well when i took off my shirt for him, he was expecting man boobs and so at first he was thinking i didn't need surgery. plus, my nipples were cold and so they became erect for a few minutes which made them look like a minor case. Anyway, he said i had two options: excision around the nipple so it becomes a flap that can just be lifted to take out the fat or by liposuction with the puncture being somewhere under the armpit area. I told him, yeah yeah i know that everyone thinks it will go away but i've had it since the 7th grade and i'm now an incoming senior. Imagine not going to pools/beaches for that long!!! So after it was established that they werent going away, he felt them and said that for me, i just have fat under the nipple and that he couldnt feel the lumpy breast tissue. I asked him that if i removed fat, wouldn't it be able to just rebuild up in that spot again? and he said no. So my question here is how does fat go there? i mean of all the places, why under the nipple? I don't want to get surgery just to have fat deposit there again later in the future. please explain this to me thx
Gynecomastia comes in many different sizes, shapes, and forms. For my patient exams, we keep the room at a standardized temperature to better evaluate the male chest. This minimizes the problem you described.
Men tend to put fat on first their chest and belly regions. We take it off there last. Unfortunately, it can be difficult to distinguish just what is causing the problem. Gynecomastia male breasts can be fat, gland, or most commonly a combination of both. Sometimes skin and sagging tissues can be a factor. Pseudo Gynecomastia is supposed to be fat only gynecomastia. The problem with that "classification" is that in almost every case of gynecomastia I have seen there is some component of gland. This gland can be very small, but it is present almost all the time. So do you have Pseudo gynecomastia when there is a 1%, 10%, 50%, or 90% deformity from fat? Reality just does not work that way.
Defining the problem with photographs sometimes can help.
However, it is impossible to tell from photographs if the deformity is from fat or gland. The dynamic images,
of my standard set of images can show a region that compresses differently. Even clinical examination differentiation can be difficult.
Fat tends to be soft, gland tends to be firm. Fingers of gland often dissect between fingers of fat. Look at this
drawing and move your mouse over the arrows. However, gland can be soft and fat firm confusing the picture. Gland tends to be located under the nipple and pinching pressure can sometimes tether to the nipple pulling it in.
Men with excessive fat do tend to have certain contour issues. Check out this
link about Sumo Wrestlers. Men tend to carry excessive weight in their chest and stomach.
Weight Loss Before Surgery is typically better than weight loss after surgery. Losing weight is a coarse tool. Plastic Surgery is best reserved as a refinement tool. You cannot pick where the weight comes from, nor goes onto. Men typically gain weight first on the stomach, love handles, and chest. We typically take weight off the same areas last. Major weight loss after surgery may not come from your chest. If like most men, you do not lose as much from the chest, it may look as if your gynecomastia has recurred. Some of my patients loose their weight after surgery and get away with it. However, weight loss after surgery is a gamble.
Getting to a weight you are comfortable with is often best. Taking weight off, having surgery, and then putting weight back on is a problem. If as with most men, weight is put on the breasts, it can look like the gynecomastia has come back.
After major weight loss, there may be loose drooping tissues.
Hope this helps,
Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture
Topic: consulted a doc today (Read 4636 times)
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