Author Topic: Help! Gyno Sufferer! Please reply, DR BERMANT!  (Read 14392 times)

Offline Chazzathekid15

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Help! Gyno Sufferer! Please reply, DR BERMANT!
« on: September 20, 2011, 01:04:41 PM »
Hi,

When I began puberty at age 13 I developed a hormone imbalance. I was never fat, but I wasn't slim either. I developed a strange shaped chest, and as I lost weight my chest remained in its state: i basically had man boobs at thirteen years old- I did loads of exercise, i had a healthy diet and there was nothing i could do about it. So I became depressed and stopped playing sports, wearing T-shirts- to hide my secret. I was so young and confused I couldn't understand why I didn't look like all my friends. I started to get fatter, not really fat but podgy. My chest got bigger and bigger- and one day my mum told me if I wanted to see a doctor about it. So I did. I was told I suffered from Gynecomastia, and as it hadn't gone away for a few years it would be likely it would never go away. So I took the surgeons advice and had the surgery. The day I walked out wearing the padding round my chest I was the most happiest I'd been in years, I finally felt like all my friends- and nobody stared at me on the train ride home. I felt normal. Two years later, I have an inverted nipple and a heavily protruding one. I have quite bad scars which show in sunlight but not so much in unnatural light. There is a dip underneath my inverted nipple, and a huge round ball underneath my right protruding one. Now, I still don't play sports or wear t-shirts- I know it is a psychological thing and I don't want to be seen as ungrateful or self-indulgent, but to someone who has suffered from a hormone imbalance, experienced stares and comments, bullying and extreme insecurity- all I want is to take off my top and go swimming for hours in a pool. All I want to do is to take my top off in the summer heat and read a book on the grass. But I can't. I don't want to see the operation as one of the biggest regrets of my life. But aesthetically my nipples look dreadful.

I went to see my surgeon a few months back, and he said revision could simply exacerbate the problem. He said that my gynecomastia has been taken away and replaced with a much less obvious problem. I am planning to have my scars removed (if i can), and am planning on getting below 10% body fat and building lean muscle on my chest to try to decrease the puffy nipple and fill the dip under my left nipple (if i can). I am very sceptical it will work, but i will give it a try. I do not want to have revision surgery, no surgeon is putting a knife in me ever, EVER AGAIN! My surgeon has dismissed the idea of the ball under my nipple being scar tissue, but says may be it is a mixture of scar tissue and breast tissue left behind. Bare in mind, my right side barely drained at all. I do not blame my surgeon, the contours on my chest are fantastic and the shape of my chest is a masterpiece compared to what it was. But my nipples are such a mess. And the problem continues....

Please, if you have any advice can you help me! What can I do besides revision surgery?

Anyone thinking of having a operation to repair their chest, let me give you advice. Afterwards, your nipples will look unnatural and you will not look good with your top off, only with your top on. No matter how brilliant your surgeon is- your nipples will be far from perfect. Plus do everything you can first, lose weight, build muscle- wait years for them to go...

Please reply- I need someone to talk to about this mess.   

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #1 on: September 20, 2011, 03:19:19 PM »
Hi,

When I began puberty at age 13 I developed a hormone imbalance. I was never fat, but I wasn't slim either. I developed a strange shaped chest, and as I lost weight my chest remained in its state: i basically had man boobs at thirteen years old- I did loads of exercise, i had a healthy diet and there was nothing i could do about it. So I became depressed and stopped playing sports, wearing T-shirts- to hide my secret. I was so young and confused I couldn't understand why I didn't look like all my friends. I started to get fatter, not really fat but podgy. My chest got bigger and bigger- and one day my mum told me if I wanted to see a doctor about it. So I did. I was told I suffered from Gynecomastia, and as it hadn't gone away for a few years it would be likely it would never go away. So I took the surgeons advice and had the surgery. The day I walked out wearing the padding round my chest I was the most happiest I'd been in years, I finally felt like all my friends- and nobody stared at me on the train ride home. I felt normal. Two years later, I have an inverted nipple and a heavily protruding one. I have quite bad scars which show in sunlight but not so much in unnatural light. There is a dip underneath my inverted nipple, and a huge round ball underneath my right protruding one. Now, I still don't play sports or wear t-shirts- I know it is a psychological thing and I don't want to be seen as ungrateful or self-indulgent, but to someone who has suffered from a hormone imbalance, experienced stares and comments, bullying and extreme insecurity- all I want is to take off my top and go swimming for hours in a pool. All I want to do is to take my top off in the summer heat and read a book on the grass. But I can't. I don't want to see the operation as one of the biggest regrets of my life. But aesthetically my nipples look dreadful.

I went to see my surgeon a few months back, and he said revision could simply exacerbate the problem. He said that my gynecomastia has been taken away and replaced with a much less obvious problem. I am planning to have my scars removed (if i can), and am planning on getting below 10% body fat and building lean muscle on my chest to try to decrease the puffy nipple and fill the dip under my left nipple (if i can). I am very sceptical it will work, but i will give it a try. I do not want to have revision surgery, no surgeon is putting a knife in me ever, EVER AGAIN! My surgeon has dismissed the idea of the ball under my nipple being scar tissue, but says may be it is a mixture of scar tissue and breast tissue left behind. Bare in mind, my right side barely drained at all. I do not blame my surgeon, the contours on my chest are fantastic and the shape of my chest is a masterpiece compared to what it was. But my nipples are such a mess. And the problem continues....

Please, if you have any advice can you help me! What can I do besides revision surgery?

Anyone thinking of having a operation to repair their chest, let me give you advice. Afterwards, your nipples will look unnatural and you will not look good with your top off, only with your top on. No matter how brilliant your surgeon is- your nipples will be far from perfect. Plus do everything you can first, lose weight, build muscle- wait years for them to go...

Please reply- I need someone to talk to about this mess.   
This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon.

Welcome to our forum. This is the place for discussion and to talk about issues such as you describe. Why not consider posting Standard Pictures for Revision Gynecomastia so others can better understand your concerns. The flexing and arms up overhead views are particularly good for demonstrating both the Puffy Nipple Complication and Male Inverted Nipple which can be a small variant of the Crater Deformity. Here is a forum discussion about Inverted Nipple Crater Complication.

Options depends on the original problem, what was done, after surgery care, and many other factors. Sorry to disagree about having the surgery. The results seen on my pages were typical for my patients. The goal was to look better with their shirts off, living life forgetting about their prior contour issues. There can be a great deal of Emotion Living with Gynecomastia. That is what I tried to document both graphically and the emotional component with videos.

If there is a contour problem shown on the standard views, then you may have surgical options (with a surgeon who can demonstrate mastery of such deformities). If the surgeon says that revision in his / her hands would be worse, then pushing for surgery is not a good idea with that surgeon. There are some limitations as to what real surgery can offer. However, that is the purpose of putting many examples up on my website. So that patients could have an idea of what my skills and limitations were.

Hope this helps,

Michael Bermant, MD
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Offline Chazzathekid15

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #2 on: October 14, 2011, 04:07:03 AM »
Hi, I don't disagree with not having the surgery. But I was immature and only 14 and completely relied on the surgeon without fully understanding the seriousness of the operation.

The contours on my chest are fine, in fact they are normal.

My nipples however are a mess- my left side is inverted Grade 2. Whereas my right side is puffy enough to be seen as a circular lump beneath a t-shirt. Behind my right nipple I have a round ball of fluid, or a seroma or something.

Can I correct my left nipple with with NIPLETTE?

Can I reduce my puffy nipple by getting under 10% body fat and building muscle, or massaging or using heat etc.?

Can I get my scars removed and how effective will it be?

Please help Doctor Bermant.

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #3 on: October 14, 2011, 01:39:54 PM »
Hi, I don't disagree with not having the surgery. But I was immature and only 14 and completely relied on the surgeon without fully understanding the seriousness of the operation.

The contours on my chest are fine, in fact they are normal.

My nipples however are a mess- my left side is inverted Grade 2. Whereas my right side is puffy enough to be seen as a circular lump beneath a t-shirt. Behind my right nipple I have a round ball of fluid, or a seroma or something.

Can I correct my left nipple with with NIPLETTE?

Can I reduce my puffy nipple by getting under 10% body fat and building muscle, or massaging or using heat etc.?

Can I get my scars removed and how effective will it be?

Please help Doctor Bermant.

This should not be construed as medical advice. I am a retired Board Certified Plastic Surgeon and can only offer general issue discussion, not specific medical advice nor intervention.

Options will depend on the actual problem. When I was in practice, I would prefer to evaluate the specifics of the problem before offering specific recommendations for my patients. This would be an extensive exploration of risks benefits and alternative methods of care. That is critical for any good surgery. Such a discussion began for my patients on my web site, continued on the phone and or in the office before considering elective intervention.

In general, lowering global fat will not improve a Puffy Nipple Complication. You cannot target where the fat comes from. If someone was able to decrease the chest fat, remaining gland scar tissue probably would become more prominent. Lowering body fat can decrease the walls of a Crater Deformity but the animation scar still looks terrible (how tissue moves with activities.)

I did discuss Nipplettes with my inverted nipple patients, but never found anyone who was able to tell me that they worked for scars. I did have some who told me that they got a small amount of help.  Practically speaking, those who had successful intervention by such mechanical treatment would not come to see me.

Scars cannot be erased. They are replaced by new scars. That is why it is so critical to understand any surgeon's skills with revision surgery before embarking on such an adventure.

Standard Revision Gynecomastia Pictures are one way to start defining the problems. I was able to diagnose many problems with such photos before seeing my patients. However, the best evaluation was with my hands on clinical exam.

Hope this helps,

Michael Bermant, MD
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Offline Chazzathekid15

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #4 on: November 13, 2011, 05:13:58 PM »
Hi

What happens to gland or scar tissue when muscle is enlarged around it?

Revision surgery is a no for me, but the gland seems to be completely inside my nipple. What does that mean?

Do surgeons ever remove muscles when performing gyno surgery?

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #5 on: November 14, 2011, 12:50:01 PM »
Hi

What happens to gland or scar tissue when muscle is enlarged around it?

Revision surgery is a no for me, but the gland seems to be completely inside my nipple. What does that mean?

Do surgeons ever remove muscles when performing gyno surgery?

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

I worked with many Bodybuilders with Gynecomastia over the years. Most complained as they built up muscle, what sits on top of the muscle just got pushed further out. This would include both gland, scar tissue, and fat, all deforming components of a cut look contour.

Surgeons do not normally remove muscle. However, I have seen disasters when surgeons removed / injured chest muscle by mistake. Here is one such example of a Failed Revision Crater Deformity After Bad Gynecomastia Surgery Done in New York and New Jersey.. The muscle injury happened after the first surgery in New Jersey.

Some forms of Puffy Nipple Gynecomastia can have the gland inside the nipple itself. This is also one variation of the Puffy Nipple Complication after poor surgery that fails to address the gland component.


Hope this helps,

Michael Bermant, MD
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Offline Chazzathekid15

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #6 on: June 26, 2012, 06:45:58 AM »
I'm thinking about opting for revision surgery. My Surgeon said that behind my puffy nipple (on the right side), there is a mixture of gland that was left and scar tissue. Will he be able to remove the scar tissue without scar tissue coming back? My aim is to make the nipple flat and normal. However if there is a large risk that by removing the scar tissue underneath the nipple there will be a crater deformity then of course I will just have to live with it.

I am willing to send pictures of both my nipples if you'd be willing to give your opinion. Is there any way I can do this privately?

 

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #7 on: June 26, 2012, 08:19:26 AM »
I'm thinking about opting for revision surgery. My Surgeon said that behind my puffy nipple (on the right side), there is a mixture of gland that was left and scar tissue. Will he be able to remove the scar tissue without scar tissue coming back? My aim is to make the nipple flat and normal. However if there is a large risk that by removing the scar tissue underneath the nipple there will be a crater deformity then of course I will just have to live with it.

I am willing to send pictures of both my nipples if you'd be willing to give your opinion. Is there any way I can do this privately?

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

All surgery and injury of significant degree results in scars. That is how the body heals itself. The art behind the surgery goes into a careful documentation of the degree of scars and just how good the surgery really is. For that I evolved my Standard Pictures for Revision Gynecomastia to look at both contours and scarring. Scars just tend not to move as well. Even more critical are the Standard Gynecomastia Videos. Both were developed to analyze patient problems before traveling from around the world to see me in Virginia such that surgery could be done the next day on a reliable basis. If someone has a method to improve a problem, critical documentation is the best way to prove it.

Just how much scarring after surgery depends on the original problem, what was done in the past, what needs to be done, surgeon's skills, surgical technique, Scar Care, After Surgery Compression Garments and many other factors I tried to optimize based on my review of the critical documentation of my work. That is what led us to move to require both Stage One Gynecomastia Garments and Stage Two Garments for our patients. The Stage 2 were elective until those using the stage 2 were doing better than those who did not. But that is part of the passion of a doctor pushing the envelope to do better and better each time.

That is part of the method behind my posting resources like How to Evaluate Gynecomastia Pictures to see just what someone claims to have achieved.

When I was in practice, I did offer confidential opinions for my patients. Sorry, as a retired Plastic Surgeon I no longer can offer that privacy. I do however, share my experience publicly here in this forum on general issues, as you can see in the many posts. Pictures can be put here on the forum publicly for all to see and for those with a passion to offer their opinions to comment. That is what this site was designed to offer, a place to share concerns and knowledge.

Hope this helps,

Michael Bermant, MD
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Offline Chazzathekid15

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #8 on: July 05, 2012, 11:30:14 AM »
Thank you. But can scar tissue be removed without more scar tissue replacing it? The scar tissue is pushing my nipple outwards and I want it to be flat. Thanks

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #9 on: July 05, 2012, 11:48:31 AM »
Thank you. But can scar tissue be removed without more scar tissue replacing it? The scar tissue is pushing my nipple outwards and I want it to be flat. Thanks

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

The body heals itself with a scar. The trick is to optimize such scarring as much as possible such as I did with my patients and their Scar Care. However, that is always not the only factor. Some individuals tend to form bad scars such as Keloids or Hypertropic Scars. When I saw such scarring on an individual with subtle gynecomastia, I usually recommended against surgery as the risk of scarring was too great for that individual to offer surgery, in my opinion. There are limitations of what surgery can offer, and that is what I tried to do for my patients. Help them the best optimized scarring for what their bodies could offer. No surgeon can offer surgery without scars. I worked hard to get as close as I could with the critical documentation to look evaluate problems and results. 

Just what options are available depend on many factors already discussed. When I was in practice, I would look at each of these issues before considering offering surgery or revision surgery.

Hope this helps,

Michael Bermant, MD
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Offline Chazzathekid15

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #10 on: July 06, 2012, 12:15:41 PM »
Sorry but I feel like your replies are automated...could you please say, from your experience, whether scar tissue can be removed from underneath the nipple successfully without more scar tissue forming afterwards or a crater forming? Thanks for the help.

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #11 on: July 06, 2012, 12:47:22 PM »
Sorry but I feel like your replies are automated...could you please say, from your experience, whether scar tissue can be removed from underneath the nipple successfully without more scar tissue forming afterwards or a crater forming? Thanks for the help.

No answers were automated.

All wounds heal with a scar, the range of scar varies as stated depending on the problem, the patient, the skill of the surgeon, after care, and all of the other factors I have already explained.  Scars seen on my website were typical for my sculpture. You can hide the degree of scarring by limiting views a patient is permitted to see. Other degrees of scarring are only best documented by clinical exam. There is no such thing as scarless surgery.

Michael Bermant, MD
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Offline Chazzathekid15

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Re: Help! Gyno Sufferer! Please reply, DR BERMANT!
« Reply #12 on: July 15, 2012, 07:06:08 PM »
okay thank you. I'm curious to know if I were to lose body fat so I would have no fat on my chest, would the scar tissue that is replacing the removed gland remain, or will it go away with the fat? For example; if I had no fat on my chest, would the hard lumpy scar tissue still remain under the nipple in front of the muscle?