Many questions regarding surgery.

[Teenaged]

Hey, I want to have surgery done for gynecomastia but I have several questions.  I have tricare prime remote insurance.  Is their anyway to know if they would help pay for the surgery?  Also, how long does recovery take?  I'm a college student so would I be able to go back to classes after a couple of days after surgery?  Also, how long do you have to wear a compression vest for and is it noticeable when wearing only a t-shirt?

I am very fit.  Not fat at all.  I am curious if the cost of surgery is any cheaper if only excision is needed and not lipsuction.  Do they gauge the cost of the surgery by the severity and complexity of the person's case of gynecomastia? 

Also, what is a good thing to tell people that I am having surgery for if they ask?  I don't really want everyone to know I'm having breast reduction surgery obviously. 

And then overall how long does it take until you can walk around without a shirt on and not have any signs of surgery such as swelling, bruising, discoloration, etc.

One last question - how important is it to find a good surgeon?  Are most plastic surgeons who list gynecomastia as one of their services capable of performing the surgery successfully?  I don't feel that my case of gynecomastia could be very difficult for a surgeon since I am in shape, not fat, and I believe my case is simply 2 small "lumps" under each nipple. 

Thanks for any help!

[JamesDawson]

Your surgeon will be able to find out if gyno surgery is covered by your insruance.

Recovery is different for everyone. The first 4 weeks are very tough but you just have to take things easy, after 2 months you won't even notice.

Yeah you could back after a few days depending how you feel, just don't go out partying or do anything strenuous in college.

You could say you broke a rib and the compression garment is a bandage/brace. You could say you fell. Theirs a few options, just be creative.

It is very very important to find a good surgeon, I've seen some posters on this forum very unhappy with surgery done by general doctors who don't specialize in gynecomastia. Just research into a couple of surgeons and you will be able to pick one out.

[Raider Fan]

Is there a reason you can't just wait until summer to have the surgery, when school will be out and there will be no rush to hurry back? 

We had a discussion recently about whether mild gyne is easier (and cheaper) to work on than more involved cases.  The doctors here essentially stated that there is no quick and simple gyne surgery, no matter how mild the case.  A mild case can be just as challenging as a more severe case in terms of contouring the chest properly and making it look good. 

As far as the surgeon, that is extremely important.  These boards are full of people who have had surgery and were not happy at all with the results.  The first gyne surgery should be the ONLY gyne surgery, and the best chance to have a good result is with the first surgery.  This surgery is definitely not one you want to pinch pennies over. You want the best, most experienced board certified plastic surgeon you can find, preferably one who specializes in gyne surgery.  Do not use a general surgeon.  If they aren't considered to be a gyne specialist, at least go to a plastic surgeon who performs the surgery regularly each month, and many times per year.  Ask to see before and after pictures of former patients, because what you see in those pictures will likely be the results you can expect. 

[dbg]

As far as telling anyone, you don't have to tell them anything.  Or, you can say you had back surgery and you can't lift things.  I told my boss (because he had to know my physicial limitations at work) that I was getting some skin taken in due to amount of weight I've lost over the last few years (around 60-70 lbs), but that was unique to me.   Anyone else who asked why I took a week off, I said it was because my mom was in town (which is true, she flew out to help me with my surgery)

I'm guessing you're a bit younger than me, so your situation is different, but it just goes to show that you can be creative with it.  Besides, people will ask once where you were and then forget you were ever gone.  Trust me when I say they're more concerned with themselves than they are you.

I've been hiding the compression strap (almost two week post op).  I've been wearing a black t-shirt with button-downed shirt over it.  I also bought some different shirts sot that people who noticed before couldn't make the comparison to what I looked like in my old wardrobe.  Also, I've been wearing shirts with large printed logos (like band shirts) so any protuding lines would get covered up.

And as far as researching the best surgeon, this is a MUST.  This kind of surgery is both an art and a science, and you'll want someone who has a lot of experience in it.  Make sure you get to see before and after pictures, both on the website and in their office.  The consultations themselves can be intimidating, but this is your body you're talking about and you have a right to demand results.

[Teenaged]

Thanks for the replies so far. Another question I have is how noticeable are the scars?

[DrBermant]

Thanks for the replies so far. Another question I have is how noticeable are the scars?

Scars after surgery depend on the original problem, what was done, skill of the surgeon, and many other factors.

You should be able to evaluate a surgeon's work by looking at before and after surgery pictures. The details of scars should be visible in such an examination. However, what is not often discussed is that you are not only talking about surface incision scars, but also the scars of the entire area operated. "Tiny" incision scars do not hide extended adhesion holding the surface skin to the deeper muscles looking disfigured on flexing the muscles. To really understand a surgeon's sculpting ability to avoid scars you should also look at pictures of arms up overhead, muscles relaxed and flexed. Movies are even more critical in showing such issues. I have posted many such examples both still flexing photos and videos.

I used to caution my patients that I could see the scars on every one of my prior patients. Over the past several years, many have come back and I cannot find the scars visually. I can feel them, I can see them up close, but not see them either on talking distance examination or on animation views. That is one of the factors that influenced changing the second stage compression garment from option to mandatory. This is the art of this sculpture. Contouring the body and leaving minimal trace we have been there. That is why carefully checking multiple views for many patients and seeing how tissues move is so critical in surgeon choice.

Hope this helps,

Michael Bermant, M.D.
Board Certified
American Board of Plastic Surgery
Member: American Society of Plastic Surgeons and American Society of Aesthetic Plastic Surgeons
Specializing in Gynecomastia and Surgical Sculpture of the Male Chest
(804) 748-7737

[Dr. Elliot Jacobs]

The purpose of modern gyne surgery is to produce a trim, contoured chest with the most minimum of scars.  The surgeon has to be able to get under the skin in order to do his work -- so an incision in the skin is absolutely necessary.  And any incision will leave a permanent scar -- that is inescapable.

However, the placement of the scars can help to hide them.  The skill of the surgeon in suturing the incision can also help.  And of course, the patient should follow the doctor's instructions for post op scar care.

On the other hand, there are other factors which influence the outcome of a scar -- such as one's individual healing capability, genetic background, etc.  All that being said, scars do tend to fade away and become hardly noticeable.  In most people, that will take six months and sometimes up to a year.

After operating on thousands of gyne patients, I cannot remember one patient who objected to the scars after they had settled down and healed -- every patient would willingly make the trade of a scar for a trimmer shape.

Dr Jacobs