Thanks everyone.  My doctor is Dr. Elliot Jacobs in New York City.  If anyone is from the New York area, I would look into him.  He's an expert in this type of surgery and he's created his own tools to perfect the way he does the surgery.  He uses a method where he scrapes out the tissue from the side of body, leaving only a small scar on the side near the ribs rather than the large scars that are often associated with this surgery; only if he cannot get all the tissue will he make the incision under the nipple.  In my case, there wasn't much fat, I think most of mine was actual glandular tissue, and luckily enough, he did not need to cut it out using an incision around the nipple.  The surgery and losing a lot of extra weight afterwards through exercise and diet have really made a huge difference.