Not sure if the surgeon was right???

[northern_sailor]

hello i am new to the board and was looking for a second opinion if possible?
basically I had a consultation with a plastic surgeon this morning, he examined my breasts but didnt really feel the size of the gland tissue behind the nipple. I had earlier been informed by a breast specialist and a GP that I would require glandular removal AND lipo however when I brought this up with the plastic surgeon today he was adamant that I will be fine just having the lipo? I am very fit and healthy and the gyno is a result of puberty so I am concious incase the fatty tissue is removed the nipples will still protrude because of the excess gland (its about 2 inches accross and an inch up and down both breasts) any ideas about what to do in this situation? should I just go ahead with the lipo and see the see what the results like or should I complain and insist the gland is removed? I have lived with this condition for years and am so pleased something is finnaly being done about it...but I dont know where I stand with the surgeons opinion.

thanks in advance!

[northern_sailor]

Any input guys? has anyone else had this problem? a doctors opinion would be much appreciated

[Dr. Elliot Jacobs]

I would absolute seek at least one or two more opinions -- preferably from plastic surgeons who have considerable interest and experience in gyne surgery.

In my opinion, it is not possible to pre-determine what is necessary to do during ANY operation.  A surgeon must be prepared to do whatever is necessary, whether lipo alone or lipo plus excision, in order to achieve the best result.

Having lipo alone first and then deciding what to do next is def not the way to go -- you may end up with a second operation, which will be harder to do and may not be as successful -- all due to the scar tissue which inevitably results from the initial operation.

Get more opinions!

Dr Jacobs

[northern_sailor]

thank you so much for your advice Dr Jacobs, I got a second opinion and have just been in for a consultation with an experienced surgeon today (he deals with at least 1 gyno case a week) he had a look and explained he would first do the lipo and see how it looks before carrying out the excision (which we both agreed I would most probably need!) however just one more question for yourself regarding the tecnique he explained to me...he said that he would make the incision all the way around the nipple, remove the gland and an extra 1cm of skin from around the nipple then stitch in all back together to prevent the skin sagging etc....whenever I have read about surgery of seen a video the surgeon has always made an incision halfway round the underside of the nipple to remove the gland? I was wondering it this is a common tecnique and if you ever use this on your own patients?? any more advice/thoughts on what I have heard today is greatly appreciated!

thanks again doc!

[Dr. Elliot Jacobs]

Most often, the access incision to excise gland is half way around the lower edge of the areola.  And most often, the skin will tighten by itself.

What your surgeon is describing is a type of complete peri-areolar skin tightening -- which can be used in certain circumstances. 

Since I haven't examined you, I cannot tell whether you need this or not.  However, in my practice, I do the complete peri-areolar incision extremely rarely.

Dr Jacobs