butchered surgeries

[David3686]

Ive been searching on this forum for butchered/poorly performed surgeries.  It seems as though theses surgeries share something in common.... glandular excision was performed. It seems that this technique leads to crater formation and suture lines may mess with nipple appearance

I am seriously considering surgery, and opting it to be fully lipo. My question is.... is lipo use less likely to cause deformities?

[Paa_Paw]

If you look carefully at your figures, One common element is that the surgeries with less than satisfactory results involved general surgeons and /or dermatologists. The possibility of adverse results diminishes greatly simply by using the services of a properly certified cosmetic surgeon.

Beyond the qualification of the surgeon, a more involved procedure is more likely to yield results that are less than ideal.

A common but very wrong idea is that if the problem is only puffy nipples, any surgeon should be able to take care of that. It is still true that a good cosmetic surgeon is still your only safe choice.

[Dr. Elliot Jacobs]

Most of the gyne experts on this forum utilize lipo and gland excision for the best operative results.  Lipo alone oftentimes leads to some improvements but not the real improvements that most men seek.

In essence, it is not gland excision that may result in poor result -- it is the surgeon who has done the gland excision.

That is why we often suggest that you find an expert in gyne surgery in your area -- do your homework, it will be worth your while.

Dr Jacobs

[headheldhigh01]

what he said.  the vast majority of unhappy cases i've seen were with lipo only since it didn't really remove the underlying fibrous stuff.  i think the gland only bad cases you're thinking of were probably by incompetents who just sliced out anything without a thought to any cosmetic appearance at all.  the worst i saw was one where the incisions were two basically random x's into the areolas.  guaranteed that was probably a general surgeon, not a ps. 

lipo is good for touchup but really should not be the primary approach, and may not even be called for in all cases. 

[AchillesUK]

Most of the gyne experts on this forum utilize lipo and gland excision for the best operative results.  Lipo alone oftentimes leads to some improvements but not the real improvements that most men seek.

In essence, it is not gland excision that may result in poor result -- it is the surgeon who has done the gland excision.

That is why we often suggest that you find an expert in gyne surgery in your area -- do your homework, it will be worth your while.

Dr Jacobs

Dr Jacobs -

Is there a reason why most surgeons choose to cut around the nipple/areola?

I ask this, as probably the most famous gynaecomastia surgeon in the UK uses only a minimal incision in the armpit and seemingly gets everything out, including gland.

Just wondering why so many surgeons choose to make an incision at such a visible location if a technique exists to do it from the armpit.

[headheldhigh01]

he might answer at a later point, but it's probably about how close they need to be to the operating area.  i suspect the side entry is for thing like a lipo cannula where they don't need to be that precise about it.  an incision on the perimeter of the areola on the other hand is slightly more visible but really does hide well - but it lets them get at the stuff directly and probably fine-tune the op much better, especially if they're taking out denser tissue or maybe adjusting the cosmetic effect on the underside. 

[Dr. Elliot Jacobs]

The techniques employed by any surgeon are an amalgam of his training, practice and experience -- and they all differ in some regard. The surgeon will perform his procedure in whatever method he feels comfortable and successful.  What counts, however, is the final result for the patient.

I perform my operation in a stepwise fashion, seeking to minimize scars at every step.  I first use a remote incision on the side of the chest just below the armpit.  I utilize instruments of my own design, which are capable of removing both fat and breast (gland) tissue.  However, they don't always succeed and if there is any residual gland tissue remaining under the areola, then I proceed to make a peri-areolar incision.  This permits direct visual access to the area.  It enables me to carefully remove virtually all of the sub-areolar gland tissue under direct vision and to stop any bleeding as well.  If there is any defect or contour irregularity present, I correct it immediately -- again under direct vision.  And then I suture the incision very carefully with dissolving sutures under the skin -- so there are no sutures to be removed.

This approach works for me -- and the peri-areolar scars tend to heal to be virtually un-noticeable. And my results speak for themselves.

As they say:  "Different strokes for different folks."

Dr Jacobs