Mr S - Mr Levick 29th July 2015

[Mr S]

After extensive years of research and deciding whether or not to go for surgery, I am pleased to say that I finally had the courage to go through the procedure and currently recovering after having surgery with Dr Paul Levick on the 29^th July 2015. I have always been silent on these forums, reading and doing research in the background and I have learned many things from reading the various posts on here from people who are continuously contributing to the forum. I would have never have had the surgery if it weren’t for the people on here, their knowledge, experiences and advice, so I hope this write up provides you with the information and guidance that you need to make the right decision for yourself and progress forwards in life. I will include references to the posts that I have bookmarked and would like to say thanks to all of those that have posted comments as well as a big thanks to a few key contributors like ‘Donut’,’hopetochange’,‘Ricardo7’,’brittguy1068’,’flatasapancake’,’Squidge’,’wbay21’,’mart365’,’Dannysofanny’,’rotors’,’mr_m101’, Dr. Karidis, Dr Elliot Jacobs (for continuous informative posts on the forum) and the main man himself Dr Paul Levick, his wife Gail and his fantastic team and staff at the Priory hospital! (if any of them happen to read this post)

Background

G has always been an issue personally with my life since I was in my teens. Although, even when I was a child, I always remember having a slightly larger chest then my friends. However, when I reached the age of 13 / 14 onwards, that’s when my chest appeared to get worse, nipples and surrounding area became ‘puffy’ in terms of appearance. Nothing that I did would make the chest reduce in size and I even used to resort to getting wooden clothes pegs, attaching them to my nipples in the event that I could ‘train’ my nipples to remain erect all of the time and therefore reduce the ‘puffy’ appearance! (The things that you do are comical as a child!).

Anyway, swimming as child was bearable but the older I got the worse my chest became. At the age of 15 /16 I visited my GP and explained the problem. My GP was quite good back then and actually informed me that this was a common problem and examined the lumps behind the nipples at the time. GP informed me that there were options and the lumps could be removed by surgery although this would likely leave some scarring. GP also informed me that this problem was extremely common amongst teenagers and in majority of cases, the breast area reduces in size and the lumps behind the nipples eventually shrink as you move out of the teenage years. As a result, I thought that the puffiness would eventually disperse but the ‘puffiness’ remained and I went back to the GP at the age of 17. At the age of 17, GP informed me to try and lose weight, get on the pec deck in the gym to help break up the fat and hopefully, that should help with appearance. So I joined the gym when I was 18 and really got into it, over the period of around 4 years (going 4 times a week), I managed to build myself up and had a really good body if I say so myself (4 pack etc). The ‘puffiness’ however remained, but I had managed to build muscle around the chest area, arms, shoulders which eventually ‘masked’ or ‘lessened’ the gynecomastia appearance. However, as all G sufferers are aware, in certain unflattering clothes the visual effect is often exacerbated, such as a normal white t shirt!

I eventually, stopped going to the gym due to a separate shoulder injury which I had surgery to correct. Gained some weight in the meantime, but nothing too bad that the gym cannot fix. However, the actual root cause of the problem, would not get fixed (i.e. gynecomastia gland) no matter how hard I worked at the gym. For a good 10 years, I have been on and off at the gym but not getting back into it properly due to motivation reasons, work life balance etc. From the age of 23 to about 27ish, I did put some fat on the chest but it was mainly gland that increased and made the chest look worse especially when the nipple wasn’t erect. When the nipples were erect, the problem wasn’t so bad, and it was only noticeable at certain angles when viewing my chest.

Reasons for Surgery

As you all know, not doing anything means that the problem would remain. There are countless occasions throughout my life until the present day where I have had to think about something that’s relatively simple. For example, when buying clothes, I needed to think about the fitting and whether or not this will accentuate the problem I had. It’s tough when you are shirt shopping and if you are a 42L and you’re at the shop buying a load of shirts and then you attempt to try a few on to make sure that the material on each shirt doesn’t make the chest appear worse despite being the same size / fitting etc! The staff explain that their policy is to let customers try a particular size and then make purchases and not try each individual shirt on but it doesn’t help people who suffer with G and cannot try every shirt there and then, ultimately the situation is a real pain. I also found that visiting value department stores with thin material t-shirts (Primark) for a one off occasions would make the chest appear worse. The amount of times I have spent in front of the mirror looking at my chest before leaving the house to make sure that the top/ shirt / t-shirt didn’t make the chest look bad before I leave the house has been a burden! Quite often, I would cover up with a light hoodie, jumper or stick with dark colour t shirts to mask the problem, e.g. darker blue’s, blacks, polo tops always suited me due to having large built shoulders and therefore the polo top would often rest on the shoulders and give me breathing space for the chest. I have always been weary of beach holidays with friends and family, taking my top off just before I tweaked my nipple inconspicuously right before diving into the sea or swimming pool to make sure that the nipples were erect! Even worse when being with a woman and regularly tweaking my own nipples inconspicuously to ensure that the chest remained erect and therefore didn’t look bad and resembled a normal man’s chest as opposed to a pre-pubescent teenage girl! My chest isn’t as bad as other peoples that I have seen on here, but it’s still a major issue when it comes to my own self confidence and other people may not notice my chest (especially when the nipples were erect) but I was always still aware of the problem and I could tell that there is an issue and that’s why I was looking to get the procedure done.

Research on the procedure

I’m 30 now and have been doing countless hours of googling on and off for the last 10 years (since 20) on Gynecomastia and how to reduce the chest size and appearance. I have been visiting this forum on and off for the last 4 – 5 years researching and trying to find out the cause and possible cure without surgery preferably! Obviously, it depends on the kind of Gynecomastia that you have, for me which was mainly glandular, I realised with the more research that I did that the problem would only go away with surgery and gland removal.  Approximately 3 years ago (2012) being in the UK, I read all of the posts on Dr. Karidis and booked a consultation with him. Now nothing against all of the Karidis patients out there, I found that he was extremely confident and would have definitely been able to do the job. However, he was at times ‘too confident’ for me and didn’t explain the possible side effects, risks, complications that could result from the surgery in as much detail as I wanted. Dr. Karidis technique involved cutting the nipple and extracting some of the gland, but couldn’t quantify approximately how much gland he would need to cut out during my procedure. That made me slightly apprehensive and although Dr. Karidis assured me that the gland would not grow back as long as I maintained my weight, I wasn’t convinced about this technique for my situation and my worst thoughts were regarding the regrowth of the gland as I aged. I have no doubt that Alex Karidis is a top class surgeon in the UK and would have no issues correcting my and other peoples chest but its down to personal preference. As a result, I didn’t go with Alex Karidis and lived with the problem and tried as best as possible to ‘work around’ my chest in everyday life for another 3 years. Approximately 1 year ago (2014), I went on a beach holiday with some cousins and everyone was in the pool having a great time. I hadn’t been to the gym properly in a while and knew that the chest wouldn’t look great and would involve me constantly tweaking my nipples. Now that isn’t a problem if the swimming pool is deep as I used to tweak my nipples under water so that it’s less conspicuous, however the water in the pool was very shallow (waist height) and I didn’t want to get in and have fun mainly because of being self-conscious about my chest. At that point, I realised that sooner or later I would defiantly need a permanent solution for my problem and once I came back to the UK I began researching on this forum again. In February / March 2015 I was browsing this forum, reading a lot of posts when I came across Paul Levick and began doing further research and reading peoples posts, past comments, how he actually does the procedure, charges etc. What I found was the most advantageous was the technique that Mr Levick uses, i.e. he goes in through the armpit, scrapes all of the gland and fat out meaning that the gland should virtually never grow back again. It’s this technique, Dr Levick’s manner and the way that he approaches the situation which got me considering him. I thoroughly researched everyone else’s posts and progress before making the decision but ultimately what pushed me into proceeding was the fact that Mr Levick would be retiring soon and after reading so many positive comments, I felt compelled to go for a consultation with Dr Levick.

I also read about people who went to Poland to have the procedure done and it was something that I was considering for cost saving purposes. However, I then thought about after care and didn’t really want to travel outside of the UK which gave me even more reason to go with Dr Levick for the procedure.

Consultation

I’m generally no good with hospitals, but after meeting Dr Levick and asking him some extensive questions, I felt that he was the right person for the job due to his technique and felt completely at ease with him. He clearly explained all of the risks, potential issues and mentioned what could be done to mitigate some of those risks as best as possible. I felt as though Dr Levick was upfront, honest, down to earth who had empathy due to being in the situation himself a few years back. After reading all of the material on here and having a consultation, I decided to proceed with Dr Levick. Dr Levick’s team also sent me in depth information, the staff at the Priory hospital itself were extremely friendly and put me at ease.

[Mr S]

The procedure itself - Preparation

I wanted to give myself the best results possible and wanted to ensure that I had fully prepared to maximise the best chances of recovery. Below are the steps that I took before the operation and I would encourage anyone else undergoing the procedure to take the below into consideration;

·         Try and not get worked up about the procedure. Relax and take it easy.

·         Get there in plenty of good time on the day and if you can get someone to drive you there (if commutable distance) that’s even better.

·         Ensure that you have adequate time off from work. I had booked 1.5 weeks to ensure that I can properly rest and recover. For the first few days following the procedure, I felt really rough and coupled with the fact that you cannot shower for 7 days, its best to have a few days off work.

·         Read all of the documentation from your surgeon properly. Dr Levick advises to stay off tomatoes, garlic, chewing gum, alcohol. He also advises to start taking Arnica tablets 1 week prior to surgery, take Arnica on the day of surgery and post-surgery. Make sure that you don’t do anything strenuous 1 week before surgery. You also need to have an empty stomach on the day of surgery and so cannot eat anything.

·         Get used to sleeping on your back, wrap yourself up in your blanket or put pillows to the left and right of you so that you don’t roll over. Whatever it takes, 3 weeks prior surgery start getting used to sleeping on your back otherwise you will have issues sleeping post operation.

·         Shave your armpits with a razor the night before surgery. Dr Levick will be making cuts here, so to prevent the bandage and tape sticking to your hairs, I would recommend shaving the arm pit hair completely the night before the operation.

·         Some posts recommend shaving the chest but that can cause in growing hairs and become extremely itchy when wearing the binder and vests after the procedure. I would recommend trimming the hair in preparation and the best all round trimmer that I came across was this one. There are no attachments required as you can adjust the length of the clipper with the device itself and it’s a fairly decent price (£25 with Amazon at the time of writing).  http://www.amazon.co.uk/gp/product/B000OS72Y0?psc=1&redirect=true&ref_=oh_aui_detailpage_o04_s00

·         I took my laptop with me, a HDMI cable and a small air mouse (like an air remote control) so that I could connect the laptop to the TV that’s in the room and watch films. I loaded up the laptop with loads of films in preparation so that I didn’t get bored. For some reason, the channels on the TV wouldn’t always tune, so it’s a good job that I had my laptop otherwise I would have been really bored.  

·         Take everything in a roller style luggage case. You shouldn’t carry anything in hand post-surgery as that can cause further bleeding, therefore take a case that rolls with a handle.

·         Wear a loose fitting top like a hoodie with a zip on the front or even a large shirt. Once you have had the procedure done, it’s difficult to dress yourself as you have the binder on so you need something baggy that you don’t have to put over your head to wear as its difficult to lift your arms.

·         Wear loose fitting footwear, as it’s hard to tie your laces post op. I had trainers that were tied on loosely and just slipped them on afterwards.

·         Make sure that you buy compression vests in advance. There seems to be different preferences as some people prefer the Macom vests without sleeves http://www.macom-medical.com/products/torsofix-vest/34?c=46 and some people prefer the Macom vests with sleeves http://www.macom-medical.com/products/sleeved-torsofix/56?c=7 I just purchased both vests (2 of each) and returned the two that I didn’t like. Note to get 15% off use the code ‘Mybreast’ at checkout which is great.

·         Compression T-Shirts – 1 week post op, some people wear compression T-shirt and then the Macom vest on top. I purchased this one and would recommend it http://www.amazon.co.uk/gp/product/B00884KXXO?psc=1&redirect=true&ref_=oh_aui_detailpage_o00_s00

·         It’s been mentioned on the forum to drink pineapple juice post-surgery. I don’t know if this helps with swelling or not personally speaking but I went ahead and stocked up before surgery in preparation.

·         What to take with you on the day of surgery;

Laptop – As mentioned make sure that you load up with films.

Shorts – After you have had surgery, put these on so that you are comfortable afterwards.  

T- Shirt or shirt – Something extremely baggy (a few sizes up) and is easy to put on post operation.
Jeans – I came in and left wearing the same pair.

Cotton underwear and socks - To help keep you feeling fresh as you cannot shower after the op. As long as your underwear is cotton, you can continue wearing this during the op itself also.  

Arnica – To take pre and post operation.

Toothbrush and toothpaste – For the day that you leave. You do get soap and towels there.

Deodorant – For the day that you leave although I just sprayed on my clothes rather than the armpit as you are bandaged up.

Phone Charger – For charging up.

Biscuits and chocolate – Reserves just in case you get hungry after the meals. I took snacks just in case.

Dressing gown and slippers (optional) – You are supposed to wear these on your way to the operation. I didn’t have any so the nurse just gave me a couple of hospital gowns to wear (wear one back to front and wear one the correct way around) to ensure that you are fully covered up when walking to the theatre room. If you don’t have any slippers, you can wear your normal shoes and they are removed once you get to the theatre.

Procedure itself

On the day of surgery, I was waiting anxiously and was nervous due to not liking hospitals in general. However, the staff at the Priory hospital are all extremely pleasant, humorous and take your mind off things and go that extra mile to look after you.

·         Once you go in to your room, a porter shows you around the room and different controls for the bed and tv. The bed moves and sits up, raises your legs up etc depending on the position you prefer.

·         Shortly a nurse will come in and ask you questions to ensure that you are in the correct area, are having the right procedure carried out, haven’t had anything to eat, takes emergency contact details just in case and checks to see if you have any allergies.

·         They will also write down your patient number on a wrist strap and get you to sign a few forms.

·         Another lady will be around to take your order for lunch / evening meal afterwards. They do keep you topped up with tea and coffee after the procedure also.

·         You then get changed and wear a few dressing gowns, fancy socks for circulation I think. You can wear your underwear as long as they are cotton.  

·         The anaesthetist (Stephan) also came around and was having a bit of banter with me and came to reassure me that I was in good hands. He asked if I was nervous and I said ‘yes’ but told me not to worry and that they would take good care of me. Stephan was a top guy!

·         The nurse and you then travel to the theatre room where they ask you more questions and get you ready and make sure you are the right person having the right procedure carried out.  

·         Dr Levick will come in and start marking a few jokes to help you laugh and feel at ease. This did help me take my mind off things and helped me to become less nervous. Dr Levick will then mark you up with a felt tip pen, examine you in detail to see where your gland tissue is and exactly where it starts from in the chest. He will then attach a sticker to your chest and take several digital pictures.

·         The nurses and Stephan then come to one side and start administering the knock out juice and tell you exactly when you will feel a pinch and the cold fluid. Another nurse has a bit of a chat with you simultaneously and they are all extremely friendly to put you at ease.

·         Next thing I know Stephan asks me if I can feel anything kicking in and I said I can feel a cold liquid running up my arm but don’t feel tired at all yet. He mentioned to wait for a few minutes and a nurse mentions that she will hold an oxygen mask near your face to help you and before you know it….You wake up in the recovery room!

·         When I woke up, at first I didn’t have a clue where I was and thought I was at home and instinctively tried to get up. The nurse comes in and says you are in the recovery room and to lie still and takes some readings from you. I can’t remember exactly what I was saying, but I remember afterwards that I was rambling a load of nonsense! Anyway after a few minutes, they wheel you on your trolley back to your room where there are several nurses checking on you to make sure that you are ok.

·         It was at this point that I instructed them to connect my laptop up to the TV and hand me my phone from my clothes. I sent my family a text confirming that I was ok and would shortly be having something to eat. I had a salmon meal which was very nice. I can remember waking up and being extremely thirsty and drank a lot of water and tea with my meal.

·         You are also hooked up to several machines. There is a foot machine to stop DVT and that constantly makes ‘cracking’ and ‘whoosh’ noises. Another machine is connected to your chest with the binder on top and that is connected to a cooling machine which continually circulates cold water around your chest to help minimise swelling. That machine is extremely soothing.

·         The nurses will ask if you have been to the toilet to pass water and will check on you every so often. I kept on drinking loads of water and tea so kept having to go to the toilet every couple of hours. You have to press a button on the remote to call the nurses, they come and unhook you from the two machines. The DVT machine keeps you awake at night, so I didn’t have any sleep at all and just watched films all throughout the night until early morning.

Post-Surgery

·         The following morning, the canteen lady will come and take your order (I went for a cheese and ham omelette) which was great.

·         The nurses then arrive and advise when Dr Levick will be coming around. Once Dr Levick comes around he asks you how you are feeling, how the procedure went etc and gives you the theatre pictures and the burger shot! He also gives you advice, what to do, what not to do, post op recovery instructions etc. He gives you an opportunity to ask any questions and in general once more puts you at easy and you cannot help but feel happy that Mr Levick has worked his magic on you. Mr Levick then shakes your hand on continues to his next patient.

·         The nurse will give you tablets (paracetamol, antibiotics etc) and give you instructions for taking them. The nurse will also remove the cannula that’s in your arm that is left there from surgery in case you need more drugs.  

·         You then pack your clothes up, tell the nurse that you are ready and they will have a porter come and collect your luggage case and take it to reception so that you can be on your way back home.

Overall the entire experience was pleasant, the staff at the Priory hospital were amazing and I cannot fault anything apart from a few channels not working on the TV! All in all, under the circumstances, it was as best experience that you can get I reckon and I would recommend anyone thinking about Gynecomastia surgery to consider Dr Paul Levick before he retires. Lastly once again, I would like to thank Dr Levick, Gail, his team and all of the staff at the Priory hospital as well as everyone here on this forum. I hope this post has been useful, it’s as comprehensive as possible and it’s my way of contributing back to the forum that has helped me make my decision.

Recovery

I am currently 4 days post op and doing my best at recovering! I thought that now is the perfect time to write up everything and post on the forum. I have had to split it into separate sections due to the word limit on each post. It’s good to put those personal thoughts down on paper as to why you feel the need to go through the procedure, personal stories etc, hopefully people can relate to my situation. There is a lot of bruising and yellowing although it’s improving as each days goes. I’m just conscious that some people need to have fluid or blood drained and hope that I don’t have complications. At the moment as I tighten the binder from time to time, the chest looks strange, really flat as a pancake. However, reading all of the posts, I’m aware that it’s a long process and my chest may not look normal until some months but I’m confident it will eventually look good. I will keep everyone on here updated with progress if people are interested.

[Charlie33]

Hi there, you must of been in the day before me  great detailed account of the procedure, I couldn't of said it better! Your story was so real it was almost a carbon copy of myself. So glad I dropped on a thread about Dr Levicks retirement.

I popped open my binder tonight to tighten it and got a bit of a shock, just like you say extremely flat! My right side was bigger so there seems to be more bruising on that side. The binder is very uncomfortable but it won't be for ever! How long are you keeping yours on?

Good luck with your recovery mate.

[sometimesuk]

Mr S, that's a good write up. I'm in this week, on the 6th, a day after my birthday so I'll be 32.

I've had the money for years, but have put it off, knowing you get the best results the slimmer you are. Anyway, the reality is i have no self control when it comes to food, and hearing of mr levick retirement was the deciding factor. I'm looking forward to it now, and getting my life back, as personally feel this condition has really held me back with lots of personal aspects of my life. No use crying over spilled milk, onwards and upwards aye.

I've booked two weeks off after, enought time to rest and hopefully get into the routine of cooking properly.

[Charlie33]

Good luck for the 6th @sometimesuk, you'll be fine. The staff are all very nice and make you feel at home. I was a little nervous lying on the bed waiting to go through the doors for the op, the next thing I knew I was back in my room wondering what day it was!
One thing I will say that might help, I got the nurse to remove the tape from under my armpits and replace it with a soft white pad dressing. I found the tape  so painful, it kept me awake!

[Mr S]

sometimesuk - Thanks for the reply my friend, its good to hear that the write up has been useful for you! Best of luck with the op, I'm sure it will go well so dont worry about it!

[Mr S]

Hi there, you must of been in the day before me  great detailed account of the procedure, I couldn't of said it better! Your story was so real it was almost a carbon copy of myself. So glad I dropped on a thread about Dr Levicks retirement.

I popped open my binder tonight to tighten it and got a bit of a shock, just like you say extremely flat! My right side was bigger so there seems to be more bruising on that side. The binder is very uncomfortable but it won't be for ever! How long are you keeping yours on?

Good luck with your recovery mate.

Thanks my friend, yeah looking at your post, I believe I was a day before you. I'm going to keep the binder on for the full 1 week and then wear the compression vest with the binder on top continous for another 4 days. After that I return to work, so will just wear the vest in the day time and then I'll wear the vest with the binder on top in the evenings for a month or so. See how it goes and see what Dr Levick thinks at the time. Keep in touch mate and let me know how you are getting on.

[Mr S]

Here are the burger shots!
Left fat - 100cm
Left gland - 128 gm
Right fat - 100cm
Right gland - 120

[Charlie33]

I'll have to get some pics up, bet your relieved mate. I had a bit more looking at your figures! Can't wait to get this binder off now, starting to really bug me now under the arms! How are you feeling?

[Mr S]

Yeah I'm very glad and relieved to have had it carried out by the best. I was always going to get it done but it was just a question of when and to anyone thinking the same, I would recommend booking time off work and just going for it.
Get your pictures and figures uploaded mate, makes a difference to the people thinking about having it done and good for comparisons. Once I showed my family the pictures and they realised the size of those burgers, they understood why I had it done! Even I didn’t think I had that much gland, after reading other peoples posts and seeing their burger shots, I thought I would be around 60 to 70 gm in terms of gland, but it turned out to be double of that.
The binders not really bugging me that much, waking up with a bit of stomach ache as I tighten the binder up a bit at night and first thing in the mornings but nothing bad. This morning I did feel a burning sensation on the nipple after I touched it very slightly, felt like my nipple was on fire but I think that’s because of the sensation starting to return I think.
Will be looking forward to a couple more days and finally showering though, still have some sticky tape residue on my shoulders so will need to scrub quite a bit. Feeling better each day and movement on arms is a lot better now and continually improving. 
How are you feeling mate? Is your chest still looking pretty flat? I would recommend tighting the binder up as it can come lose from time to time.

[Charlie33]

Hi, managed to have a good wash this morning ( out of the sink mind ha ) my left side which was the smaller looks spot on! The right side has quite a bit of  fluid that I can see in a swelling below the nipple. I think this can happen and this was the larger side. I've also given the binder a right good tighten up ! A lot more movement today and managing to change t shirts on my own.
Right side :
Fat 150
Gland 193

Left side
Fat 150
Gland 132

[Mr S]

Yours were a lot bigger than mine, I bet you are really pleased to have all of that out?!
Do you have your burger shot pictures?

[jay-dub]

Hi Mr S
I also had my surgery on 29th July. Like me I am sure you are glad that now it is done and the recovery can begin!
Tomorrow it will be 7 days post op and I can't wait to take off the binder. Isn't too bad during the day but it is certainly uncomfortable at night. I know the healing process takes time and that is well documented but there is no pain and I think patience is all that is needed. I think one of the most testing things is the inactivity.
Have you tried on the Macom vest yet? Is it more comfy than the binder?

[jay-dub]

Also very excited to have a shower tomorrow morning!

[ggnail]

This is without a doubt the most comprehensive post here. And many thanks for making me relaxed as I'm having mine with Dr Levick tomorrow 5th Aug. I've been so nervous all day at work lol but I can't wait to start a new chapter in my life...