Gland excision via nipple or armpit

[cruelnature]

Going for some consultations with surgeons at some point soon and would like to get a general feel for what people believe to be the best method based on their own surgeries...

From what I've read, nipple incisions offer a more complete gland removal and less bruising/recovery time.

Looks like armpit entry can cause scarring, contour damage over the surface of the chest but can also get fairly complete gland removal.

Comes down to a choice of scar location for me.  Realistically (photos perhaps) how noticeable are scars in each location?

[DrBermant]

Going for some consultations with surgeons at some point soon and would like to get a general feel for what people believe to be the best method based on their own surgeries...

From what I've read, nipple incisions offer a more complete gland removal and less bruising/recovery time.

Looks like armpit entry can cause scarring, contour damage over the surface of the chest but can also get fairly complete gland removal.

Comes down to a choice of scar location for me.  Realistically (photos perhaps) how noticeable are scars in each location?

Each surgeon used the tools and techniques he / she prefers.

The problem is that gynecomastia comes in so many different forms.  I prefer to let what I find during surgery help guide what needs to be done.  An incision at the edge of the areola opens up for me an artist's palette of tools not available when using the armpit approach.  That is why I prefer my Dynamic Technique.

I have also seen patients from other doctors with channel problems between remote access sites and the areola / nipple.  Scars, adhesions, and depressions can look terrible.  Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexion here to see what I mean.  

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat.  

The areola chest skin interface is a great place to hide a scar.  Check out the many before after pictures of this Areola / Nipple Gallery here, here, and here.  These results are typical for my sculpture of my patients.

How tissues move is important.  The human body is beautiful in animation.  That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views.  Limited view demonstrations can pick the best angle to hide deformities and problems.  Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor.  It is like an artist selecting a paint brush.  The results are what matters, not with what tool they sculpt.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[cruelnature]

Dr Bermant, thanks for replying.  I've read similar responses from you in the past and understand that your preferred approach is an incision at the edge of the areola.

I would like some real people's experiences as well.  Not to try to draw out negative emotions, but has anyone possibly regretted the approach that their surgeons took, either way?

I am in Frankfurt, which is apparently a centre for gender reassignment therapy (you can tell just walking around!) and the endocrinologist I saw last week seemed to be very au fait with gynecomastia surgery procedures, to go as far as to suggest some plastic surgeons who see lots of breast reduction and enlargement, as well as gynecomastia cases.  He mentioned that they use an incision at the edge of the areola generally.  My only concern is how extreme scarring would be - out of 10 cases, how many leave unsightly scars when in the hands of an experienced surgeon?  Does skin type affect scarring?

I have had major surgery and surgery per se doesn't worry me, it's just that since this is purely cosmetic I'd like to know a historical incidence and so the inferred likelihood of unsightly scarring for incisions around the areola....

[nukem2k5]

From what I've read, nipple incisions offer a more complete gland removal and less bruising/recovery time.

Looks like armpit entry can cause scarring, contour damage over the surface of the chest but can also get fairly complete gland removal.

Comes down to a choice of scar location for me.  Realistically (photos perhaps) how noticeable are scars in each location?

I don't know where you got this information but I have to disagree with you.  I had excision through my armpits and my scars are basically invisible, even when I pull back the hair and look for them.

As for chest contouring, that really depends on your surgeon and the operation.  I also had lipo, so he was able to 'sculpt' my chest and it looks fine.  Have a look at my pics.

Later I'll take some of my incisions for you.