Re: Why not Armpit Incisions??

[DrBermant]

I've seen two guys on this board who had armpit incisions and the plastic surgeons who did it removed all the gland with some kind of tool or 'clamp' I'm not sure.  Both of these guys look GREAT.  I don't understand why more doctors don't use the armpit incision method?  Is it just harder?  More risky?  I don't get it, it seem's like the perfect place for a scar as opposed to Dr. Hamas's crappy method.

Each surgeon used the tools and techniques he / she prefers.

The problem is that gynecomastia comes in so many different forms.  I prefer to let what I find during surgery help guide what needs to be done.  An incision at the edge of the areola opens up for me an artist's palette of tools not available when using the armpit approach.  That is why I prefer my Dynamic Technique.

I have also seen patients with channel problems between remote access sites and the areola / nipple.  Scars, adhesions, and depressions can look terrible.  Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexion here to see what I mean.  

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat.  

The areola chest skin interface is a great place to hide a scar.  Check out the many before after pictures of this Areola / Nipple Gallery here, here, and here.  These results are typical for my sculpture of my patients.

How tissues move is important.  The human body is beautiful in animation.  That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views.  Limited view demonstrations can pick the best angle to hide deformities and problems.  Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor.  It is like an artist selecting a paint brush.  The results are what matters, not with what tool they sculpt.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[nukem2k5]

Obviously the skill level of the PS greatly determines their ability to perform this type of procedure.  I definitely feel that Dr. Metzner is a very experienced and esteemed surgeon and this is why he's able to to it without cutting into the areola.

It's evident that many surgeons choose to make the incision in the areola because it's easier to see what they're doing.  I'm very glad that Dr. Metzner does the armpit incisions because I did not want scars on my nipples.  He was able to feel around under my skin and skillfully sculpt my chest using his method.  

If anybody is looking into having their gyne removal with Dr. Metzner feel free to PM / Email me.