Had consultation today but have some more questions.

[Kill3rK]

Ok, I tried posting in my last post ut for some reason I couldn't. I had my consultation today, and I love my doctor. Him and his staff are incredibly nice, and they are very comforting. He took me in his office and we shot the shi* for awhile with one of the nurses talking about twitter and facebook. Then we got down to business. I have an extensive family history of medical problems, heart surgeries, diabetes, MS, ECT. And he seemed very concerned about it. Then we got to the real issue: my gynecomastia.

He said that most of my breasts are gland, and that it would definitely have to be removed. He also said that because my gland was so big, he is going to have to take it via an incision near my armpit. I told him my concerns about scarring, and that because I am so young, I don't want scars to be to visible. He said that because of my skin tone it shouldn't be that visible. I asked him how much tissue I have and if he thinks it would be more then 350gm and he said it would probably be about 150cc which is about 350-375gm. But I can't recall if he said in total or from each breast. He Also said I will have the drains for a few days.


I told him prior to my consult with him, I have been in constant contact with my insurance company, and
they told me that I need a minimum of 350gm removed from each breast. He said that 350gm is a lot of tissue and that most likely I will not have that much tissue. But he said he would have his nurses send the insurance company the information, along with the pictures he took, and hope for the best. I did not schedule the surgery because I can't get it unless insurance covers it.

I'm hoping the insurance company will cover it, I'm a college student with no credit.
Basically my question is, is removing the gland from the side near the armpit normal? Will there be a lot of scarring this way?

[Litlriki]

I think most of us remove the glandular tissue through an incision along the edge of the areola.  I do make a small (1/4") incision in a fold near the armpit, and I do liposuction through that incision. I'm not sure what he means by taking the glandular tissue via that route--it's a long ways away from the tissue, and I feel that I have greater control when I'm right next to it, rather than approaching it from afar.

As for insurance coverage...Good luck. You must not live in Massachusetts!

Rick Silverman

[George Pope, M.D.]

I would imagine most plastic surgeons remove the breast tissue through an areolar incision as Dr. Silverman does; I certainly do.  I agree that it would be very difficult to directly excise tissue through the armpit area.  Is your surgery talking about liposuction from that approach?

Since you have nothing booked yet, you have time to get a few more opinions from plastic surgeons in your area.  Good luck getting the procedure covered by insurance; most companies do not cover that.

[Kill3rK]

Thank you both for replying. he said that the top of my breast is all muscle, but the bottom of it is all gland, and tissue. I could never really feel the gland until he pointed it out. As I said before, I have been in contact with my insurance provider (BCBS) and they stated I would need a bear minimum of 350gm removed from each breast, but that seems like quite a bit. The doctor said I was right around that amount but I think he meant in total. He said my case was severe, so I don't know. I'm about a B cup. I do not live in Massachusetts, but I did the first 11 years of my life and I am probably relocating back in the next few months and I was hoping to have the surgery here in Florida before I move back. He also said that since my case was so bad and the gland was so big he probably wouldn't be able to fit it through an incision in the areola. Is that normal? Wouldn't he just cut the gland in half and take it out in pieces? I'M definitely considering a second opinion now that you both said that is not normal.

[George Pope, M.D.]

You can take out a huge amount of gland tissue through an areolar incision. Does your surgeon do a lot of this type of surgery?  Doesn't sound like it. You definitely need another opinion. The goal here is to get your chest to look great so you are happy to be seen without a shirt on. How can one accomplish that leaving visible scars on the chest or armpit?
I would be happy to see you here in Orlando, but I don't take insurance. Have you checked out any other plastic surgeons in the Naples/Ft. Myers area?

Dr. Pope, MD