Author Topic: Small Gland  (Read 11965 times)

Offline ElGringo

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Small Gland
« on: August 10, 2011, 10:50:54 PM »
Hi Dr. Bermant,

I am 20 years old and have had puffy nipples for about 6 years now.
A few weeks ago I decided to ask a plastic surgeon about my gynecomastia and he said he thinks the gland is too small to be surgically removed. He also said that there was the possibility of leaving a crater deformity if the gland was removed.

I am very skinny; 6'1, 143 pounds and exercise regularly so I must have a low body fat percentage.
My glands are very small indeed. So small that they do not create a lump in the chest, but still big enough to make my nipples puffy.

Have you ever worked with patients with similar conditions?
I heard once that removing the gland alone should leave a natural look on my chest since I have a low body fat percentage. Based on your experience, is that true? Or is your fat flaps technique usually required in these cases?

Your help is very much appreciated,
Thanks in advance,
ElGringo

Offline DrBermant

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Gynecomastia Forum - Re: Small Gland
« Reply #1 on: August 10, 2011, 11:46:29 PM »
Hi Dr. Bermant,

I am 20 years old and have had puffy nipples for about 6 years now.
A few weeks ago I decided to ask a plastic surgeon about my gynecomastia and he said he thinks the gland is too small to be surgically removed. He also said that there was the possibility of leaving a crater deformity if the gland was removed.

I am very skinny; 6'1, 143 pounds and exercise regularly so I must have a low body fat percentage.
My glands are very small indeed. So small that they do not create a lump in the chest, but still big enough to make my nipples puffy.

Have you ever worked with patients with similar conditions?
I heard once that removing the gland alone should leave a natural look on my chest since I have a low body fat percentage. Based on your experience, is that true? Or is your fat flaps technique usually required in these cases?

Your help is very much appreciated,
Thanks in advance,
ElGringo

I have worked with many Bodybuilders with Gynecomastia that have very low body fat and small gland. It does not take much to ruin the cut shape of the male chest.

Puffy Nipple Gynecomastia is its own unique problem and sculpture. Each surgeon has his / her own skills and techniques. Yes you are right, excision of the gland alone can create a Crater Deformity Defect and looks terrible. I have operated on many men with tiny glands and you can see a small subset of them in this Gland of Gynecomastia Gallery. Each picture links to the cases they were taken from to better understand that individual. The other option is to go to my Puffy Nipple Gallery to start with the many forms that puffy nips take, go to that patient's pages and then and look at the gland that I removed. My format has been to document the gland removed at the end of the operation by placing it on the chest to see how close the removed gland approximated my before surgery marking / estimate.

I evolved my Dynamic Technique to target the gland first and then use the remaining fat as a potential resource to enable me to remove more of that firm structure that does not look good when flexing the chest muscles. Doctors who avoid showing a careful documentation of the problem and surgical solution can hide defects revealed with my Standard Gynecomastia Pictures or even more critical my Standard Gynecomastia Videos. Fat Flaps are but one of many tools I bring to the operating room to contour each patient. When most of the deformity is gland and little fat, I am more likely to have needed these flaps to get my results.

If your doctor felt uncomfortable with such a problem, then he may not have know how to deal with that problem. I also have seen many unhappy patients who had a surgeon who targeted fat first leaving another contour problem: the Puffy Nipple Complication. That is why it is so critical when Picking your Gynecomastia Surgeon to look at actual before and after pictures on how they manage that particular variation of gynecomastia.

Welcome to our forum. Why not consider posting your pictures here so that others can better understand your concerns.

Hope this helps,

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

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Re: Small Gland
« Reply #2 on: August 11, 2011, 10:35:00 PM »
Thanks for your reply Dr. Bermant!
I will post pictures of my condition soon.

I face 2 problems:
1) I live outside the U.S. and where I live there are no gynecomastia specialists.
2) Although I would consider flying to the U.S. to have the surgery done, I still rely on my parent's income and they disagree with me having surgery done outside the country since it's cheaper here. Which basically takes me back to problem number 1.

I could spare some money but still the average price for the surgery in the U.S. ($6000) exceeds my budget.

I wish there were more surgeons like you Dr. Bermant. I really admire your dedication to a problem that affects so many of us.
Thanks for your help!
ElGringo

Offline DrBermant

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Re: Small Gland
« Reply #3 on: August 14, 2011, 09:26:23 AM »
Thanks for your reply Dr. Bermant!
I will post pictures of my condition soon.

I face 2 problems:
1) I live outside the U.S. and where I live there are no gynecomastia specialists.
2) Although I would consider flying to the U.S. to have the surgery done, I still rely on my parent's income and they disagree with me having surgery done outside the country since it's cheaper here. Which basically takes me back to problem number 1.

I could spare some money but still the average price for the surgery in the U.S. ($6000) exceeds my budget.

I wish there were more surgeons like you Dr. Bermant. I really admire your dedication to a problem that affects so many of us.
Thanks for your help!
ElGringo

Perhaps that is why I saw so many Gynecomastia Patients from the United Kingdom and around the world who preferred what I offered. It actually can cost less traveling to an expert than needing much more expensive Revision Gynecomastia Surgery.

Many of my patients needing stabilization of their problem or time to save money told me that Body Shaping Garments provided a great temporary contour option to feel comfortable until they were ready for surgery.

You are quite welcome! Thank you for your kind words. It has been a lifetime of passion. We look forward to your photos.

Hope this helps,

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

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Re: Small Gland
« Reply #4 on: August 28, 2011, 08:12:16 PM »
Sorry it took me so long to get the pictures. I thought the more pictures the better.

Here they are:



Pectoral muscles flexed:


Arms lifted up:


Right nipple:








Left nipple:








I hope these pictures can give you an idea of my condition.

Thanks for your replys Dr. Bermant, your help is very much appreciated!
ElGringo

Offline DrBermant

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Re: Small Gland
« Reply #5 on: August 28, 2011, 08:34:54 PM »
Sorry it took me so long to get the pictures. I thought the more pictures the better.

I hope these pictures can give you an idea of my condition.

Thanks for your replys Dr. Bermant, your help is very much appreciated!
ElGringo

Yes, very nicely done. The pictures are a classic case of Puffy Nipple Gynecomastia. The Anatomy of Puffy Nipple Gynecomastia will consist of gland, fat, and skin.

Seeing examples of your surgeon's expertise with this variation is critical to understand what risks you are taking with that surgeon's operation.

Actually too many pictures can obscure the facts of the contour which is why I limited my normal Standard Gynecomastia Pictures to fewer views.

Hope this helps,

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

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Re: Small Gland
« Reply #6 on: September 02, 2011, 07:49:48 PM »
Dr. Bermant,
I think I might just go for it with the plastic surgeon in my country. I have come to the conclusion that the possibility of leaving a crater deformity is better than living with my condition. There is simply no way for me to afford a specialist in this matter and the psychological impact that this problem is having on me is just unbearable. At least my nipples will no longer be puffy and I wont have to arch my back so it won't show through my shirt.. and I would rather explain my friends I had a "ball of mass" removed from my chest and therefore the crater than explaining why my nipples are puffy. I go to the beach a lot and I always have to come up with an excuse to be the last to get in the water so I can apply sunblock in peace while nobody is watching me. I am always the one with the shirt on even if it is the hottest day of the year. I pinch my nipples for minutes before I take my shirt off, etc. This problem has grown to the point where I am completely embarrassed of showing my chest. Not the usual problem of a person who surfs at least once a week.

Based on cases similar as mine, what do you think is the possibility of leaving a crater deformity after targeting gland first?
Do you think it's too risky?

I understand that you can't make conclusions out of pictures, but since you are the most experienced person I know in this field, I give great value to your opinion.

Thanks in advance,
ElGringo

Offline DrBermant

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Re: Small Gland
« Reply #7 on: September 20, 2011, 03:58:41 PM »
Dr. Bermant,
I think I might just go for it with the plastic surgeon in my country. I have come to the conclusion that the possibility of leaving a crater deformity is better than living with my condition. There is simply no way for me to afford a specialist in this matter and the psychological impact that this problem is having on me is just unbearable. At least my nipples will no longer be puffy and I wont have to arch my back so it won't show through my shirt.. and I would rather explain my friends I had a "ball of mass" removed from my chest and therefore the crater than explaining why my nipples are puffy. I go to the beach a lot and I always have to come up with an excuse to be the last to get in the water so I can apply sunblock in peace while nobody is watching me. I am always the one with the shirt on even if it is the hottest day of the year. I pinch my nipples for minutes before I take my shirt off, etc. This problem has grown to the point where I am completely embarrassed of showing my chest. Not the usual problem of a person who surfs at least once a week.

Based on cases similar as mine, what do you think is the possibility of leaving a crater deformity after targeting gland first?
Do you think it's too risky?

I understand that you can't make conclusions out of pictures, but since you are the most experienced person I know in this field, I give great value to your opinion.

Thanks in advance,
ElGringo

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

I have already posted How to Pick a Gynecomastia Surgeon. In my hands I preferred my Dynamic Technique where I targeted the gland first to optimize the dynamic results. What I put on my website was typical for my patients' results in my hands.

However, you cannot use my results or my methods to evaluate another doctor's skills. You need to understand what that surgeon's skills are before risking a terrible Crater Deformity or some other defect.

Hope this helps,

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