Late in the Day questions

[man-chest-r]

So, I wish I knew about this board a couple of weeks ago.

Here's my story and questions. It has been about 4 days since my surgery.  I went to my gp, who was sympathetic, but decided to go private rather than via the NHS - from the stories here I am glad I did. What I didn't have is the list of questions that this board would have provided. There you go.

The surgeon said when we first met, and reiterated on the day that his approach was to be conservative. He said that he would remove glandular tissue and do lipo, but not too much of the latter, because this could lead to problems if I lost weight later (spooning?); which I do need to do.  He also made me feel better by stating all the risks and drawback before he had seen me shirtless, and then saying, immediately he saw me, yes, you do need to have it done. He also said I should have had it done 20 years ago, which was true, and, any young guys reading this, take it from me, face the demon now rather than live with it.

After the op, he came and saw me, told me he had removed about 120 grams of tissue (altogether) which he thought is a lot. Is it ? I am not wearing a compression vest, just a fairly wide tape across my chest (should I be worried?). It cost me £2500 which seems ok, if the treatment is Ok.
I am seeing him again early Jan. What do I need to ask? I do want to get to the gym, start swimming etc asap to lose wieght generally, any advice?

And, anyone, anyone know of any counsellors in the NW of UK I can talk to about this ? My wife has been very supportive, but I need to talk to someone else. I have to say, I am only now admitting to myself how much this whole gyno thing has messed me up, how hard it has been....

[Time_to_fix_it]

Hi and welcome to the boards,

Yes I think if you had found this site before your surgery then you might have picked up a few pointers beforehand such as:

•   Getting your hormones checked to make sure there is no underlying cause for your gynecomastia.  The fact that you have had it for over 20 years, and assuming it isn’t still growing, would indicate that it happened around puberty and your hormones naturally corrected themselves afterwards as most young mens do.
•   Getting consultations with several surgeons who regularly do this procedure to find one that you felt happy with regarding experience and methodology.

However hindsight is not something any of us have and things seem to have gone smoothly so far for you so fingers crossed.  In answer to the questions you raised:

•   From my own experience, and from that I have read from other peoples posts, 120 grams isn’t a great deal to have removed so don’t worry.  I had a moderate case and had 250 grams of gland and fat removed from both sides.  Some people with quite severe cases have had over 400 grams removed.
•   I am surprised that you weren’t advised to wear a compression vest.  There are a number of Plastic Surgeons who carry out this procedure many hundreds of times a year who insist on one being worn 24/7 for 4 weeks and then at night for a further 3 weeks.  Maybe it would be worth raising this with your surgeon when you see him in January.  However if the tape you have been given is wide enough and tight enough to give you the compression you need, then maybe that will be enough.
•   I guess you will want to ask your surgeon when you see him in January when you can start massaging and when you can take up certain forms of exercise.  My PS (who does over 300 of these a year) said only light exercise and no massaging during the first 4 weeks.  After my 1 month post op check up he gave the go ahead for massaging and vigorous exercise.
•   I’m sorry I can’t help you with the counselling question. Maybe your GP would know someone?  This website is full of information with hundreds of people going through exactly the same as you.  We have all tried to hide the condition in the past.  Many of us have had surgery to correct it and some people have learned to accept and live with it.  You might find that reading the posts of others on here and posting your own experiences could actually be a useful way of getting it out of your system.

Good luck with your healing.  If you have read the posts of others who are healing you will know that the surgery is really the easy and quick bit.  The healing process takes many, many months and is often a rocky road of intermittent swelling and battles with scar tissue formation.  Feel free to ask question, there are a lot of knowledgeable and experienced men on this site who can help.

Good luck and keep us posted as to how you get on.

[man-chest-r]

Here's an update. Having been to have my dressing change, and expressing my concern about the absence of bandage/vest, having only the tape, I got a call back from my surgeon, which was impressive in itself. He was confident that what he had provided would do the job. Said he had done 200 or so of these kind of operations, and that in his experience too much emphasis could be put on the vest/bandage. He was good, but the nurses at the hospital engaged in changing dressings didn't quite fill me with confidence that they had done a lot of this, although they were very very good personally and in terms of their competence and contactibility.

I saw the surgeon again face to face, and he examined me. I have to say that this far my chest isn't as flat as I had hoped. His view was that there was very  probably some  fluid swelling still to go down - which I am happy to take his word on - and that we would revisit in a couple of months to see how it had panned out. If needed he said he would give me a little more lipo; but said that at the same time I should try losing weight - which was my intention anyway, so he could assess what my more normal physique would be. I guess I am one of those not unhappy with a big gut, because at least my chest doesn't look disporportionate. He said he wouldn't charge for the lipo if it was needed, which was cool. Again, he stressed his conservative approach, and reiterated how complex he thought this kind of surgery was, which I think is confirmed by some of the postings here, and how many surgeons he knew had stopped doing it because of the instrinsic difficulties.

On the surgery itself, I have v. small nipples, and now have scars of about 2-3 cms at 3 oclock and 9oclock, but they are very fine, and much better than I had anticipated.

Actually facing up to talking to the GP, finding a surgeon etc was not easy, and I kind of got through it by telling myself I was grappling with a demon, and that short term pain was worth the gain, so I am troubled by not being out of the woods yet. But in terms of the life I have ahead of me, what is a few more months.

[man-chest-r]

Also, I should say that I am in the process of seeing an endocrinologist. I was referred to the NHS by my GP, but went privately to gain some time. The initial assessment was that I had ideopathic gynecomastia, rather than there being some underlying cause. I am not quite convinced, probably because I have had fertility problems too.  However, the person I saw arranged for some thorough blood tests through the NHS - I would have ended up in his NHS clinic anyway, and think I only gained a couple of weeks by going private. At the time it was worth it though.

Will update on this side of things too.

[rockstar6181]

Which Surgeon did you go with? 2500 sounds a good deal esp if he offers follow up corrections at no extra cost.

[man-chest-r]

I am kind of hesitant in naming the surgeon until I am clearer about how it actually works out.....

[rockstar6181]

ok thats understandable, keep us informed of your progress, hope it all works out for you.

[man-chest-r]

OK. Saw the endocrinologist. The contrast between the NHS hospital/waiting rooms/treat you like a number in a waiting room of 30 odd for this and the BUPA hospital where I had surgery is stunning. But, saying that, when I got to see the medic - registrar - he made me feel there was as much time as needed,  told me my detailed blood tests had come back with normal ranges, which had been the case with my less rigorous GP tests too. I should maybe have asked for details (? any suggestions) - but will ask my gp for the letter he said he will send to her.

He said that I should - might as well - have the testicular scan planned, but that if it was OK they would just send me a letter to that, which would save me having to go back again if not needed which helps them and me. A student in the room which I hadn't anticipated, but what the hell.... So, despite my misgivings hooray for the NHS on this one.

Otherwise, I have been reading lots of the other posts, esp the Poland sagas - someone should write a tv play about that, could be more insightful than a documentary - and find they give me a lot more confidence about things so far. Clearly people are getting the same message from different surgeons about gland/fat removal, about gland first, a bit of lipo maybe, but maybe anticipate coming back for a bit more lipo if needed.

With that in mind, I am more confident in at least saying the deal I got was at the BUPA hospital in Manchester. If anyone wants to send a pm to discuss please do so.

[man-chest-r]

Ok, so the way this thread is panning out, it could/should have been a diary.

Saw my PS, who I think highly of, couple of days ago.

I think I need revision. He said, sure, you do. But I need to think about my weight. Am 5'11'; 210 lbs. Said he would do the revision now, but I need to think long and hard about whether I intend to lose weight or stay like this for the rest of my life. What I need to do, he told me, is lose at least 20 pounds, then he would revise. If I want to be overweight for the rest of my (implicitly shortened) life, I could have the revision now. However, if intended to sort myself out weightwise then there is danger of spooning if he operated now. Also might be skin that needs taking away.

Good advice, I guess.  So, I sign up for weightwatchers online. But wish it was all over.

[outertrial]

Glad its working out with you, the surgeon seems sensible. I recommend a book called Diets Dont Work by Bob Schwarz for overcoming overeating.

[man-chest-r]

thanks, will get the book. Mind you, if I lost 2 lbs for every diet book I bought.....

[outertrial]

But its Diets DONT work! Youll see what i mean when you read it anyway.