Droopy Nipples - Donut Mastopexy - advice needed

[canadian55]

Hello Dr.s , 
Age 27, Height 6' Weight 170 lbs 

After living with gyno since 12 or 13 I am finally in a position to go ahead with surgery. Recently a PS assessed my gyno and determined it to be mostly fat and some gland. They then recommended that in my case I also address the "droopy gyno" or lower sitting nipples on my chest. Personally, I never really picked up on this aspect until it was mentioned. 
Based on the photos - would you recommend a tightning/lifting procedure such as a donut mastopexy? 
I have to decide very soon a prompt reply would be incredibly helpful. 

[George Pope, M.D.]

I answered your question in the User Photos section.
Dr. Pope, MD

[Dr. Elliot Jacobs]

Would strongly avoid any type of nipple re-positioning, donut mastopexy, etc.  If you have properly performed, simple gynecomastia surgery, your nipples should be fine.  Most guys have nipples similar to yours -- don't make something more complicated than it needs to be.  Would strongly suggest a second opinion before you have your surgery.

Dr Jacobs

[DrPensler]

First from your photos with your body type it is highly unlikely that the majority of your tissue is fat. Second your moderate gynecomastia should respond well to standard treatment without any mastopexy and the scars associated with it..

[canadian55]

Dr. Pope, Jacobs and Pensler, 
Thank you all very much for your replies, it was incredibly helpful. 

[canadian55]

Hello Doctors and Users, 
I thought I would post an update. These results are 2.5 months out. The operation involved lipo and gland excision using peri-aero incision. 
At first I was quite pleased with the contour, but that seems to have changed over the past month particularly, perhaps due to scar tissue. I can feel a very hard nodule about the size of a grape under each nipple. I also feel like much of the "bulk" in the chest remains. This operation was performed by a highly experienced gyno surgeon. 
For now, being patient. 

[Dr. Elliot Jacobs]

You are right in the middle of the prime scar tissue building stage.  Relax.  Realize that the body naturally heals with scar tissue.

Would also not obsess about what you can feel -- after all, you are doing this procedure for it to look good.  Would you walk down the beach and ask folks to feel your nipples for any scar tissue?  On the other hand, if the scar tissue is making the nipples bulge, then possible treatment with cortisone down the line might be helpful.

Best to get back in touch with your surgeon about these concerns.

Dr Jacobs

[canadian55]

Thanks so much for the feedback Dr. Jacobs.
Do you think massage would help in the meantime? Is it true that massage only "speeds up" the softening of scar tissue, but in reality doesn't impact the final result? 

[Dr. Elliot Jacobs]

During the healing process, there is both swelling (ie fluid) and scar tissue present. Massage will definitely help to mobilize and reduce the fluid and may help to soften scar tissue.  It certainly can't hurt and may indeed help a bit.  No harm in trying.

Dr Jacobs

[canadian55]

Thanks very much Dr. Jacobs