Choice of surgeon and location

[cruelnature]

This is my first post, so first off, great forum.

Was debating whether to post this here or in one of the more general forums.... anyway here we are.

I'm 26, 6'1" and weigh under 140lb so fairly slim.  Have had one-sided gyne since puberty and want to do something about it.  In warm and cold weather the right breast looks normal to me (despite having slightly more than usual glandular mass under it).  I had an NHS consult in London a couple of years ago, with ultrasound that confirmed slightly excessive glandular mass on each breast.

The left side looks normal-ish in cold weather with shoulders back, but any crossing of arms or hunching makes a crease above the excessive glandular mass on that side, and the tissue under and extending around the nipple is made very obvious.  And in warm weather it's pointy to the extent that I try to 'will' my nipples to remain hard as though it's cold weather.  When running with tensed muscles only the left nipple moves!  Embarrassing.

Also have the habit of going for shirts with pockets, wearing shirts that are baggier/black etc..

Anyway my situation is weird.  Live in Germany and have booked to see an endocrinologist here next week, but suspect nothing will show up.  My GP in the UK said this was a case for surgery a few years ago but I hadn't the money and didn't want it done on the NHS after horrendous scarring I received from another procedure (medical, not plastic/cosmetic FYI).

Now, money is not a problem and I was initially planning to fly Stateside to Bermant and recouperate in a 4-star for a couple of weeks but have been hearing about Stanek, Levick and Kardis in the UK, and going back to stay with family in London for some TLC and mamma's cooking sounds much more appealing!

I think an armpit incision will be best because I kinda like the look of my nipples and don't want anyone knifing them!  On the other hand, I only seem to hear reports from Levick patients here and the consensus is that he does a total wipeout on fat and gland.  Obviously I want all the gland gone but the fat coverage on both sides is just about perfect.  Just below the nipples is where the problem is, especially on the left.

Questions:
1. Has anyone slim like me had bad post-op experiences in the long-term?
2. How long would I realistically need to recover before taking a 1.5hr flight back to Germany?
3. Do all the aforementioned UK surgeons use armpit entries?
4. Skin sticking to muscle etc - is this simply caused by not massaging regularly?
5. Given unlimited freedom in every sense, would any of those posting here have chosen another surgeon abroad for their procedure, and why?

Thanks in advance.

[Pferdestärken]

1. Can't comment, I'm a bit lardy!
2. Couple of days. Best check with your travel insurance as often is can be invalidated by recent surgery.
3. I think Levick invented that procedure; I've heard Kardis(Karadis?) learned it from Levick - don't know about others.
4. I suspect lack of massaging and/or use of compression garments may be connected, but don't really know.
5. I considered exactly the route you suggested. I decided against on the grounds that the whole process is far more than just the op. Good aftercare, follow up visits, possible revision surgery all have to be factored in. The Priory is 30 mins drive for me so nothing else made sense on that basis.

I think you might get more for your money in the States, and if you can afford to budget for three or four trips out to see your surgeon over a 12 month period it may be worthwhile - but you might get just as good results here. You do get the impression that surgeons Stateside have bee "at it" longer than over here, and may have had more opportunity to refine their techniques. On the other hand there is a great tendency for people in the States to "talk the talk".

By that I mean that any claims they make may need a slightly larger pinch of salt than any claims made by surgeons over here - except that British surgeons tend not to make any claims in the first place. Its a culture thing.

I see the same thing in my line of work, IT. If you believed the hype they push out, the US are at the forefront of everything IT.  Go out there for a while, work with them, you realise that its 90% front. Half the time they struggle with the basics, but they can trot out the latest research verbatim. Ask them to actually DO something and they don't know where to start. "All mouth and trousers" as my nanna used to say.

Oh, final note. I don't think Levick does go for a "total wipeout" on fat (gland, yes). I know with me he said up front he would be leaving some fat in, and he has. I know of one other who has the same experience for definite.  I'm still a bit fat elsewhere and I feel the amount of fat left on my chest is entirely in balance with that. I got the impression that this is a recent refinement of his technique specifically intended to address some of the "skin sticking" issues.

He'll probably have to "thin out" the fat to balance the loss of mass when the gland comes out though I'd have thought - gland incision alone will leave a crater. Have you seen what 30g of gland looks like!

Good luck - and hi!

[doddy]

About your slim question - I wouldn't call myself 'slim', but possibly slimmer than a few of the guys who have this op..  

So, no, I haven't really had any bad experiences post op. I went with Levick and am really happy with my results and am getting more and more happy as every week passes.

I'm a little over 3 months post-op now, and I had a minor case, although it was worse than my pre-op pictures make out here:

http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=11;action=display;num=1119895377

Those are from 12 weeks post op, so I'm a little further down the line now.

[cruelnature]

Thanks for your replies folks.  Have already checked out both of your diaries and pics - fantastic results - and no nipple scars, which is key.

The reason for my concern is other people who have posted experiences of skin sticking and lumpy, irregular chests a year or more post-op.  Is this usually only with larger people?

Went for a consultation here in Frankfurt with an endocrinologist - he gave me an ultrasound because they can apparently tell whether the gland mass is benign or other based on that, and also can tell whether it's lactating tissue.

Anyway, he says it doesn't look like it would be the sort of tissue to grow back after surgery.  Going for a whole slew of blood tests on Tuesday then will get a medical report and take it to a surgeon if all looks well.

On another note, the endocrinologist was happy to recommend me a few plastic surgeons in Frankfurt who deal with gynecomastia regularly.  Will consult with them first, before going to the UK for consults.