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,
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, MDLearn More About Gynecomastia and Male Breast Reduction