basically what he wants to do is leave the nipple fully intact (i.e., leave it connected to tissue so I'll retain sensitivity) but cut circular all the way around it, completely remove about 3/4' or 1" of skin all the way around it (envision the piece of removed skin being in the shape of a donut or tire), then get in there and remove all the gyne/fat (which i'd think one good thing about this is he'll definitely have more room to move around in there!), then close the skin up around the nipple.  Obviously they'll be some scarring around the nipple, but that does seem like an easier place to hide it than having marks under or around the sides of the breast, which I'm not crazy about.  I definitely wouldnt want a large scar line under each breast where excess skin had to be removed.  Plus one of my breasts is slightly larger than the other so I'd think he would need to remove perhaps slightly more skin from one side than the other, which that also worries me a little.

Thoughts?  Thanks in advance for any feedback.   

Excess Skin Reduction for the Male Chest is a valuable compromise for those with a major degree of extra skin. The scars can be a significant issue. When a donut mastopexy (circle of skin around the nipple areola) is done badly, you can get this Large Areola Nipple Complication. It is rare for my normal gynecomastia surgery patient to need a skin reduction. Almost all of my patient's skin shrinks just fine without that compromise reduction. You can see many such examples on my website. You can also see the tissue evolution even shortly after surgery when you check the individual sculpture pages.

Start out with this Nipple Areola Reduction Picture Gallery and then look at the other nipple areola galleries.

After major weight loss, the skin does not shrink as well and skin reduction techniques become valuable compromises.

Each doctor has his / her own skills and abilities. Carefully check a doctor's before and after examples of that specific type of surgery before undertaking their surgery! Without such pictures, having surgery by that individual is a greater gamble. 

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia of Male Chest Ptosis - Sagging and Male Mastopexy Chest Lift Sculpture

[Dr. Elliot Jacobs]

If you really want some other opinions, then I would suggest you post a series of good photos of your chest.

Even though you are 37, you will probably have some elasticity in your skin.  I am very familiar with the technique that is described -- and I avoid it if at all possible.  The reason is that the scar completely around the areola tends to stretch out again, widen and sometimes distort the areola.  For the vast majority of my patients, adequate removal of the excess underlying tissues will allow the skin to tighten up so that the patient is satisfied.  May not absolutely perfect -- but perfectly acceptable (and without additional scars).

Dr Jacobs