UK - 2nd Surgery Post op - some proffesional advise sought please! :)

[Toffer]

Hey guys, it's been a little while! I've been in hiding. Anyway - here is a rundown of what I've had done. Note that I am military and as such have recieved free treatment (UK):

My Gyne (May 2007) - I was uncomfortable with this - we all know the story so I'll spare you the details.


After The Surgery (Gland Excision & Lipo) As you can see below this left my chest in a good way contour wise, but my areola's were left over sized. This was exacerbated by the scarring as the surgeon felt it necessary to go for donut mastopexy :S


So, following that surgery things started to look a lot better. I took my top off in public at work (abroad) and had a few jokes said about my nipple size but nothing major. Fortunately they're mostly good friends and some of the guys knew about my problem.

Anyway, as the doc had made a little mess on the appearance side, I went back for revision surgery this month which was areola resizing. No gland removal or anything. fortunately the gyne doesn't seem to have reared it's ugly head yet;

Here's me today (The stitches are still present and colouring from surgery so try to look past that):



After a lengthly discussion with my surgeon it was decided that they would attempt to correct the nipple size and remove the oval appearance, whilst shrinking the overall look by a few mm also. The end result is relatively good. I was advised thast too small a nipple could leave scars that would be more prominent and prone to "pukker" up at the edges.

So I am, once again, nearly satisfied.

My concern/question to the surgeon; Having had the nipples re-sized, they have made a slightly "pyramid" shape, which mildly resembles the original gyne I had a while back. Is this normal, i.e swelling and will it return to a flatter shape again? or is it likely to stay this way now?

Picture of the pyramid shape.

[George Pope, M.D.]

You're going to be fine.  That's just typical postoperative swelling.  You'll look great when the swelling goes down.  Nice Job!

Dr. Pope, M.D.

[Toffer]

Excellent, thanks for the advise

[300zib]

Im no doc and not trying to make you feel bad but your chest looked normal to me in the pre-op pic.  Also your doc had no reason to remove your nipples cause your cause was so minor.  I just understand why he would op to do the surgery that way.  Any how revision pics look good just takes some time for all the swelling to go down.

[George Pope, M.D.]

His nipples were not removed.  He obviously had gynecomastia in the preop photos, and the surgeon in the revision procedure merely performed an areolar reduction, to reduce the diameter of his areolas.  That is commonly performed.

Dr. Pope, M.D.

[oldspice]

yeah, i think his chest looks fantastic. its going to look perfect once he is fully healed, might not even be able to tell u had the procedure done, congrats.

[DrBermant]

Hey guys, it's been a little while! I've been in hiding. Anyway - here is a rundown of what I've had done. Note that I am military and as such have recieved free treatment (UK):

My Gyne (May 2007) - I was uncomfortable with this - we all know the story so I'll spare you the details.


After The Surgery (Gland Excision & Lipo) As you can see below this left my chest in a good way contour wise, but my areola's were left over sized. This was exacerbated by the scarring as the surgeon felt it necessary to go for donut mastopexy :S


So, following that surgery things started to look a lot better. I took my top off in public at work (abroad) and had a few jokes said about my nipple size but nothing major. Fortunately they're mostly good friends and some of the guys knew about my problem.

Anyway, as the doc had made a little mess on the appearance side, I went back for revision surgery this month which was areola resizing. No gland removal or anything. fortunately the gyne doesn't seem to have reared it's ugly head yet;

Here's me today (The stitches are still present and colouring from surgery so try to look past that):



After a lengthly discussion with my surgeon it was decided that they would attempt to correct the nipple size and remove the oval appearance, whilst shrinking the overall look by a few mm also. The end result is relatively good. I was advised thast too small a nipple could leave scars that would be more prominent and prone to "pukker" up at the edges.

So I am, once again, nearly satisfied.

My concern/question to the surgeon; Having had the nipples re-sized, they have made a slightly "pyramid" shape, which mildly resembles the original gyne I had a while back. Is this normal, i.e swelling and will it return to a flatter shape again? or is it likely to stay this way now?

Picture of the pyramid shape.

Large Male Areola After Gynecomastia Surgery can be a complication of some techniques. On that link you can see the progression for my typical patient having that type of sculpture.  How tissues heal and evolve with revision depends on the problem to be treated, surgical techniques, skill of the surgeon, after surgery care, scar care, and other factors best discussed with your surgeon.

For most of my patients there is a natural areola reduction without resorting to skin reduction options as you can see in this Male Areola Reduction Gallery and .Nipple Areola Reduction Gallery.  Healing and evolution after gynecomastia surgery can be much faster and there is less of a scar compromise.  My patients also tell me they prefer a smaller scar when possible.

That is why I evolved my Short Scar Internal Chest Lift for patients with a drooping chest.  You can find typical healing after my Internal Male Chest Lift here.

However, for some patients, there is just so much excess skin, such as after massive weight loss, that they need even larger scars such as in this skin reduction chest lift.  You can see typical healing after larger skin reduction chest lift on this link.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[puffbiggie]

OMG, so sorry dude.  IMO your nip should not have come off.  Perhaps the exp lvl of the doc, but man, I hope the 2nd surgery corrects it all. 

Please keep us posted and let us know how it feels.  Not sure if you even have any nerve endings left with such drastic cut out. 

I'm definitely not going to UK for my op.

[George Pope, M.D.]

OMG, so sorry dude.  IMO your nip should not have come off.  Perhaps the exp lvl of the doc, but man, I hope the 2nd surgery corrects it all. 

Please keep us posted and let us know how it feels.  Not sure if you even have any nerve endings left with such drastic cut out. 

I'm definitely not going to UK for my op.

Please scroll up and read my post above.  His nipples were NOT cut off.  You're the second post here that thinks they were.  Reducing the areolar diameter should not affect sensation.  The nerve supply to the nipple travels through the chest tissue from the 4th intercostal nerve.  Cutting and stitching areolar skin around the perimeter of the nipple/areola complex  does not remove sensation. 

Dr. Pope, M.D.

[Toffer]

Hi guys,

So, it's been nearly 4 years since my operation. My nipples were too big for me to comfortably take my shirt off in public and this caused me problems when on holiday with my (fortunately very understanding) girlfriend, amongst plenty of other times in and out of work.

Although all my old shots are gone, I will post up some new pictures soon.

I had one more chat with my surgeon in January, and we agreed to have another areola revision.  This time I've told myself it's the final one, and the surgeon agrees.  I went under local anaesthetic (!) and was awake the whole time, which was actually really good. There were two surgeons working together and they made me feel comfortable thorughout.

The initial results feel and look good (under the butterfly stitches etc).  I am just keeping my fingers crossed that in 10 days when the nurse removes the dressings that my nipples stay the size they are now. I've been advised that it's not guarenteed that they stay the same size, as the surrounding skin might pull them out again. I really hope this isn't the case. If a doc could advise me of the likely outcome, it would be great!

If they do survive this one and the results are good, I'll be over the moon! 

.....here's to hoping!

[Toffer]

Oh yeah, also, if anyone can advise any mehtods to aid keeping the nipples at this size for as long as possible to 'take shape', that would be appreciated (or will this not work?)