Revision surgery: will excision only suffice?

[hertog88]

I was just wondering what he best option would be for a person like myself. I have puffy nipples and I have had 3 surgeries in total. Excision only + lipo only + lipo only (was promised lipo/excision, long story)... my nipples have improved lets say 50% or so, I was wondering for my final surgery do you think I should get lipo + excision (the lipo to tighten the skin) or would excision alone suffice? I am not asking for medical advise or anything, just people's opinions, that's all.

Thanks

[JamesDawson]

Pictures are a great help so upload some if you can. How long has it been since your last surgery? 3 surgeries a lot, revision might not make anything better but it depends how much gland was removed the first time.

[hollisterco]

I've had 2 surgeries and it was excision both times. I'm actually 3.5 months post-op and one of my nipple is still puffy, but probably because of the scar tissue.. i'll maybe need an other revision, who knows.. But in my case, excision was what i was looking for, because in the end, you always have the possibility to minimize the fat by training hard, but there's no way you can improve your gland situation.. it has to be remove..

good luck!

[Dr. Elliot Jacobs]

I was just wondering what he best option would be for a person like myself. I have puffy nipples and I have had 3 surgeries in total. Excision only + lipo only + lipo only (was promised lipo/excision, long story)... my nipples have improved lets say 50% or so, I was wondering for my final surgery do you think I should get lipo + excision (the lipo to tighten the skin) or would excision alone suffice?

If you have already had three operations, there is undoubtedly significant scar tissue present as well as some residual tissue.  Would very strongly suggest that you consult a gyne surgeon who has significant experience in revision surgery -- you want any new surgery to be your last surgery.  It is also important for you to understand that sometimes only some improvement can be obtained through revision surgery -- looking for perfection after three prior operations is probably not possible.  And sometimes nothing more can be done. A surgeon should inform you of the prospects for improvement. That is called realistic expectations.

Dr Jacobs

[DrBermant]

I was just wondering what he best option would be for a person like myself. I have puffy nipples and I have had 3 surgeries in total. Excision only + lipo only + lipo only (was promised lipo/excision, long story)... my nipples have improved lets say 50% or so, I was wondering for my final surgery do you think I should get lipo + excision (the lipo to tighten the skin) or would excision alone suffice? I am not asking for medical advise or anything, just people's opinions, that's all.

Thanks

There are many possible variations for the Puffy Nipple Complication After Gynecomastia Surgery. Options depend on the particular variation. Excision alone rarely is the answer. You can see sever different variations of how I have address this problem on my site. This is a particularly challenging surgical sculpture. Picking the surgeon for such refinement should be done only after reviewing many examples of that doctors revision work.

Hope this helps,

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

[hertog88]

Thanks for the help guys. I will try to take some pictures and post them.

First of to the doctors, I have realistic expectations and am not expecting perfection. I understand 3 surgeries is alot, but it SHOULD have stopped at 2 if the doctor did lipo + excision the second time around or atleast during the 3rd surgery, I am very sure that the reason my nipples are still puffy is because the first doctor removed too little gland. Now I am getting it done and the doctor said he will do excision only, I am not seeking medical advise, all I need is your opinion if I should tell my doctor to add in a BIT of lipo, not really to take out fat but more of for the fat to be "re-countered" so to speak. I have read that with many successful surgeries of puffy nipples this is done.

I understand that I would have to find a doctor who is an "revision expert" like yourself Doctor Bermant and pretty much all of the doctors who contribute to this board, but unfortunately I live in a country where we don't have "revision experts" and can only find a few doctors who do gynecomastia surgeries, on top of that, it's alot less expensive here, so I have to go with what I got over here.

All I need is an opinion really, thanks for telling me I'd need to go to a revision expert, but I can't unfortunately right now. =)


my current financial situation including financial and the country I live in will only give ma a few choices of doctors who have done gynecomastia surgeries.

[DrBermant]

Thanks for the help guys. I will try to take some pictures and post them.

First of to the doctors, I have realistic expectations and am not expecting perfection. I understand 3 surgeries is alot, but it SHOULD have stopped at 2 if the doctor did lipo + excision the second time around or atleast during the 3rd surgery, I am very sure that the reason my nipples are still puffy is because the first doctor removed too little gland. Now I am getting it done and the doctor said he will do excision only, I am not seeking medical advise, all I need is your opinion if I should tell my doctor to add in a BIT of lipo, not really to take out fat but more of for the fat to be "re-countered" so to speak. I have read that with many successful surgeries of puffy nipples this is done.

I understand that I would have to find a doctor who is an "revision expert" like yourself Doctor Bermant and pretty much all of the doctors who contribute to this board, but unfortunately I live in a country where we don't have "revision experts" and can only find a few doctors who do gynecomastia surgeries, on top of that, it's alot less expensive here, so I have to go with what I got over here.

All I need is an opinion really, thanks for telling me I'd need to go to a revision expert, but I can't unfortunately right now. =)


my current financial situation including financial and the country I live in will only give ma a few choices of doctors who have done gynecomastia surgeries.

Choice of the first surgeon as well as one for revision are really critical issues especially for someone trying to avoid the need for a revision in the first place. However, compromises are part of life. Not everyone can sculpt like a Michelangelo or paint like a Da Vinci. That is why checking the product of that doctor's techniques is so important.

However, when considering total costs, you need to take into account the additional expenses of the revision operations and time off from activities. That may be one factor in the many patients who travel a great distance preferring my techniques / experience.

Good luck on your exploration and revision.

Hope this helps,

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

[hertog88]

Okay, thanks Dr. Bermant. But can you really not answer my question? All I want is to be able to know if it would be recommend to insists that my Plastic Surgeon add in a little lipo to "contour" or move the fat under.

Thanks

[DrBermant]

Okay, thanks Dr. Bermant. But can you really not answer my question? All I want is to be able to know if it would be recommend to insists that my Plastic Surgeon add in a little lipo to "contour" or move the fat under.

Thanks

If you need to insist a surgical technique, you are in the wrong doctor's office. A doctor who needs to be instructed how to perform the surgery is not an acceptable compromise or risk in my opinion. A doctor should be selected by examples of their work.

Hope this helps,

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