Video of Surgeon removing ALL of the Gland...

[Sgt. Harry Balls]

This is interesting

http://www.youtube.com/watch?v=wS8E1hM12S8

People here say to leave some under the nipple so it does not depress but what if you have good pec muscles like a bodybuilder wouldn't the depression overtime be non existent or unnoticeable in people who lift weights and have a larger then normal pectoral muscle?

[Rocky76]

Jeez.. I don't know but I don't like that strategy to much. There also seemed to be a lot of red tissue removed as opposed to the usual white Gynecomastia tissue in this video.

The tissue behind the nipple is also rather important to keep the nipples from going inverted or other anomalies. I'm not by any means a Dr. but from what I have gathered it's certainly not as easy as just cutting it all out. There has to be a certain balance between adipose layer and actual muscles. If the skin adheres directly to the muscle etc it's not going to look right. Having big pectoral muscles doesn't not change the natural balance of layers from skin to muscle.

[Sgt. Harry Balls]

With well developed Pec muscles I think it would look very nice because there wouldn't be a chance of abnormal depression of the nipple because it will default back on the pec muscle correct? I actually would not mind this at all.

By adhere you don't mean the nipple fuses to the muscle in some way, it still floats above the muscle allowing full range of motion correct?

Would be interested to hear what a Dr has to say about removing the small gland from behind the nipple in someone who has large pec muscles.

[jojo82]

I'm not going to second guess the surgeon because he's the one with the MD and sitting there with the patient, but the right breast looked substantially concave directly under the nipple.

[Sgt. Harry Balls]

Jojo I have heard people having that 'look' initially with even surgery that leaves small amounts of the gland behind the nipple it is only when a few month passes that it forms nicely.

[jimboyeeehaw]

Its wierd, I cant bring myself to watch the video, groses me out thinking thats what was done to me
Evan the great vid on Dr Jacobs site I had to stop when he got to the surgery part.


Anyways if im not mistaken I believe my surgeon said she leaves a tiny bit of glad behind the nipple as its normal and everyone has it, or something to that effect.

I only had the surgery 2 weeks ago, and forgetting about my left side.. my right side like absolutely perfect.
I can feel theres a little bit of something behind the nipple and it looks completly flat, not puffy at all.  

Seems like there are so many techniques for doing this sort of thing. Evan the consultations are differant (espeacily in each country). From the sounds of it in USA alot of people get blood tests and all sorts of other tests before they have surgery, but here in Aus (from what i've read) noone realy goes through any pre-test stuff. However that might also have something to do with how experienced the surgeon is, or maybe even insurance or private health cover reasons etc etc.  

[Dr. Elliot Jacobs]

In my practice, the size of the pectoral muscle plays no part in the decision making process for the operation.  What is important is to leave a uniform layer of fat between the skin and muscle so that the skin can glide smoothly with no attachments or puckering.

When I remove gland from beneath the areola, sufficient amount of tissue must be removed so that it lies flat -- but not concave.  It is not necessary to remove all gland from under the nipple -- just enough to do the job.  Men who do not have gyne still have a bit of breast tissue beneath the areola -- that is the normal condition.  There is no need to remove everything in order to do the job "right".

The experience of the surgeon is deciding how much to remove and how much to leave intact is critical.  That is why it is a good idea to research carefully and only go to a plastic surgeon who is experienced in gyne surgery.

Dr Jacobs

[DrBermant]

Re: Video of Surgeon removing ALL of the Gland...

This is interesting

People here say to leave some under the nipple so it does not depress but what if you have good pec muscles like a bodybuilder wouldn't the depression overtime be non existent or unnoticeable in people who lift weights and have a larger then normal pectoral muscle?

Sorry, depression, craters and adhesion do not look good on a bodybuilder. The distortion really can hurt the look of a cut chest.

Actually no surgical technique can remove "all of the gland."  In the Anatomy of Gynecomastia, there are fingers of gland that run through fingers of fat. Even disfiguring radical mastectomy for men can have elements of residual gland. On that particular video, there is a major amount of gland left under the areola, it is the white component.

Although targeting the gland first is a hallmark of my Dynamic Technique, it should never come at the price of a Crater Defect Complication. This is not cancer surgery, the gland does not have to be removed.

In evaluating a video about a surgical method, you should look for before and after surgery results. You can sometimes look up a doctor's results by searching the internet and reviewing before and after pictures. Any technique to be viable should at least do well in a limited set of still pictures.

Going beyond the basics, evolving an operation that looks good both at rest for a photograph and something that looks good flexing, playing sports, activities, and in a warm room when the areola muscles can relax and reveal the underlying contour. If there is a crater at the end of the surgery just lying on the back, that is not something that is better than leaving gland behind. Firm gland under the areola at least looks good sometimes. The problem with leaving the firm tissue behind is that it does not compress like fat, does not move like fat, and when the areola muscles relax, it can show through as in this detailed explanation of the Puffy Nipple Complication of Gynecomastia Surgery.

To demonstrate a more complete targeting the gland first and then using the remaining tissues to contour the chest check out this new page I posted Gynecomastia Surgery Video. You can see the difference under the areola, the white gland has been removed. I demonstrate the contour with this technique with videos of this patient's tissue moving after surgery. Results of variations of this technique can be seen all over my website.

Hope this helps,

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

[Sgt. Harry Balls]

Whoa that's great info I am no longer concerned about some gland remaining thanks again Dr!