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areola reduction to get rid of puffy nipples

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areola reduction to get rid of puffy nipples
« on: February 04, 2009, 07:21:52 PM »
I just went to a plastic surgen and he told me i need to get areola reduction because I just have lose skin and not a lot of gland. Any one ever heard of getting this done on a male. ???

Linkback: https://www.gynecomastia.org/smf/index.php?topic=16811.0

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DrBermant

Re: areola reduction to get rid of puffy nipples
« Reply #1 on: February 04, 2009, 08:18:45 PM »
I just went to a plastic surgen and he told me i need to get areola reduction because I just have lose skin and not a lot of gland. Any one ever heard of getting this done on a male. ???

Puffy Nipple Gynecomastia Surgery typically does not need a skin reduction component.

Your doctor should be able to show typical pictures before and after such surgery.  Each doctor has his / her own skills and techniques.  I have seen disasters from doctors trying to perform Male Large Areola Reduction Surgery with inadequate experience. Unless something is done to counteract the forces of the chest pulling on the skin, the areola will expand again after surgery. 

You can see Graphic Pictures During Surgery to Reduce Big Areola and early evolution of tissues for my sculpture.

Male Mastopexy Skin Reduction for Male Chest Ptosis can be a valuable tool for those whose massive extra skin is a major factor in their deformity.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia of Male Chest Ptosis - Sagging and Male Mastopexy Chest Lift Sculpture

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Offline Ryuuk

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Re: areola reduction to get rid of puffy nipples
« Reply #2 on: February 04, 2009, 10:20:28 PM »
Yeah. I had it done last wednesday.

If you have large areolas from excess skin, you get it removed.

what, you think you're the only person on a gynecomastia board who has had to have skin reduced?

Oh and don't let Dr Bermant's images of the HUGE AREOLA REDUCTION startle you. It's an extremely bad example, I personally don't know why he uses it. It caused unnecessary alarm to me before I had my surgery and I tell you now my chest looks nothing like that mess.

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DrBermant

Re: areola reduction to get rid of puffy nipples
« Reply #3 on: February 05, 2009, 08:32:41 AM »
Yeah. I had it done last wednesday.

If you have large areolas from excess skin, you get it removed.

what, you think you're the only person on a gynecomastia board who has had to have skin reduced?

Oh and don't let Dr Bermant's images of the HUGE AREOLA REDUCTION startle you. It's an extremely bad example, I personally don't know why he uses it. It caused unnecessary alarm to me before I had my surgery and I tell you now my chest looks nothing like that mess.

Right after surgery areola reductions done will be the size set by the surgeon.  If the surgeon did not respect the tensions pulling the areola back to the original size or larger, the problem will become apparent as the tensions stabilize, usually several months after surgery.  I posted such images as a warning to those contemplating surgery to check pictures by the surgeon they choose to see what type of results that surgeon achieves for that problem.  I have seen many such complications done by other surgeons not familiar with the dynamics of the small male areola.  Prevention of  that problem is so much better than needing revision surgery.

Unfortunately images of examples here often disappear after time:
http://www.gynecomastia.org/smf/index.php?topic=15442.msg108047;topicseen#msg108047

Why don't you post pictures before surgery, now, 3 months, and 6 months after surgery.  Measuring the diameter of the areola before and at those time intervals will also tell if the extra skin reduction created a problem.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

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Offline Ryuuk

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Re: areola reduction to get rid of puffy nipples
« Reply #4 on: February 05, 2009, 09:35:57 AM »
Before my surgery my Doctor told me all about his drawstring technique and how he had to counterbalance the forces.

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DrBermant

Re: areola reduction to get rid of puffy nipples
« Reply #5 on: February 06, 2009, 06:35:30 AM »
Before my surgery my Doctor told me all about his drawstring technique and how he had to counterbalance the forces.

Each of the failures I have seen also had "drawstring" sutures.  However, when the surgeon makes the mistake of using dissolvable sutures and the force is great enough, disaster happens!  That is why seeing pictures of successful sculptures by a surgeon for this specific problem is so important.  Again, that is why I have posted such examples so the public can be aware of this problem.

Hopefully, your solution is effective and you remain happy!

Hope this helps,

Michael Bermant, MD
Learn More About Plastic Surgery

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Offline Ryuuk

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Re: areola reduction to get rid of puffy nipples
« Reply #6 on: February 07, 2009, 07:58:56 AM »
Before my surgery my Doctor told me all about his drawstring technique and how he had to counterbalance the forces.

Each of the failures I have seen also had "drawstring" sutures.  However, when the surgeon makes the mistake of using dissolvable sutures and the force is great enough, disaster happens!  That is why seeing pictures of successful sculptures by a surgeon for this specific problem is so important.  Again, that is why I have posted such examples so the public can be aware of this problem.

Hopefully, your solution is effective and you remain happy!

Hope this helps,

Michael Bermant, MD
Learn More About Plastic Surgery

It doesn't help at all, you know most surgeons use dissolvable sutures you don't need to try to scare people.

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DrBermant

Re: areola reduction to get rid of puffy nipples
« Reply #7 on: February 09, 2009, 09:52:40 AM »
Before my surgery my Doctor told me all about his drawstring technique and how he had to counterbalance the forces.

Each of the failures I have seen also had "drawstring" sutures.  However, when the surgeon makes the mistake of using dissolvable sutures and the force is great enough, disaster happens!  That is why seeing pictures of successful sculptures by a surgeon for this specific problem is so important.  Again, that is why I have posted such examples so the public can be aware of this problem.

Hopefully, your solution is effective and you remain happy!

Hope this helps,

Michael Bermant, MD
Learn More About Plastic Surgery

It doesn't help at all, you know most surgeons use dissolvable sutures you don't need to try to scare people.

The problem with dissolvable sutures, is that they dissolve.  If there is still tension of the chest skin on the areola after the retaining suture dissolves, the areola will enlarge.  For a woman's breast with larger areola than men, this is not typically an issue.  For the male chest with smaller areola, the forces are just greater pulling the areola bigger.  Also any increase in size is more noticeable in the smaller structure.   That is why for women, dissolvable sutures are what most doctors use.  But for men, that is not the case.

Actually I have seen more than 20 patients with problems of enlarging areola from other surgeons' male mastopexy.  3 of these cases came from the Australia / New Zealand region.  All of them have been with dissolvable sutures.  All of the surgeons I have discussed this problem with all use a permanent suture to minimize this issue. 

However, it is a question of a balancing of forces.  That is why I suggest that anyone planning on such surgery should check out that particular doctor's technique and actual pictures before and after surgery.  If that doctor's method works, then he / she should be able to show you  documented results.  Male Mastopexy is just different than the same operation on a larger diameter areola of a woman.

Your specific situation may work out just fine, time will tell.

Hope this helps,

Michael Bermant, MD
Learn More About Male Chest Lift Surgery

Re: areola reduction to get rid of puffy nipples
« Reply #8 on: February 10, 2009, 09:22:40 AM »
I just went to a plastic surgen and he told me i need to get areola reduction because I just have lose skin and not a lot of gland. Any one ever heard of getting this done on a male. ???

I have to agree with Dr Bermant here - i rarely perform areolar reduction for puffy nipples; the cause is usually excessive glandular tissue causing the puffiness. In general, one does use dissolvable sutures for this type of procedure, but when one is trying to reduce the diameter of the areola, the primary cause is excessive stretch from the surrounding chest skin, NOT an excess of areolar skin - as such, in order to try to counteract the pulling forces of the chest skin on the areola, a permanent suture is typically used in a purse-string type fashion - even with this, though, you can have stretching of the areola skin. In short, I would avoid it unless absolutely necessary.

Re: areola reduction to get rid of puffy nipples
« Reply #9 on: February 10, 2009, 09:52:08 PM »
Puffy nipples are due to excessive breast tissue directly beneath the areola.  This tissue pushes the areola up and outward, stretching it in the process and creating a dome-like areola.  This process is akin to the initial breath in blowing up a long, narrow balloon -- you get something that looks like a puffy nipple.  In many cases, if the surgeon removes the appropriate amount of excess tissue, the areola will flatten and shrink in diameter -- spontaneously.  There is no need, in my opinion, ever, to perform an areolar reduction -- the scars, even in the best of hands, are not good.

In the few patients I have had who had very very large areolas, there was enough of a spontaneous shrinkage of the areola that they were satisfied -- perhaps not perfect but perfectly acceptable. 

Some wisdom:  sometimes it is better to have a result which is pretty damn good rather than trying to get a perfect result (ie smaller areola) with poor scars that will be a significant tip-off to anyone looking at you.

Pick your poison.

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


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