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surgery via underarm?

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surgery via underarm?
« on: June 27, 2007, 04:17:44 AM »
hey had gyno since around age 15. i am an athlete and it bothers me that the more i work my chest the worse it actually looks. My nipple areolar complex has become ptotic on my pectoral wall and faces more downwards than out like it should. I am sick of stimulating my nipples everytime i have to take my shirt off to try and hide the gyn. i have only a small peice of gyn under my nipple (basically no subcutaneous fat at all) and it bothers me that i have had girls say that i have bigger boobs than they do, and its only because of this small piece of gyn on top of a well developed pectoral muscle

i have been to a PS in sydney who said he would do the surgery via a hemiareolar incision, resect the gland and perhaps a bit of lipo (but probably wont need it because of little fat). H e said the surgery would give me a tighter looking chest.

i am just wondering has anyone done gland excision via the underarm in australia (in particular sydney). i have no worries about the surgery procedure itself and believe it is justified due to the pain it has caused me over the years (constant nipple pinching/groping, girls noticing)...however i am worried about the resultant scarring and believe if underam surgery was avaiable i would look into it...

further more has anyone used dr mark kohout...apparently he is testing a new method via the underam wear he uses a surgical tool that he used for sweat gland removal to remove gyn?

these are some pictures...i know i dont have large pendulam breasts howvere my nipples stick out throuh my shirts/singlets badly


Linkback: https://www.gynecomastia.org/smf/index.php?topic=10697.0

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DrBermant

Re: surgery via underarm?
« Reply #1 on: June 27, 2007, 08:01:46 AM »
hey had gyno since around age 15. i am an athlete and it bothers me that the more i work my chest the worse it actually looks. My nipple areolar complex has become ptotic on my pectoral wall and faces more downwards than out like it should. I am sick of stimulating my nipples everytime i have to take my shirt off to try and hide the gyn. i have only a small peice of gyn under my nipple (basically no subcutaneous fat at all) and it bothers me that i have had girls say that i have bigger boobs than they do, and its only because of this small piece of gyn on top of a well developed pectoral muscle

i have been to a PS in sydney who said he would do the surgery via a hemiareolar incision, resect the gland and perhaps a bit of lipo (but probably wont need it because of little fat). H e said the surgery would give me a tighter looking chest.

i am just wondering has anyone done gland excision via the underarm in australia (in particular sydney). i have no worries about the surgery procedure itself and believe it is justified due to the pain it has caused me over the years (constant nipple pinching/groping, girls noticing)...however i am worried about the resultant scarring and believe if underam surgery was avaiable i would look into it...

further more has anyone used dr mark kohout...apparently he is testing a new method via the underam wear he uses a surgical tool that he used for sweat gland removal to remove gyn?

these are some pictures...i know i dont have large pendulam breasts howvere my nipples stick out throuh my shirts/singlets badly



Liposuction Is Great for Sculpting Fat

The arm access site makes the doctor's work much easier for the liposuction component of the surgery.  The remote site gives a better seal and makes surgery go much faster.  However, removing gland is much more difficult and cannot be done as well as a direct approach.  In addition the arm access sites look very strange, the scars just do not hide well and really show up on animation (like lifting the arms).  My many revision patients who had other doctors start with arm access sites have told me they prefer my peri-areola scar to their original scars.  The access I need for surgery at the edge of the areola is usually much less than half.  I prefer a much smaller incision which looks better but can take more work during surgery.

When gynecomastia is from fat, liposuction works very well for contouring the chest.  I have seen many patients from other doctors who tried to use liposuction alone techniques that left gland behind that the patients just did not like for Revision Gynecomastia Chest Sculpture.

Here is an example of Revision Surgery after Liposuction alone.   Here is another revision after liposuction alone.

The problem is picking the right method for what actually is that patient's problem.  That is why I prefer my Dynamic Technique that permits what I find during surgery to guide my sculpture.

I have also seen patients with channel problems between remote access sites and the areola / nipple.  Scars, adhesions, and depressions can look terrible.  Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexion here to see what I mean.

As any artist, I take my cannula selection and access sites very seriously and have evolved what permits me to achieve my results.  I have considered and evaluated many, many technologies.  The many different types of cannula I use have their own advantages and qualities.  I pick a subset of these cannula that varies for the many different types of gynecomastia male chest sculpture that I see.

Gland removal by any technique can still leave a depression when  a major part of the problem is from gland.  For gland removal, I prefer the greater precision of removal under direct visualization and feel.  This also give me access to many more elements for my artistic palette of my Dynamic Technique to sculpt the remaining tissues.

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat.  How tissues move is important.  The human body is beautiful in animation.  That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views.  Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor.  It is like an artist selecting a paint brush.  The results are what matters, not with what tool they sculpt.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture


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