Gyno & Droopy Nipples-Need Advice

[sfaquaboy]

I've lived with gyno since I was 13. Eleven years ago when I was 45 I had lipo done on my chest. I was moderately satisfied with the results but had some saggy skin. I've never been overweight and am in pretty good health. Today, at 56, I'm looking to have another procedure done. One surgeon said removal of fat & glandular tissue should work, the skin should tighten on its own. I doubt it will because it didn't after the last procedure. The second surgeon suggested fat/glandular tissue removal and possibly a donut lift. No skin removal would be necessary. I have another consultation next week with someone else. Attached are some pics. I'm not sure what is the best procedure for this. I'm not looking for miracles. I just don't want to feel self conscious anymore being out in public shirtless. Any advice on what procedure would give me the best outcome. Thanks.

[nicknack]

From what little I know, the gland is the main issue.  The gland will never go away, no matter how much fat you lose.  If you're getting the gland removed, you might as well get lipo and look more chiseled after.

[sfaquaboy]

That's the plan. I was considering a donut lift excision but it might be over-kill. Thanks for the input.