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question about scars

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question about scars
« on: December 26, 2009, 02:33:47 AM »
has anyone had a nipple reduction surgery along with there gynecomastia surgery? if so was the scarring bad?

Linkback: https://www.gynecomastia.org/smf/index.php?topic=19708.0

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DrBermant

Re: question about scars
« Reply #1 on: December 26, 2009, 08:52:47 AM »
has anyone had a nipple reduction surgery along with there gynecomastia surgery? if so was the scarring bad?

It depends on what you mean by "Nipple Reduction."  If you mean Long Nipple Reduction, that can be done as a second stage procedure under local anesthesia. Scars are limited to the anatomic nipple.

Are you asking about Areola Reduction Surgery?

Areola Reduction Surgery is a significant compromise that I rarely recommend unless there is a great deal of excess skin (such as After Massive Weight Loss or in large breast Transgender Female to Male Chest Contouring.) There are many techniques to tighten the skin and remove areola, each has their own compromises.  However, flat nipples hanging well below the pectoral muscles look much worse than scars from reduction.  For major amounts of excess skin, a Skin Reduction Chest Lift may be an option.  Depending on sutures to hold areola tissues at a smaller size is a real risk as seen in the example below where I revised a mess from Australia surgeon's use of dissolvable sutures.  Permanent sutures can break, stretch, and get infected.  Such risks are better explored during a consultation after an evaluation.

Warning Graphing During Gynecomastia Areola Reduction Surgery Pictures

You can see actual pictures during a  Revision Donut Mastopexy Areola Reduction Surgery here

Photographs during surgery to reduce big areola continue here. and there are more Pictures during surgery to reduce male areola here.

The areola usually expands with bigger breasts.  Like a balloon, with deflation (surgery) there is a reduction in diameter unless there is a layer of remaining gland after gynecomastia surgery.  Roll your cursor over that text or image and you can see a drawing of gland that can be left behind after surgery.  I have seen many examples of gland adherent to the muscle areola complex that keeps the areola puffy and larger diameter.  That is why I prefer to target the gland first with my Dynamic Technique for Gynecomastia.

Check out the many before after pictures of this  Areola / Nipple Reduction Gallery, Areola Reduction Picture Gallery, and Pictures of Areola Reduced with Gynecomastia Surgery.  These results are typical for my sculpture of my patients.

Here is a balloon demonstration of nipple / areola shrinkage typically seen with my gynecomastia surgery.  When a breast gets bigger, so does the diameter of the areola nipple complex.  Remove tissue from the breast and it is like this balloon deflation.  However, not all tissues shrink the same.  Tissue over stretched, older patients, scars, and gland remaining after gynecomastia surgery can limit this decrease.  Here is a demonstration of deflation with areola staying the same size.  That is why I prefer to target this gland first with my surgery.

Take your time to browse through the galleries of nipple areola pictures before and after gynecomastia surgery to see actual results for my patients.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

Re: question about scars
« Reply #2 on: December 26, 2009, 12:16:54 PM »
For most gynecomastia patients, when the excess tissues are removed during surgery, the areola (pigmented skin surrounding the actual nipple) will spontaneously reduce in size.  I would not recommend a formal areolar reduction operation for fear of significant scarring. 

If your problem is a nipple which itself is too long or projects too far from the skin surface, then usually this too can be reduced during the same operation.

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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