On TRT, OP booked but doctor says he will leave some gland

[leehaney]

Hi
I'm on a TRT and will be for the rest of my life. wich would mean that i always have testosterone that can convert to estrogen. I checked my levels and my estrogen can be quite high after incjection. 
Doctors in Sweden are quite strict when it comes to medicines so i've added some Armidex (0,5mg ED) to keep estrogen in place.
how ever i will be on a surgery to remove my gynecomastia in the middle of august.
The doctor says he doesent dare to remove the whole glands because he's afraid of craters.
as you can see on pictures i have quite good muscle mass, wouldn't that prevernt the crater issue?
i'm just afraid that it will grow again since i'm on TRT. Ive had my gynno since a teenager when i was a bit owerweight and it started to grow a bit with the TRT.
risk is that it will grow again and i have to pay for annother surgery. on the other hand o have the option to request him to remove as much as possible wich may result in craters= another surgery.
so there are many qustions that i shoudl appriciate to get some advice on.
one final thing, should i stop taking Armidex so that the gynno is as big as possible pre-surgery?
https://www.dropbox.com/s/59teft6emoewvkm/IMG_0671-Copy.jpg?dl=0
https://www.dropbox.com/s/aupitla0ek7zb7e/Foto%202015-07-17%2021%2023%2056.jpg?dl=0
https://www.dropbox.com/s/kw24ma4nuzdahce/Foto%202015-07-17%2021%2023%2032.jpg?dl=0

[Dr. Elliot Jacobs]

Arimadex is a good drug to prevent estrogen buildup if you on on long term TRT.  Whether you should stop taking it prior to gyne surgery is a question you should direct to your endocrinologist.

As for the proposed surgery, I politely disagree with your surgeon.  When faced with similar situation to yours, I routinely excise all the sub-areolar breast tissue and oftentimes am faced with a temporary crater deformity that I produced.  I then perform fat flaps immediately to fill in the crater.  I do this on many cases successfully.  The result is a sculpted chest with only fat under the nipples -- not breast tissue.

Good luck!

Dr Jacobs