This is the page where you can review questions and stories from patients, view the opinions of lay persons, and see answers from Dr. Bermant and other physicians. Do you want to ask a question, post an answer, or make a comment? Information E-mailed to me will be considered for posting.
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Dallas Texas Gynecomastia Revision for Specialized Cannula Liposuction Only Failure
had surgery to remove gyno several years ago. right side has what feels like scar just at the bottom of the nipple and runs sideways towards my side. there feels like a whole if you press where the nipple is. Looks bad to me. I went back several times and dr injected for the scar but no improvement. Dr - in Dallas did surgery with all lipo, no incison to remove gland , some kind of lipo he supposedly invented that has larger sharper cannual i think you call them do you think you can help? Can it all be done in one trip? What would I need to do? What might the total cost be I do have pictures he took before and can take pics now. You can see mch better when i flex. If you brag your finger down from top to bottom it will actually hang when ot get to nipple area. I hope maybe scar can just be removed and a little shaping, don't want t a lot smaller , but now it looks concave from shoulder to nipple thanks
Dr. Bermant responds:
Unfortunately, I see many patients complaining about such "special liposuction suction tools" that supposedly remove gland. I even coined a phrase Puffy Nipple Complication after Gynecomastia Surgery and wrote that page to demonstrate the deformities I have seen and treated. Liposuction does well for fat, but does not remove gland. I find it fascinating that to date, I have yet to see any of these doctors who design such tools demonstrate the gland component with analysis of the removed tissue under a microscope. Fat and gland components are readily distinguished. Firm gland actually would sink to the bottom of the liposuction canister and a simple filter would be able to demonstrate the removed tissue like I do for each of my glands removed on the chest. Instead, what I have seen during revision, are patients where a hole was dug in the fat for the remaining gland.
The quality of a sculpture is not how it looks in a limited set of still photos, but how you look while living life. Fat does not compress like gland or scar tissue. Flexing muscles pushes firm gland and scar tissue out more than the fat. My Standard After Gynecomastia Pictures and Standard Gynecomastia Videos are designed to demonstrate dynamic issues like flexing.
Cost of Gynecomastia Surgery depends on the problem to be treated. Revision Surgery is often more complex and therefore more expensive. Jane is my office manager and can better discuss typical total costs, fees, and what time we have available. She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.
We are glad to help you explore your concerns during a Preliminary Remote Discussion. To minimize travel to Virginia, most patients start with our preliminary remote discussion. With the remote, patients typically can schedule a tentative surgery that follows the day after their confirmatory in office consultation. Otherwise once seen in the office, surgery will then need to wait until the next available opening usually several weeks later.
Texas Gynecomastia Revision for Specialized Cannula Liposuction Only Failure
My name is - and I am inquiring about gynecomastia revision. My plastic surgeon performed liposuction (no excision) with a specialized cannula to remove excess fat/tissue in my chest. He said my condition was more pseudo gyne than anything else. I am 2 months post op and it is clear that he didn't get the hard breast tissue. I am including pictures of my right and left nipple and my chest. My right breast has a little more tissue than the left (a half dollar as opposed to a quarter). While I am pleased with my overall chest contour from the surgery I am displeased that my nipples appear to protrude out even more (all the fat is gone).
I don't feel confident in my plastic surgeon and I want to select a doctor that has a lot of experience with gynecomastia and the excision of tissue. I am 36 years old, 6'2", 210lbs, and in good shape and health. I live in the East Texas area so I wanted to start a dialogue through email and get some feedback on a revision before I make a consultation or selection. I also understand that I probably have more healing to do before I decide to have a 2nd procedure done. I am optimistic however, that the revision isn't necessarily a revision if the hard breast tissue wasn't excised to begin with. So hopefully I can still get good results.
Thank you so much for your time. I would appreciate any information you can give me including an appropriate time span to wait for the 2nd procedure, approximate cost if it can be established through the pictures I sent, and any other information that you see as important.
Dr. Bermant responds:
2 months is rather early to determine what the results will be like. Tissues need to heal before considering revision surgery. This can take 6 months or more depending on the damage caused by the surgeon's technique and healing. Firm healing tissues can feel like scar or residual gland. Traumatic sharp cutting cannula can also cause more tissue damage taking longer for the tissues to soften.
Liposuction can work well on fat, but does not remove gland elements. Pseudogynecomastia is a nebulous label since it is difficult to determine just what is fat vs gland by exam of the chest alone. That is why I prefer my Dynamic Technique to target the gland component first.
We see many Texas Gynecomastia patients who prefer my techniques. To minimize travel most start with our Preliminary Remote Discussion where we send forms and ask that you send us our Standard Pictures for Revision Gynecomastia Surgery.
Houston Texas Gynecomastia Revision for Liposuction & Nipple Reduction
Re: Revision to chest/nipple surgery
Dear Dr. Bermant,
I have had liposuction of the chest and reduction of nipple length that didn't produce the results I had wished for.
The doctor liposuctioned the lower pecs. However, one pec that was slightly larger before surgery is still larger, and I'm not sure if it is breast tissue or just fat. The doctor "reduced" the nipple length by cutting some skin from the shafts, pushing them in and resewing them there...which gives me kind of a "button" look with slight puffiness in the areolas that wasn't there before. From looking at your surgery photos, I think that you could fix it.
I had seen your website before my surgery but decided I could do it locally (big mistake). I'm a 47 year old male, 5' 7", 140lbs in good shape and health...since I'm in Houston, Texas, I would like to find out what my next step is to discuss my situation. I am planning a family vacation in June that could coincide nicely with surgery at your location in Virginia.
Thanks in advance for your help,
Dr. Bermant responds:
Liposuction can manage the fat component. However, I have seen failures after liposuction only residual gland and from uneven liposuction contouring itself. This is surgical sculpture and each doctor has his / her own skill levels.
Male Long Nipples can look strange. Male Nipple Reduction is also an art form and checking what a doctor's work looks like is much better than hoping the skill is there. I have heard many lament that they used my site to learn about the problem and solution, tried to go to a doctor closer, but did not check what that other doctor's results look like.
We are glad to help you explore your concerns during a Preliminary Remote Discussion or an in office consultation. If interested, Jane is my office manager and can explain the process. She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.
Dallas Texas Gynecomastia Revision for Liposuction Only Failure
I have been reading the studying the information presented on your website and also the discussion forums for over a year now.
I have had a liposuction only surgery to address my gynecomastia and I am very disappointed with the results. I live in Dallas, TX. I am interested in finding out more about your remote consultation, prices, etc…
In addition to a gynecomastia surgery, I am interested in possible sub-mental liposuction as well.
Thank you for your time.
Dr. Bermant responds:
As you can see here in this collection of experiences, you are not alone in asking for help after liposuction alone attempts to correct gynecomastia done elsewhere. We are happy to help you explore your concerns during a consult or our Preliminary Remote Discussion. The best place to start to learn about the process is this site. Beyond that, Jane is my office manager and can explain the process. She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.
San Antonio Texas Gynecomastia Revision for Liposuction Only Failure
Dear Dr. Michael Bermant,
In 2005, I originally went to a local Dr. here in San Antonio. I consulted her with my gynecomastia issue, and her suggestion was to that liposuction should correct the problem. After the surgery, I was disappointed with the results, and she tried to remedy the situation by telling me that it will take a full year for the skin to tighten to a point where I could see a difference. This never happened.
Fast-forward a year, and she recommended that more liposuction had to be performed, and breast skin removal. It has been seven weeks after the surgery, and while there is an improvement, it is nowhere near what the average person -including myself- would consider normal. As proof of this, I still cannot wear a button shirt without my breasts separating and lifting. Additionally, I still have to wear loose-fitting shirts. I spoke with my Dr. and she was still adamant that it would take six months or more to see results. I am starting to lose faith in her surgical skills.
I can still feel that the glands are as dense as they were from before I started any of the surgeries. Meantime, I still feel uncomfortable walking around in a t-shirt, let alone topless. I am 25 years old 165lbs, and I think it's about time I settle this bodily issue properly.
Attached, I have four photos; the first two are of the right and left breast after the original liposuction surgery. They were taken approximately two months after surgery. The second set of photos show my breasts, as they are today, almost seven weeks after the second surgery. I am still waiting –and hoping- to see a nice result; however, I feel more and more doubtful that there will be a significant improvement. I am basing this on the fact that I did not see any further improvement after the first surgery.
From these photos, do you see promise that your gland removal technique can be beneficial? Secondly, how long should I wait before optioning for gland removal?
Dr. Bermant responds:
Tissues do take some time to heal and evolve after surgery. Just how long depend on the original problem, what was done, and many other factors. As you can see here in this section, you are not alone with concerns about the failure of liposuction to deal with gland. It just does not manage it.
Liposuction also does not tighten skin. Some shrinkage occurs with the deflation of skin. The majority of the shrinkage happens on the operating table. Some additional shrinking can take place over the next few weeks. Beyond that further tightening can happen over the next several months, but most occurs right afterwards.
Gland Removal Revision Surgery can help with the contour problems caused by remaining gland. I have seen some amazing areola shrinking when this is a factor. Other loose skin issues might need skin reduction to manage.
We are glad to evaluate images during our Preliminary Remote Discussion. Jane is my office manager and can explain how this works. She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.
Houston Texas Gynecomastia Revision for Liposuction Only Failure
Your site is very helpful. Several years ago, I ran across your site and have used it as a basis for my decision to have surgery. I am 41 years old and have a mild case of gynecomastia which I think was caused by steroid use in my 20's.
Approximately 3 months ago, I had undergone ultra sonic liposuction by a well respected plastic surgeon in Houston. However, I am contemplating having more tissue removed because the tightness and extra mass under my nipple is still there. My doctor removed more tissue on my upper pecs than under my nipple.
I just want to have this done correctly and from your website, it appears that you surgically remove the mass rather than using liposuction. My doctor doesn't think I need to have an incision made around my nipple to remove the mass. The concern that I have is that the mass that I originally wanted removed is still there and wasn't removed by the liposuction.
I am willing to travel if need be to Virginia. Can you send me some information and what cost would be associated correcting with my condition.
Dr. Bermant responds:
Unfortunately not all surgeon have the same skills. It would be nice to be able to go to a museum admire some sculpture and then go to a local artist and have them make you something that was just like you saw at the museum. There is a art to this surgical sculpture.
Liposuction is great for fat, but does not manage glandular elements. That is better dealt with excision. Check out this Discussion on Liposuction and Gynecomastia Gland Failure. I designed this new forum for a better dialogue and interaction than this older method of experiences.
Your options depend on many factors that we are happy to help you explore during a consult or our our Preliminary Remote Discussion. Jane is my office manager and can explain how this works. She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.
Marshall Texas Gynecomastia Revision for Smartlipo Only Failure
I am a 19 year old male having issues with gynecomastia. I am of healthy weight (150 lbs @ 5'10"), and have puffy nipples. Recently, I sought the help of a local plastic surgeon. He had gotten the new Smartlipo machine, and suggested its use for my case. I thought nothing of this procedure at first. He made a very small incision between my armpit and chest to insert the Smartlipo laser. He then used a back and forth motion throughout my chest and breast tissue. He then removed the laser (he did not excise any breast tissue) and told me that he "vaporized" the breast tissue&that was causing my puffy nipples and that within four weeks my body would work this once breast tissue (now he called it scar tissue)& away and the problem would be resolved. Now 10 weeks after the procedure, I see and feel no change other than my breast tissue being firmer that before the procedure. None of the breast tissue that he claimed to vaporize to scar tissue has gone away at all (NONE!). I mention this to him at an appointment today and he told me not to rush anything and that I shouldn't question the surgery because he has 30 years experience as a doctor and I do not. I have looked up the uses of Smartlipo and have found nothing saying that it can vaporize or solely remove breast tissue - I mentioned this to my doctor and he seemed to get angry and couldn't not give any evidence to support the procedure he performed on me. Your website shows you to be a rather precise and respected surgeon. What advice do you have, and when could I possibly schedule a re-do with you?
Dr. Bermant responds:
Thank you for your kind words about my passion for precise sculpture. 10 weeks is too soon to determine results. Firm healing tissues can still be a contour factor. It can take 6 months or longer before considering revision surgery.
Sorry, Smart Liposuction does not manage gland component. I have yet to see sufficient proof that the gland is managed by that method. You can see that you are not alone with concerns after liposuction only gynecomastia surgery not working. I have seen and sent to pathology the gland scar tissue complex removed during the revision process.
Check out this much more extensive answer about Smart Liposuction Gynecomastia Complications. That new forum is an easier way to discuss this issue permitting direct dialogue.
We are happy to help you explore your concerns during a consult or our remote discussion. If interested Jane is my office manager. She can normally be reached at our office by phone Monday - Friday 9-5 Eastern Time at (804) 748-7737.