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Type of surgery *IMPORTANT*

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Type of surgery *IMPORTANT*
« on: August 13, 2011, 09:51:20 AM »
 I've scheduled the surgery but I have a concern with the type of surgery that is going to take place. My gynecomastia is severe and there is quite a bit of streching of the areola and yet Dr. Fielding has decided to go with an " Excision Bilateral Gynecomastia" procedure that only goes through two little incisions. I haven't heard of anyone else going with this procedure and even though the other doctor that I consulted said the same thing (or I'm assuming, he pointed to the same area and said the incision would be the same size) I'm worried that he wont take enough out or that my areola will still look stretched. I've watched a few surgeries and I cant even fathom him being able to remove the gland through such a little hole! Please get back to me as soon as possible, I need to know if I should postpone or cancel the surgery, I cant wait an entire year to have this corrected if he doesn't end up taking out enough; I dont want smaller boobs, I dont want them at all!

Linkback: https://www.gynecomastia.org/smf/index.php?topic=23899.0

Re: Type of surgery *IMPORTANT*
« Reply #1 on: August 13, 2011, 11:37:05 AM »
Most surgeons are quite adept at removing even large amounts of gyne tissue through a small incision.  After all, the object of the surgery is to get the best looking chest with the least amount of scars.

Dr Fielding has an excellent reputation -- why not trust him to do the best job possible?

Dr Jacobs
Dr. Jacobs 
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
815 Park Avenue
New York, New York 10021
Telephone:  (212) 570-6080
Email:  dr.j@elliotjacobsmd.com
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.com/revi

Re: Type of surgery *IMPORTANT*
« Reply #2 on: August 13, 2011, 12:14:27 PM »
I do trust him which is why I didn't think to ask the question during the pre-op; figured he's been doing this for years now and I'm sure im the same as others. But I've been reading a few other posts on this forum and started to worry. Thanks a lot for the quick response, I'm sure dealing with frantic and irrational patients must get old after a while  :-\

Re: Type of surgery *IMPORTANT*
« Reply #3 on: August 27, 2011, 12:03:24 PM »
I just got out of surgery yesterday. I was under general anesthesia and it took me 3 hours after the surgery was complete to wake up which meant I wasn't able to talk to Dr. Fielding after the surgery or take a look at the result. The surgery was liposuction only which is why I'm concerned. When I first started this process my family doctor instructed me to get both a hormone test and a scan of my chest. He said that there wasn't much  fat once he looked at the scans and that my hormones were normal. When I went for my consultation and told Fielding about this he told me that there was a lot of fat, without looking at the scans. I'm worried now that the results wont leave me with a flat chest and I'll have to go through this process all over again, I honestly don't know if I can take another year of this. The only thing that is keeping me optimistic is that my nipple pre-op didn't appear to be sticking out as it does with some cases where the glad is also removed and the fact that Dr. Lista also suggested only liposuction. I'll post the pre-op pictures, please let me know if you would have suggested only liposuction.


Offline Litlriki

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Re: Type of surgery *IMPORTANT*
« Reply #4 on: August 27, 2011, 02:49:00 PM »
If your surgeon got a lot of fat and felt that there was no significant amount of gland, you might find that the skin will retract adequately and the result will look ok. But just looking at your pre-op photos and thinking about similar patients, I'd have planned for liposuction, excision, and possibly a peri-areolar reduction, though it's reasonable to remove the extra skin in the office after the tissue has tightened up (9 months to a year later).  I have some single-stage resections on my website, and one of them looks a lot like you.  He required skin removal, which I did initially (Patient #1 in the gynecomastia with skin resection section of my photos).

At this point, you should just allow time to heal your chest and see how things come out.

Good luck,

Rick Silverman
Dr. Silverman, M.D.
Cosmetic and Reconstructive Plastic Surgery
29 Crafts Street
Suite 370
Newton, MA 02458

Certified by the American Board of Plastic Surgery

Re: Type of surgery *IMPORTANT*
« Reply #5 on: August 27, 2011, 02:59:43 PM »
Thanks Dr. Silverman,

My biggest worry is that I will be left with the same result except the breast will look deflated and more saggy, just without the fat inside. Do you think this is a legitimate concern? I cant imagine any doctor would seriously assume that a result like that would be satisfactory. Without the skin tightening, is that what it could look like? By the way, I looked at Patient 1, it was done to perfection. If I knew that was a possibility I would have flown out and had the surgery done by you. I have no idea why Dr. Fielding didn't agree to a glad removal or why he hadn't even suggested tightening the skin.


Offline Litlriki

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    • Dr. Silverman's Website
Re: Type of surgery *IMPORTANT*
« Reply #6 on: August 27, 2011, 04:01:27 PM »
There are many circumstances where I will just treat the "inside" first, and deal with the skin at a later point.  I discuss this at length with the patient, so that they understand that we are doing a two-stage procedure, and the second stage is under local anesthesia in my office, so there is minimal cost to the patient.  The skin will tighten, and it may be adequate, such that you can avoid further scars.  That's usually the reason for doing it staged--to minimize scars and minimize risk of nipple loss. 


Re: Type of surgery *IMPORTANT*
« Reply #7 on: August 27, 2011, 04:09:24 PM »
Okay so if I'm not satisfied with the result I can still have it fixed right? How much would you charge for the second stage? Also, would you accept out-of-the-country patients?

Re: Type of surgery *IMPORTANT*
« Reply #8 on: August 30, 2011, 10:39:21 PM »
Not sure what was wrong with me, when I wrote this thread I was pretty depressed and having some strange mood swings, had no idea that was a side-affect of the Anastasia  :-\ I went in for my pre-op with Dr. Fielding and everything looked...brilliant. There was no sagging and I had no idea why I ever doubted the man, hes honestly a genius. He was extremely comforting and answered every single question with a smile, despite there redundant nature :) I was considering deleting my posts since they poorly influence Fielding's reputation but I've decided to keep it up, many patients gets worried before the surgery and I hope that this thread can reassure those patients patients, its true what everyone says Dr. Fielding is...


Re: Type of surgery *IMPORTANT*
« Reply #9 on: October 28, 2011, 08:46:44 PM »
Heres an update:

One week after surgery:

1 1/2 Months after surgery:

*The marks where the breasts sagged are all but gone and the scars are not too noticeable.

Don't waste your time living with this when there is a cure!

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