Author Topic: Puffy Nipple Forum - Gynecomastia Stress Distracting Osteopathic Medical Studies  (Read 28222 times)

Offline DrBermant

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So there were only two gynecomastia accredited experts in the United States you, Dr. Bermant, and Dr. -. Now since you have retired there is only one. Congratulations on your career of helping many men with gynecomastia. Even though you retired could I still do the remote package that you offered? I saw that you were a physics major in college. I can see why your techniques are so dynamic, since physics incorporates a lot of laws and forces. I am going to be a first year osteopathic medical student, but I might not make it through because of issues with my nipples that are distracting me (my right nipple in particular). I will probably post in the abodybeautiful.com  Puffy Nipples forum.

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

Thank you for your kind words. Yes, the Physics background were my specific approach to my medical education, analysis of problems and problem solving. Seeing how tissues move and react to gravity (hang) are critical in understanding both the problem and success of solution.

My Dynamic Technique for Gynecomastia went well beyond forces and how they react. The methodology itself varied depending on the problem, what was found during surgery, and what happened afterwards. The Physics background meant I was more interested in proof: documentation for analysis instead of verbal hand waving. That is why each problem I tried to solve was broken down into contributing components and kept evolving my documentation system and surgical sculpture to keep trying to improve what I was doing throughout my career.

Sorry, being retired means I no longer offer our Preliminary Remote Package and the How to Learn More resource is evolving to reflect current reality. I do still share my knowledge and experience here on this forum and sites. 

It does not take much Puffy Nipple Gynecomastia to upset the contour of the male chest. Here is a great video about the Emotion and Stress of Living with Gynecomastia.

Body Shaping Garments are one option many of my patients told me they found powerful to control their look until their problem stabilized or timing was right for their surgery. Look at that series of pages to see the Physics background, a series of different body types showing just how effective the garments are for contour changes instead of a model without gynecomastia for sales. That was part of my method of analysis and how effective the solution especially on motion, check the Body Shaping Movies to see the bouncing and momentum factors.

You are welcome to post in our forums, that is what they were designed for, sharing concerns and experiences, venting frustrations, showing results. Use our integrated resources just below the window that change for the different forum topics. Tools at your fingertips. Contribute to the evolution of this learning experience.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction
« Last Edit: July 24, 2012, 10:53:52 AM by DrBermant »
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Offline DrBermant

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So there were only two gynecomastia accredited experts in the United States you, Dr. Bermant, and Dr. -. Now since you have retired there is only one. Congratulations on your career of helping many men with gynecomastia. Even though you retired could I still do the remote package that you offered? I saw that you were a physics major in college. I can see why your techniques are so dynamic, since physics incorporates a lot of laws and forces. I am going to be a first year osteopathic medical student, but I might not make it through because of issues with my nipples that are distracting me (my right nipple in particular). I will probably post in the abodybeautiful.com  Puffy Nipples forum.

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

Thank you for your kind words. Yes, the Physics background were my specific approach to my medical education, analysis of problems and problem solving. Seeing how tissues move and react to gravity (hang) are critical in understanding both the problem and success of solution.

My Dynamic Technique for Gynecomastia went well beyond forces and how they react. The methodology itself varied depending on the problem, what was found during surgery, and what happened afterwards. The Physics background meant I was more interested in proof: documentation for analysis instead of verbal hand waving. That is why each problem I tried to solve was broken down into contributing components and kept evolving my documentation system and surgical sculpture to keep trying to improve what I was doing throughout my career.

Sorry, being retired means I no longer offer our Preliminary Remote Package and the How to Learn More resource is evolving to reflect current reality. I do still share my knowledge and experience here on this forum and sites. 

It does not take much Puffy Nipple Gynecomastia to upset the contour of the male chest. Here is a great video about the Emotion and Stress of Living with Gynecomastia.

Body Shaping Garments are one option many of my patients told me they found powerful to control their look until their problem stabilized or timing was right for their surgery. Look at that series of pages to see the Physics background, a series of different body types showing just how effective the garments are for contour changes instead of a model without gynecomastia for sales. That was part of my method of analysis and how effective the solution especially on motion, check the Body Shaping Movies to see the bouncing and momentum factors.

You are welcome to post in our forums, that is what they were designed for, sharing concerns and experiences, venting frustrations, showing results. Use our integrated resources just below the window that change for the different forum topics. Tools at your fingertips. Contribute to the evolution of this learning experience.

Hope this helps,

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

from a note before I was retired:

Quote
Hello Dr.Bermant. I am a young man aspiring to be a physician but I have been having issues with puffy nipple gynecomastia. I have had one initial surgery to remove fat, but my right nipple was always larger than the left and the areolar skin on my right nipple was hanging over, and the actual right nipple projection was larger than the left. I had another surgery to remove some of the areolar skin from the right nipple. Then I had yet another surgery to make the actual right nipple projection smaller. I have had three surgeries total. I still feel as if the areolar skin on my right nipple is still hanging over, especially when I slouch my shoulder over. The first surgery was done by - in NJ and the other two were done by -. I am wondering if your techniques would have made my right nipple's areolar skin smaller and tighter. I wanted to fill you in on my story. Gyencomastia has affected my life drastically. I live in New Jersey, and my name is -. Maybe I could stop by one day or send you some pictures.

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

Revision surgery is another set of problems completely. Puffy Nipple Complication after Gynecomastia Surgery is a term I coined for the many patients asking for help after surgery done elsewhere. This contour problem solution particularly needs to be seen dynamically, how the tissue moves as the muscle flexes and when the arms lift overhead.

Excess Skin Reduction for Gynecomastia rarely needs to be done unless there was major weight loss. Issues from prior reductions can vary greatly from subtle problems to this Large Nipple Complication from Skin Reduction Gynecomastia.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery
« Last Edit: July 24, 2012, 10:54:48 AM by DrBermant »
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Offline daboul 2

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this is me, the guy who this post is talking about. i might post up "Revision Gynecomastia Surgery
Standard Pictures For Evaluation of Male Chest Scars and Deformity".  i could try to take the pictures myself. 

Offline daboul 2

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could i post pictures one by one using the attachments and other options future?

Offline DrBermant

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this is me, the guy who this post is talking about. i might post up "Revision Gynecomastia Surgery
Standard Pictures For Evaluation of Male Chest Scars and Deformity".  i could try to take the pictures myself.

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

Here is our resource on Standard Pictures for Revision Gynecomastia Surgery. If loose skin was a component for skin reduction, there are additional views to assess loose skin factors on Standard Pictures for Male Mastopexy.

could i post pictures one by one using the attachments and other options future?

How to Post Pictures on Forum. includes methods for self photography but being able to accurately frame the images. Not all phone cameras are the same quality. The Apple iPhone 4s camera was found to do the job quite well.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery
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Offline daboul 2

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Bermant Puffy Nipple Gallery - Before and After Pictures
« Reply #5 on: April 06, 2011, 01:35:11

Large Gland Removed Through Tiny Edge Areola Incision.

Puffy Nipples Before Surgery

Calipers Set to Before Surgery Dimensions

Calipers Set to Before Surgery Dimensions


The after surgery images are only 7 days after surgery. The steristrips are there for both wound support and areola splinting.


I have a question, so "The steristrips are there for both wound support and areola splinting." What is areola splinting? I don't know if my surgeon used steristrips.
« Last Edit: July 25, 2012, 01:52:26 AM by DrBermant »

Offline daboul 2

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Another question



What exactly was the problem here?

"A 'crease' in the areola after surgery can be from many possible issues. When there is a great deal of extra areola skin shrinking during surgery, some patients can have a temporary slight fold that resolves over time.  For my patients, I have now added some areola strapping / support with tape to help minimize that issue when it seems to develop during surgery. That way the problem never starts and we start out with a nice flat areola.  I have also seen Male Inverted Nipples from both primary gynecomastia and also as small versions of a Crater Deformity After Gynecomastia Surgery by other surgeons.  I have been able to repair such deformities with revision surgery when there are sufficient local tissue resources."

What does this "crease", and "slight fold that resolves over time" look like? Were you usually able to get your patients to have nice flat areolas? I feel like my right areola isn't nice and flat, but maybe I am over exaggerating it.

here is the link of that conversation
https://www.gynecomastia.org/smf/14/nipple-crease-post-op/msg170229/#msg170229 [nofollow]

and another link

https://www.gynecomastia.org/smf/38/nipple-crease-3-and-a-half-months-post-op/msg132999/#msg132999 [nofollow]
« Last Edit: July 30, 2012, 09:19:57 PM by daboul 2 »

Offline daboul 2

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http://www.abodybeautiful.com/forum/index.php/topic,411.msg564/topicseen.html#msg564

This guy's areola looks kind of wrinkly and folded. I mean in the after surgery pictures.
« Last Edit: July 25, 2012, 02:03:47 AM by DrBermant »

Offline DrBermant

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Bermant Puffy Nipple Gallery - Before and After Pictures
« Reply #5 on: April 06, 2011, 01:35:11

Large Gland Removed Through Tiny Edge Areola Incision.

Puffy Nipples Before Surgery

Calipers Set to Before Surgery Dimensions

Calipers Set to Before Surgery Dimensions


The after surgery images are only 7 days after surgery. The steristrips are there for both wound support and areola splinting.


I have a question, so "The steristrips are there for both wound support and areola splinting." What is areola splinting? I don't know if my surgeon used steristrips.


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

Areola splinting is a technique I evolved to help control the shape and contour of my patient's tissues early in the evolution of their healing.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction
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Offline daboul 2

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http://www.plasticsurgery4u.com/procedure_folder/male_breast/puffy_nipples_gyno.html [nofollow]

And did this guy's right nipple turn out flat? It looks like you used steristrips.
« Last Edit: July 30, 2012, 09:06:32 PM by daboul 2 »

Offline DrBermant

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Another question

What exactly was the problem here?

"A 'crease' in the areola after surgery can be from many possible issues. When there is a great deal of extra areola skin shrinking during surgery, some patients can have a temporary slight fold that resolves over time.  For my patients, I have now added some areola strapping / support with tape to help minimize that issue when it seems to develop during surgery. That way the problem never starts and we start out with a nice flat areola.  I have also seen Male Inverted Nipples from both primary gynecomastia and also as small versions of a Crater Deformity After Gynecomastia Surgery by other surgeons.  I have been able to repair such deformities with revision surgery when there are sufficient local tissue resources."

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

Taking my answers out of context without their embedded links is just not complete and not fair to the viewer trying to understand. 

Here is the original answer with the links as they were before you posted:

A 'crease' in the areola after surgery can be from many possible issues. When there is a great deal of extra areola skin shrinking during surgery, some patients can have a temporary slight fold that resolves over time.  For my patients, I have now added some areola strapping / support with tape to help minimize that issue when it seems to develop during surgery. That way the problem never starts and we start out with a nice flat areola.  I have also seen Male Inverted Nipples from both primary gynecomastia and also as small versions of a Crater Deformity After Gynecomastia Surgery by other surgeons.  I have been able to repair such deformities with revision surgery when there are sufficient local tissue resources.

Quote
What does this "crease", and "slight fold that resolves over time" look like? Were you usually able to get your patients to have nice flat areolas? I feel like my right areola isn't nice and flat, but maybe I am over exaggerating it.

How tissues evolve over time depends on the original problem, what was done and many other factors. That is why I tried to document how tissues evolved with my Standard Images to show how the tissue moved and creased on the chest. That system of documentation was the best I was able to come up with for that process. You can see variations in degree of success depending on the problem when comparing the after massive weight loss patients to the gynecomastia patients. That is also why I put up so many examples on my site, so that the limitations of what surgery offered could be demonstrated as well as how the tissue evolved after surgery. For my typical gynecomastia patient tissue evolution was like Healing After Gynecomastia Surgery. You can follow many other examples on my site.

Hope this helps,

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

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http://www.abodybeautiful.com/forum/index.php/topic,411.msg564/topicseen.html#msg564

This guy's areola looks kind of wrinkly and folded. I mean in the after surgery pictures.

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

Which pictures? Some are only the day after surgery. That set was a demonstration of how the areola skin diameter shrinks and documentation measurements, look for my standard sets to see how the tissue looks without the calipers in the way and artificial hand positions for the patient to hold the caliper for the photograph.

Hope this helps,

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

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http://www.plasticsurgery4u.com/procedure_folder/male_breast/puffy_nipples_gyno.html

And did this guy's right nipple turn out flat? It looks like you used steristrips.

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

No, I did not need steristrips for areola tissue control on that patient from what I remember. The pages show what we achieved for that individual, a nice contour. We saw patients from around the world, so many did not return for longer follow up pictures. It was so much fun when they did come back to see the changes and evolution.

Hope this helps,

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