My NHS experience so far...

[radio-boy]

I had recieved a referral from my GP to see a breast surgeon  at the walsall manor hospital about removing my gyne. The surgeon sent me for an ultrasound scan, which revealed normal breast tissue. He then checked my testicles, and also pressed hard on my liver while i breathe in and out.

The surgeon then took two needles and took samples of cells from the breast tissue, which actually quite hurt, and still aches a bit now! I have to go back next week for the results of the test, and then he will talk to me about surgery, if i still want it. all in all a more satisfying experience than last time i went to the hospital to see a general surgeon who just said "yes, we can cut it out".

One thing he did mention... he said he woulc only remove the breast disk itself, and not the natural fat. Is this normal? Thanks chaps.

[phantom]

What I would ask myself is this, "Do I want surgery to improve what I consider to be 'women-like' breasts to a 'normal' male contour."

You most certainly need to ask your surgeon this, "What are the medical grounds for removing glandular tissue only and not liposuction for fat?"  Are there a clear medical benefits for having any glandular tissue removed alone?  Will glandular tissue removal alone give you the aesthetic results you want?

Radio-boy, how would you describe the appearance of your chest at present?  Do you have any pics to show us?  If glandular tissue removal is all that is requited to make your chest look 'normal' then fine.  However, if your chest requires further work to 'sculpt' it into 'normality' then frankly you are wasting your time using this surgeon and he or she is wasting theirs.

I cannot possibly comment on your personal circumstances but time and time again we read how dissapointed other guys are when either fat or just glandular tissue are removed alone.

You really need to establish what kind of outcome you can expect from surgery with this surgeon.  If fat removal would improve your outcome, then I'd seriously reconsider your options.

My case of gynaecomastia was layers of fat in between strands/lays of glandular tissue.  It would have been near impossible to separate the two and pretty pointless in just removing the glandular tissue because the fat was contributing to the 'over hang' of the breast in any case.

Let us know how you progress.

Hope that helps.

[radio-boy]

Thanks for the reply Phantom , helpful as always.

Ok, its part two, went to get the results of my cell tests, and speak with the surgeon. He was more convincing than the chap i saw last week, and certainly sounded like he knew what he was talking about, and has done the operation before. He said he was prepared to do the op, but in many cases he isnt, as they are just overweight people.

Without me having to promt him, he told me about the cuts just under the nipple, and how i would have drains for about 24 hours. Also, if there is any liquid after the 24 hours, it can be removed using a needle.

Here is the best bit, i have booked the operation. 6th of April. no, not 2007, THIS YEAR!. Is this the same NHS???

[phantom]

The whole thing sound more promising now!  Out of interest, did the surgeon say what kind of cut he was going to do?  Do you know if the cut is the now-more popular 'crescent' cut around the areola or the more 'dated' 'T' or 'anchor' cut? where a vertical incision is made form the bottom of the areola and extends downward for about an inch or so.

The latter method produces more visible scar - which as far as I am aware does fade over time, but might be more prominent than a crescent cut around the lower half edge of the areola.

[radio-boy]

It was certainly the crecent scar. Is this a good sign then?

He drew a little picture of a nipple and how the cut goes a semicircle around, just inside the pink skin. He did say, that there was a very minute chance of the nipple actually dying, as it limits the amount of blood going to the nipple, but he did make it very clear that this is unlikely, and more common (but still rare) in smokers. and im not a smoker.

The guy was very young, must have been late 20's i think. But he certainly instilled more confidence in me than the last two!

[phantom]

You sound much more confident about this surgeon and optimistic and I believe that is the when you know you have found the right surgeon.  The crescent cut is probably the most common procedure these days.  My first initial consultation was with a surgeon that described the old-school 'T' cut.  I was really put off by this method as I knew other, newer and less invasive techniques were being practiced elsewhere.

My incisions were made at the crease of the armpit.  I don't think it's any better or worse than a crescent cut, I think this is down to a surgeon's preference.

Best of luck and I look forward to your post-op report!

[radio-boy]

Must tell you though chaps, im terrified. Not been to hospital before for anything other than stitches.

[radio-boy]

Well you can be sure that i will be having the surgery. I feel like my time is running out, and im running out of chances to be young, and i wont let this stop me. Anyone else feel the same?

Im looking forward to surgery, but im terrified at the same time.

[Hypo-is-here]

wishing a speedy recovery and a good result for those with upcoming surgery!

[markashleigh1979]

That comment about the nipple dying has put the fear of God onto me!!!!! I think i am going to beg my Surgeon to make the incission through my Big Toe , just to be on the safe side .
Seriously though, is the nipple thing true?......ouch

[radio-boy]

He really did seem to know what he was talking about. He said that it has never happened to a patient that he had seen, but he had to warn me just incase, because if he didnt, he said it was bound to happen. He said a less than 1% chance. And i believe him as i have never seen a case of that on here. Do you smoke? if not, the chance of that happening is even slimmer.

[radio-boy]

One week today and my surgery will be all over.... Gulp!

I think the only worry i have is that the results wont be what i want. I dont want the oerfect chest, i just dont want to sag when i lean over or feel it when the inside of my arm crosses my chest. I want to be able to wear any T shirts i want without the need for at least one other tshirt underneath.

Straight after surgery, is there any problem lifting stuff etc? Or driving a few days after the op?

Gotta say, im terrified. And excited. And anxious. all at the same time.

[phantom]

Hello r-b

Everything you are feeling pre-op is what we all go through.  It's a life-changing experience into the unknown!

You will feel significant discomfort (but I would not really call it painful) for the first two weeks, so excessive lifting is a no-no.  You should be able to drive within 3/4 days after the op.

[radio-boy]

Just a little update with my surgery which will happen on thursday.

My mind is in overdrive at the moment, as phatom says, it should be a life changing operation. I guess my fear is that it wont change my life, and with being the NHS, he will be over conservative. I go from this thought, all the way to the other side thinking, wow! i cant wait! im already thinking about going out and buying clothes that FIT not clothes that hide my gyne. Then as soon as i think of that, i go back to thinking, uh oh, what if he doesnt take enough out?

I doubt that revision will be too much of an option on the NHS either.

I just want it to be done, and it to be gone.

Its like a diary this!

[phantom]

Be assured that a surgeon on the NHS is just as obliged to do as best job as he or she can as a private surgeon.  On the whole, any medic is often quite big-headed about their job and wants the reputation for being 'the best'.  It's in their own selfish interest to make you happy - it's what gives them a higher perceived respect from peers.

Imagine you had some kind of skin rash and you went to you GP.  He or she would prescribe you something to clear it up.  If it did not work, would you GP say "Sorry son, I've tried to get shot of it once already.  I can't try anything else, you've had your chance - this is the NHS aferall.  Go home and continue to suffer or go and see a private GP."  Ethics don't allow it and you GP would be obliged to continue treatment until the condition is either managed or cleared before you are discharged.

If a few months after surgery, there is still some work to be done, you will need to see your GP to refer you back to the surgeon.  If he or she agrees the job is not complete, then there are grounds for revision.  It would not be ethical to discharge you at this point if there was real evidence of some of the gynaecomastia remaining.

Best wishes to you for Thursday.