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Doctor wants to leave a little tissue behind....did yours?

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Doctor wants to leave a little tissue behind....did yours?
« on: December 03, 2008, 08:29:03 PM »
The doctor says in order to prevent the nipple "caving in" he wants to leave a little tissue behind when he does the procedure. I'm not really questioning his method as he is the professional but I was wondering if it will still look like I have gyne if he plans on leaving a small bit behind?

Linkback: https://www.gynecomastia.org/smf/index.php?topic=16284.0

Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #1 on: December 03, 2008, 09:26:07 PM »
well, my doctor said he was gona leave enough behind so it would blend in properly with my body weight, and i said ok, but looking at the procedure, i think he took out more, and made me pretty flat, even from the sides...so im pretty satisfied...
i suggest that you let the doctor do his job, because if you have a little bit of thickness, it would be better to just leave some tissue in there..its not gona harm u, although it might get in the way a bit if you are trying to build muscle up there..
good luck

Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #2 on: December 03, 2008, 11:01:40 PM »
yeah that's the thing I have a very athletic frame, 6'4 or so and ~200lbs. I want to build up more muscle once my procedure is done and I have the okay to lift again. I'll just bring these things up with him before the surgery is done in 2 weeks :D

Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #3 on: December 04, 2008, 09:12:38 AM »
good luck with the surgery! im 2 days post op and it hurts like crazy

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DrBermant

Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #4 on: December 04, 2008, 08:11:14 PM »
The doctor says in order to prevent the nipple "caving in" he wants to leave a little tissue behind when he does the procedure. I'm not really questioning his method as he is the professional but I was wondering if it will still look like I have gyne if he plans on leaving a small bit behind?

Some doctors leave gland behind to minimize Crater Deformity Complication after Gynecomastia Surgery.  With my Dynamic Technique Gynecomastia Surgery, I prefer to target the gland first and NOT leave a shelf of gland behind.  Gland is firm and does not move like fat.  I see many patients coming to me for revisions  not liking residual puffy nipples after other surgeons' use of that method.  My Fat Flap Sculpture permits me to support the areola and nipple with fat instead of remaining gland.

The many results on my website are typical for my patients.  To achieve these results I push the envelope using many different elements to optimize the sculpture of each patient.  Patient education is also important for realistic expectations.  That is why I have such an extensive website for this problem.

Hope this helps,

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

Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #5 on: December 05, 2008, 07:29:09 AM »
It is important to leave tissue beneath the nipples to prevent cave in.   In all men,the only tissue directly under the nipples is breast tissue.  Therefore, an appropriate layer of breast tissue must be preserved in order to prevent contour problems.

Bear in mind, it is only the excess tissue on the chest that produces gynecomastia.  And the standard gyne surgery is not a cancer operation, in which every cell of breast tissue must be removed.  Breast tissue, in normal amounts, does not constitute gyne.

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: Doctor wants to leave a little tissue behind....did yours?
« Reply #6 on: December 06, 2008, 06:16:34 AM »
Thanks much to all, this has helped ease some thoughts now.

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Offline user87

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Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #7 on: December 10, 2008, 10:45:47 AM »
If you remove ALL of the gland, will you definitely create a crater deformity? or is it possible to have the nipples flat although all of the gland was removed?

Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #8 on: December 10, 2008, 01:16:03 PM »
It is possible, in some cases in which the patient is slender, to remove most of the breast tissue beneath the areola, but you must still leave some breast tissue or risk a crater or depression of the areola.

Please understand, gyne is the presence of excess tissue.  Leaving a bit of normal breast tissue to support the areola is just fine.  Remember, this is not a breast cancer operation, in which you really want to remove as much breast tissue as possible.

Dr Jacobs

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Offline user87

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Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #9 on: December 10, 2008, 02:55:00 PM »
ok .. very interesting
thx

EDIT:
Is tissue that you can squeeze "normal breast tissue"?? Or shouldn't there be anything left that you can squeeze or "play with" anymore?

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DrBermant

Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #10 on: December 10, 2008, 03:38:20 PM »
If you remove ALL of the gland, will you definitely create a crater deformity? or is it possible to have the nipples flat although all of the gland was removed?

No surgery can remove all of the gland.  However, gland left behind does compress like gland, not fat.  I have seen many patients from other doctors unhappy with this remaining gland that does not look natural in motion or when the areola muscle is relaxed.  Here are just a few of the many examples I have seen and treated:

Revision Gynecomastia After Failed Liposuction By Other Surgeon

Revision Puffy Nipple Gynecomastia After Failed Liposuction By Other Surgeon

Revision Gynecomastia After Liposuction and Partial Gland Excision By Other Surgeon.

That is why I prefer to target the gland first with my Dynamic Technique Gynecomastia Surgery.  My Fat Flap Sculpture then can be used to support the areola with tissue that moves like surrounding fat.  Yes, there are many more examples of this technique on my website.  Gland targeted first and almost all removed, the surrounding fat replacing that gland.  I have never seen a crater deformity from my sculpture. 

The fat moves like fat, feels like fat, and when the areola muscle relaxes, a more natural look.  The gynecomastia contour soulution is not just one that looks good on a single view photograph, but one that looks male playing volleyball, at the beach, and when the areola is relaxed.

Hope this helps,

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

Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #11 on: January 20, 2009, 08:16:32 AM »
so the crater is caused by taking the gland out and leaving a hole in the layer of fat?  So if the person has very low bodyfat then there should not be much of a crater there??

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DrBermant

Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #12 on: January 20, 2009, 09:02:36 AM »
so the crater is caused by taking the gland out and leaving a hole in the layer of fat?  So if the person has very low bodyfat then there should not be much of a crater there??

Removing all the gland typically results in the skin of the nipple healing against the muscle.  With very low body fat, the crater walls will be thinner, but on animation the tissue sticks.  Having a little fat between the nipple skin and muscle provides a natural layer of lubrication for tissue movement.  Check out this Video of A Gynecomastia Surgery Crater Deformity Defect Scar.

I work with many Bodybuilders with Gynecomastia and others with very low body fat.  I do target the gland first removing just about all of the gland, and then use the nearby tissue as a Fat Flap to contour the chest.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

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Offline jc71

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Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #13 on: January 21, 2009, 10:40:28 PM »
don't be too judgmental after surgery. No surgeon will get it absolutely perfect. My surgeon left a little more in my left side than my right. When I really look at it, I can tell, but very few people will notice with a casual look.....and besides, it beats living with big fat moobs

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Offline Grandpa Bambu

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Re: Doctor wants to leave a little tissue behind....did yours?
« Reply #14 on: January 21, 2009, 10:54:38 PM »
Please understand, gyne is the presence of excess tissue.  Leaving a bit of normal breast tissue to support the areola is just fine.


The following definition is from the Merriam-Webster online dictionary...


Main Entry:
    gy·neco·mas·tia
Pronunciation:
    \ˌgī-nə-kō-ˈmas-tē-ə\
Function:
    noun
Etymology:
    New Latin, from gynec- + Greek mastos breast + New Latin -ia
Date:
    1881

: excessive development of the breast in the male



Both males and females have glandular tissue. However, as Dr. Elliot metioned, male gland only becomes an issue when it's 'excessive'.  ;)

GB
Surgery: February 16, 2005. - Toronto, Ontario Canada.
Surgeon: Dr. John Craig Fielding   M.D.   F.R.C.S. (C) (416.766.8890)
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