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Gynecomastia removal (complete or leave a little bit for nipple structural integrity)?

Hi, I'm looking to get gyno done. One of the doctors I spoke with mentioned that he completely removes the gland and the other mentioned that he leaves some under the nipple to ensure it doesn't collapse. I have very mild gyno and I want to make sure it doesn't come back if I use Propeia or another medication that can stimulate growth. Not sure which doctor to go with? Any advice ??

Doctor Answers 7

Gynecomastia Removal and Nipple Integrity?

August 2nd, 2016
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Without photos it isn't exactly clear what your situation is, but it sounds like you only have a modest amount of true gynecomastia or glandular breast tissue. This tissue lies below the nipple and is in direct contact with nipple and surrounding areola. When removing the gland it is not possible to completely remove every last bit of glandular tissue because it would result in excessive thinning of the tissue which would likely lead to necrosis or death of the overlying nipple and areola. Depending upon the amount of glandular tissue removed there will be an open space left behind after the tissue is excised. This space must be filled in by mobilizing some of the surrounding tissues into the space, otherwise you will end up with a depression under your nipple and areola. The bottom line is, is that it is not possible to remove all the glandular tissue without risk of creating other problems, so there will always be some small risk of recurrence.
Braden C. Stridde, MD
August 2nd, 2016

Gynecomastia Removal and Nipple Integrity?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Without photos it isn't exactly clear what your situation is, but it sounds like you only have a modest amount of true gynecomastia or glandular breast tissue. This tissue lies below the nipple and is in direct contact with nipple and surrounding areola. When removing the gland it is not possible to completely remove every last bit of glandular tissue because it would result in excessive thinning of the tissue which would likely lead to necrosis or death of the overlying nipple and areola. Depending upon the amount of glandular tissue removed there will be an open space left behind after the tissue is excised. This space must be filled in by mobilizing some of the surrounding tissues into the space, otherwise you will end up with a depression under your nipple and areola. The bottom line is, is that it is not possible to remove all the glandular tissue without risk of creating other problems, so there will always be some small risk of recurrence.
Braden C. Stridde, MD

Gynecomastia removal (complete or leave a little bit for nipple structural integrity)?

August 13th, 2016
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Thank you for the question. It is important, in my opinion, to NOT  remove all of the glandular tissue;  a few millimeters of glandular tissue left intact below the nipples/areola complexes will help prevent contour depressions ( "saucer deformities").   Ultimately, careful selection of your plastic surgeon will be key. Best wishes.

Web reference: http://www.poustiplasticsurgery.com/Procedures/Procedure_gynecomastia.htm

Tom J. Pousti, MD, FACS
August 13th, 2016

Gynecomastia removal (complete or leave a little bit for nipple structural integrity)?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thank you for the question. It is important, in my opinion, to NOT  remove all of the glandular tissue;  a few millimeters of glandular tissue left intact below the nipples/areola complexes will help prevent contour depressions ( "saucer deformities").   Ultimately, careful selection of your plastic surgeon will be key. Best wishes.

Learn more: http://www.poustiplasticsurgery.com/Procedures/Procedure_gynecomastia.htm

Tom J. Pousti, MD, FACS

About Gynecomastia Surgical Techniques

August 12th, 2016
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Several common factors can cause gynecomastia including excessive levels of #estrogen, natural #hormone changes, use of recreational drugs or alcohol, medications and their associated side effects, and, various health conditions. Also, there are different types of #gynecomastia.
There are three types of surgical #treatment #options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you. The excision technique is used on cases of #gynecomastia where excess skin and glandular breast tissue must be removed and the areola or nipple needs reduction and repositioning to create a natural looking appearance. The incision patterns are determined by the specific condition of the patient. The doctor will recommend this procedure which combines the liposuction technique and excision technique to create a natural look. Patients are given specific instructions for the recovery period. Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

Web reference: http://www.pacificcenterplasticsurgery.com/for-men-procedures-newport-beach/gynecomastia/

Jed H. Horowitz, MD, FACS
August 12th, 2016

About Gynecomastia Surgical Techniques

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Several common factors can cause gynecomastia including excessive levels of #estrogen, natural #hormone changes, use of recreational drugs or alcohol, medications and their associated side effects, and, various health conditions. Also, there are different types of #gynecomastia.
There are three types of surgical #treatment #options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you. The excision technique is used on cases of #gynecomastia where excess skin and glandular breast tissue must be removed and the areola or nipple needs reduction and repositioning to create a natural looking appearance. The incision patterns are determined by the specific condition of the patient. The doctor will recommend this procedure which combines the liposuction technique and excision technique to create a natural look. Patients are given specific instructions for the recovery period. Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

Learn more: http://www.pacificcenterplasticsurgery.com/for-men-procedures-newport-beach/gynecomastia/

Jed H. Horowitz, MD, FACS

Gynecomastia removal

August 2nd, 2016
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It is always better to leave a little tissue under the nipple areolar complex during gynecomastia surgery, so there is not a contour depression in this area.
Malcolm A. Lesavoy, MD
August 2nd, 2016

Gynecomastia removal

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It is always better to leave a little tissue under the nipple areolar complex during gynecomastia surgery, so there is not a contour depression in this area.
Malcolm A. Lesavoy, MD

Gynecomastia correction

August 2nd, 2016
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Hello,  thank you for your question.   Correction of gynecomastia should leave some breast tissue under te nipple/areola complex in order the have natural outcome.  Removing all breast tissue under the nipple will only create distortion to the area and should avoided.  Have a great day. 
Derby Sang Caputo, MD
August 2nd, 2016

Gynecomastia correction

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Hello,  thank you for your question.   Correction of gynecomastia should leave some breast tissue under te nipple/areola complex in order the have natural outcome.  Removing all breast tissue under the nipple will only create distortion to the area and should avoided.  Have a great day. 
Derby Sang Caputo, MD

Need of an expert in gynecomastia surgert

August 2nd, 2016
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How should I choose a surgeon?
Choose carefully. The decision is yours. Advice to assist in making your selection.Only a board certified plastic surgeon
1. Experience matters. Choosing a surgeon increases the likelihood that they have seen a case similar to yours in the past. Selecting a surgeon whose practice is focused on gynecomastia exclusively is also an indicator of experience.
2. Results matter. The more before-and-after pictures, the better. Pay attention whether the surgeon is confident enough to show multiple angles of the same patient.
3.Only gynecomastia Reviews matter.
4. Expertise matters. Is your surgeon recognized by the profession as an authority in the field? Have they authored books or medical journal articles regarding your surgery?
Be realistic about your expectations. Also, revision surgery tends to be significantly more difficult than initial surgery.So be extremely careful choosing the right Plastic Surgeon at the beginning.

Web reference: http://www.gynecomastia-md.com

Mordcai Blau, MD
August 2nd, 2016

Need of an expert in gynecomastia surgert

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

How should I choose a surgeon?
Choose carefully. The decision is yours. Advice to assist in making your selection.Only a board certified plastic surgeon
1. Experience matters. Choosing a surgeon increases the likelihood that they have seen a case similar to yours in the past. Selecting a surgeon whose practice is focused on gynecomastia exclusively is also an indicator of experience.
2. Results matter. The more before-and-after pictures, the better. Pay attention whether the surgeon is confident enough to show multiple angles of the same patient.
3.Only gynecomastia Reviews matter.
4. Expertise matters. Is your surgeon recognized by the profession as an authority in the field? Have they authored books or medical journal articles regarding your surgery?
Be realistic about your expectations. Also, revision surgery tends to be significantly more difficult than initial surgery.So be extremely careful choosing the right Plastic Surgeon at the beginning.

Learn more: http://www.gynecomastia-md.com

Mordcai Blau, MD

Gynecomastia

August 2nd, 2016
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It is important to leave a small cuff of tissue behind the areola to prevent depression contour deformity. Seek a specialist in your area
Stuart A. Linder, MD, FACS
August 2nd, 2016

Gynecomastia

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
It is important to leave a small cuff of tissue behind the areola to prevent depression contour deformity. Seek a specialist in your area
Stuart A. Linder, MD, FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.