19300: Lipo vs semilunar technique

I was referred to a plastic surgeon by my PCP. This also happens to be the same site that I'm currently doing my clinical rotations at (med student). I was assessed by the surgeon and we discussed his proposed POC that involved a combination of lipo and excision of glandular tissue. He advised that he had little faith that I would get insurance to approve the procedure because he has seen very few get approved in 26 years of practice. He did not know that I have a DPT and am currenting attending medical school. I was initially denied (due to insufficient medical documentation submitted by the surgeon). I appealed the decision, provided more supportive documentation and the procedure was approved. 

Two weeks later, his office contacted me via phone to set up an appt to discuss the surgery. During the visit the surgeon advised that he was surprised I got it approved and he said that he will put me on the surgery schedule for the 25th. He advised that he no longer thinks that liposuction is warranted and he will just do the excision. He said that I won't be able to shower for 5 days after the procedure due to the heavy dressing that will be applied. He said that I will not need any pain medications and he will not be writing any prescriptions and my pain can be controlled with NSAIDs and APAP. He advised that I would be able to go back to the gym withi 2 weeks. 


I have doubts that this will be a pain free procedure. I also have doubts it can be tolerated with only APAP as I can not take NSAIDS due to intolerance. My other concern is his change in treatment plan. I don't know if this is the most appropriate as it is not the gold standard in practice. 


Could someone please provide me their opinion. I have attached a photo for reference. Thank you!


M, 31, Indiana

Tags:170-189 lbs pain excision treatment gynecomastia pain medication

Liposuction with central mound excision(Semilunar) would give you a great result. Nipple sensation may change with surgery. Seek a board certified plastic surgeon to evaluate you in person in your area to have options! Good Luck!