Surgery options UK/EU?

[mixer]

Hi, I developed full on gyno after using propecia three or four years ago. At first it wasn't noticeable then when I put on weight after using anti depressants/sleeping pills it got to the moob stage. In last year or so I've lost thirty to forty pounds but they remain, although I am still slightly above BMI. Had 'puffy nips' from puberty but never knew that was gyno.

I am wondering if I get the gyno removed would I be sure it wouldn't reappear? Pretty certain I would need both lypo and gland removal (given that I had had puffy nips beforehand anyway) but the problem is I have a mass of low testosterone symptoms caused by the propecia and there is as yet no real treatment for them. This includes central weight gain and putting on weight on my chest so how can I know it wouldn't reappear even if I was very careful with my diet?

Also, what are the best options for carrying out the procedure? I'd be more inclined to travel abroad if it was a couple of grand cheaper but obviously wouldn't want a botched job. I have read about somewhere in Belgium as well as a couple of Polish places.

[Jonny5]

Karidis' website says - Will the fat or gland come back? "The short answer to this is no. As fat cells have achieved their set number in any given part of the body by puberty, increased caloric intake will not lead to volume gains in the treated site. It is important therefore to maintain your weight afterwards by sensible eating and regular exercise.

However if you do put on excess calories after surgery, you will notice that other areas of your body may be then be affected.  The only exception to this rule is if there is a massive weight gain. In this case new fat cells can be seen in the previously treated area.

As Dr. Karidis removes about 95% of the gland volume very little remains to enlarge and therefore it is exceedingly rare for the condition or gland to reappear."

As I understand it the gland removal will take care of puffy nipples forever but if you gain weight you risk fat coming back. As there are obviously serious underlying issues here only a visit to your GP can really answer this. Either way I am firmly of the belief that you should go into this procedure with low bodyfat. That way you can be sure that whatever is being removed cannot be dealt with with good old fashioned diet and exercise. If you're overweight you'll have fat on your chest, having that removed but still a big belly/arms/legs will look disproportionate. I also think it makes it much more difficult to get a natural result with regards to excess skin and contouring, it can end up looking very much like you've had surgery which I assume is not desirable for most people. I appreciate not everyone may agree with this, indeed I've heard people say they would use the surgery as the motivation to finally get in shape. Personally I think doing it the other way round makes a lot more sense.

With regards to the best options, in the UK it's widely accepted that Levick or Karidis are the way to go. They have the most experience, excellent reputations and seem to have pretty much cornered the market for this procedure. They're also the most expensive. If you believe that 'you get what you pay for' that can be reassuring, although undoubtedly their popularity has forced the price up.  I'm sure there are plenty of great surgeons out there but personally I wasn't willing to risk finding out to save a few quid, that's something you'll need to weigh up for yourself.