This young man presented to me with complaints of gynecomastia and “puffy nipples.” He was mentally affected quite a lot – he had a history of depression and PTSD, as he was ex-military. He had frank glandular tissue on examination, with very little actual body fat. These are the more challenging cases of gynecomastia surgery because my goal is to remove as much of the gland as possible and not leave a hole.
In his case, I did liposuction and I removed 98% of the gland, which you can see in the pictures. I had to raise up some internal flaps of normal fatty tissue to bring into the area where the gland was removed so it would be even and flat.
This result is perfect in my opinion. He still thinks there is some fullness and some element of “puffy nipples,” but on examination there is nothing abnormal. It’s not uncommon for me to obtain a stellar result, but the patient still feels they have something “left.”
This is the nature of the beast, the psychology that is working here is strong so, as always, I call a spade a spade and in his case he is all normal. I often send them the before and after pictures for comparison because this really helps them to “see” the improvements.
Look at his oblique and side views to really appreciate the improvements. The puffiness is gone and his chest is FLAT. As always, we have encouraged him, coached him, and given him the best “marching orders” for him to continue to work on getting his head where it needs to be. It’s important to show my patients their results and to try to ensure that they appreciate them and internalize them. It’s important that the “own” their results.
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