N.H.S- not happy at all

[D24]

Hi kingboob, as you predicted the news is not good. I went today for the follow up that lasted litteraly 60 seconds. The surgeon examined me lying down, how you get the full picture of the apperance lying down I do not know, I mean do you travel round on your back....no. He confirmed the hard lump behind my right nipe and about 2 inches in diameter is a hematoma but couldn't see the point in operating to remove it. I asked him about the gland that is there since I was 11 or 12 and was TOLD it's not it's off the lipo. Yep you read rite I was told I'm wrong about what's been in my own body for 12 years. He concluded with sayin it will dissapear within 9 months and told me 2 see reception about making an appointment for me in 9 months and that was the end. Basically I feel like shite (excuse the language). I have private health care from work so I've contacted them to arange a private consultation which I think will be to no avail. The surgeon said they sucked out 250 from the left and 200 from the right (fat).
P.s I hope your situation comes good kingboob

[DrBermant]

Hi, first off i'd like to stress that i know a lot of people have been agreed surgery on the NHS and i'm not trying to put anyone off here, it's just my personal experiance. I had surgery for my gynecomastia last thursday. Lipo only was carried out and i don't look any different, i still have puffy nipples and now feel so down that iv'e gone through all the waiting and sitting in the day case unit for hours waiting to be called into theatre.The elation i had that the torment of having the condition was going to be over is now diminished. I have an appointment to see my GP tomorrow to discuss my concerns. i'll get sum pictures up ASAP but i can't bring myself to look at my chest right now i feel that dissapointed.

A few days can be very early after surgery with some techniques.

Posting Standard After Gynecomastia Pictures can help other better understand your concerns.

Firm tissues after surgery can be residual gland, but also can just be healing tissues or scars.  Different surgical techniques injure tissues to different degrees.  The body typically needs to heal before considering revision surgery. Rushing into secondary surgery can be a mistake unless there are complications that need to be addressed or the next surgery is component of a staged procedure.  Time to tissues softening can vary depending on the original problem, what was done, after surgery care, Scar Care, After Surgery Compression Garments, and many other factors. Options depend on the problem to be treated. Time can range from 6 months to a year but can vary depending on many issues best explored with your doctor.

I see many patients who complain of residual Puffy Nipple Gynecomastia after another doctor's surgery.  There are many possible problems causing such a deformity.  The most common is remaining gland behind the areola as seen in these Anatomy of Puffy Nipple Drawings.  Check out the images with the link for remaining gland after surgery to see what I mean.  

Liposuction is great for fat, but does not do well for gland at all.  As shown in the anatomy link, there are usually fingers of gland between fingers of fat.  Liposuction no matter what technique (sharp cutting cannula, specially designed cannula, ultrasonic, laser, or "smart") targets the fat first.  Remove the fat and the gland remains behind condensing the fingers making a firm mass.  

Even if the doctor achieves a flatter chest, that firm mass does not look like fat, move like fat, or compress like fat.  It just does not move well or look good (especially on animation).  That is why few doctors will show results with chest muscles tightened or arms up over the head or movies showing the tissues in motion.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia Surgery

[D24]

Visited my gp today to ask for a reccomendation for a private consultant as my private health care thru work requested. Had a chat with him and my opinion on the nhs has now gone lower that ever which I didn't think was possible till today. I had a lecture about beauty is in the eye of the beholder etc etc. Now this gp has been a gp for as long as I can remeber,I'm 24 and I remeber seein him when I was 4 or 5 yr old so I thought he'd hav at least seen a few cases of gyno but the things I heard today frankly amazed me.  He told me that you can't remove gland as it only makes a mess of a mans chest and doesn't look rite! He examined me in a cold room so ofcourse my nipples shrunk so I explained why it appeared normalish but he said oh no it's not cold in here. He did confirm I have a lot of gland but said the nhs would simply not operate as if everyone got surgery for something they didn't like there would be no money for important things. This must mean the people who don't work,smoke,drink and end up having heart and ling problems due to abusing their bodies are the important things. Yet someone who's worked since leaving school even during going to college and university has a genuine medical condition can't be helped. Now at this point I thought hold on a minute you've just said the nhs won't do the surgery for this condition erm hold on iv already had surgery for it. The inconsistencies are unbelievable. Well that's my rant over, I see the private consultant on Friday, I just pray that my private healthcare plan will pay for the gland to be removed.

[kingboob]

I highly doubt it.   Private health insurance usually will not pay for cosmetic surgery for any reason at all (including mental issues).  The only time might be if the surgery is re-constructive after an accident/burns or something.

[D24]

This is an update I wasn't expecting to be writing but here it goes.....
I saw the private consultant and explained the half procedure done by the nhs and he examined me. He felt the hard lump all around my right nipple about the diameter of a golf ball and an arregular shape and sticks out very prominantley from my chest and sat me down. He said he did not like the look or feel of it and he wants an ultrasound and a biopsy doing on it, he sent me straight away for a ultrasound. The gentleman concentrated heavily on this lump, once on the left nipple and kept running the tool over and around my right nipple. He repeated this around 6 or seven times. I got called into the consultants office and he asked my fianceé to come in with me, this is when I knew something was amiss. He explained that they rate things like this on a scale of 1-5, 1 being benign and 5 being cancerous. He said he rates it between a 3-4 and has arranged for a second gentleman to carry out an ultrasound and mamagram on Monday to determin if it is benign or cancerous. So as you may expect I'm a little in shock. He did say the chances of it being cancerous are very slim but he wants to eliminate it first. I explained the surgeon who performed the surgery litlerally poked it and said I'd had a hematoma and didn't know if that helped at all and the private consultant said no we will start from scratch and sort this out.  

[creative]

I can't really begin to imagine what you must be feeling right now. I only hope things go well though and it's not the c word! I'm sure you must be even more pissed at the nhs now, but lucky you have good private insurance. All the best mate.

[D24]

Thanks for the kind words creative, yeah as you can imagine i do have very strong feelings about the NHS. I've thought a lot about everything that's happened throughout my visits to my GP and the hospital, one thing i can't quite understand and anybody's welcome to correct me here if I'm wrong but to me if i had pseudogynecomastia then fair enough lipo only would have been required but as it was diagnosed as gynecomastia i.e true gyno then the condition is the gland and fat therefore the gland needs to be corrected. Obviously my mind is on getting to the bottom of the issue of this lump first but I'm thinking that the NHS have seriously Fu**ed up here, especially essentially now washing their hands of it. When the private consultant told me his concerns i don't know why but i said say it's not cancerous and just due to the lipo can you still remove the glands and he laughed and said yes of course we can but let's get this sorted first. To be honest i feel so privileged that i have this private health cover, weather it will pay for the gland to be removed i don't know but the difference in the NHS to the private hospital is frankly unbelievable, the friendliness of the staff, the time they take to listen and talk is how the NHS should be.

[thetodd]

the think is with gland reduction is that if the surgeon isnt any good, you will look deformed! What the surgeon said to me (nhs) was that they dont do gland reduction because of people complaining of poor results. And that he only done gland removal now for old patients with extreme cases of gyne. As in take away the whole gland and have no chest at all (which would make you look like a freak!).

You do need to have a small amount of gland in your chest, all the decent surgeons will leave a small disc of gland behind. Im sure he's doing reduction but make sure hes not doing complete removal because youl have extreme crater deformities. Good luck anyway if you kicked up enough fuss and got reffered to an NHS hospital with a decent surgeon youd probally get fixed on the NHS. But it would be a long process!

[D24]

Thanks for the advice thetodd, I had my biopsy lastnight by a second gentlemen who performed another ultrasound. He said he thinks by looking at it it's because of the lipo that's been performed but took samples just to be sure, I have to wait till Friday for the results. The consultant said he's confident it's nothing serious but will wait for the results and that he'll perform the gland excision and make my chest a lot flatter. He also said because of the pain and the lump that's formed my insurance should pay for it so fingers crossed they do and the lump isn't cancerous. I don't know whether to let it drop with the nhs or complain and get some answers why half a procedure was done. One things for sure the revision will not be done by the nhs even if they offered it to me.

[DrBermant]

the think is with gland reduction is that if the surgeon isnt any good, you will look deformed! What the surgeon said to me (nhs) was that they dont do gland reduction because of people complaining of poor results. And that he only done gland removal now for old patients with extreme cases of gyne. As in take away the whole gland and have no chest at all (which would make you look like a freak!).

You do need to have a small amount of gland in your chest, all the decent surgeons will leave a small disc of gland behind. Im sure he's doing reduction but make sure hes not doing complete removal because youl have extreme crater deformities. Good luck anyway if you kicked up enough fuss and got reffered to an NHS hospital with a decent surgeon youd probally get fixed on the NHS. But it would be a long process!

Checking actual before and after pictures can reveal what can and cannot be done, especially if it is not just one or two views that change from patient to patient.

Actually, I do not leave a small disk of gland behind. I have seen just too many patients unhappy with the results from other doctor's who do leave gland. Remaining gland is firm, does not feel like fat, does not move like fat, and when the areola muscle relaxes, residual puffy nipples just does not not look good at all. This is especially true on animation.  That is why many doctors do not show pictures with muscles flexing or arms overhead.

Good surgical sculptors can remove massive glands as you can see from this Gallery of Gland Removed from Gynecomastia Surgery and not have Crater Deformity after Gynecomastia Surgery. You can click on any of the gland pictures and go to the before and after surgery patient photos. 

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[D24]

well today i got three bits of fantastic news:

1. My biopsy results came back fine, no cancer. Turns out to be a formation from the lipo performed by the NHS. He did say what it was in medical terms but i was so relieved that it's not cancer i kind of didn't take it in.

2. Private consultant said he would operate to remove the glandular tissue, he spoke very knowledgeable about the procedure and how it would be done and has performed this surgery a lot. Also my surgery is the 29th of this month so less than two weeks to go!

3. My private healthcare have confirmed they will pay for the surgery

So I'm ecstatic at the minute, couldn't be happier. To think all this hassle has came good and will soon be over i can't tell you how happy i am. All the feelings of wearing what i want and swimming confidently instead of waiting till there's nobody around are filling my head again. I can't wait

[londonlad]

Fantastic news D24, I'm so delighted for you that it's not cancerous.  Best of luck for your second operation!

[D24]

Thanks londonlad, I've been following your story and I'm pleased you've managed to get somewhere with the nhs and it sounds like the consultant you've spoke to genuinely knows how to correct the condition. Hope all goes well for you.

[thetodd]

quality! get some pics up when your all fixed up

got well lucky with the private healthcare paying out mate

[D24]

quality! get some pics up when your all fixed up

got well lucky with the private healthcare paying out mate

Will do, i know i couldn't believe it. I think it was because of this hard lump after the NHS lipo that may have provided more reason for the surgery. I may be wrong as to why it's been accepted but all i know is i'm very happy it has.