Q&A with Dr. Blau M.D., P.C.!

[SpeedoGuido]

Dr. Blau,

I'm 52 years old (natural for life). As I age my pecs are getting flabbier... and when I get lean my skin doesn't snap back like it used to. If I have the surgery will you be able to tighten the skin in my chest area? If so, will it stay pretty tight for at least a few more years?
I still look pretty good for an old guy (the pic in my avatar is less than a year old) but these flabby pecs are really bothering me.

[Dr Blau]

dr. blau do you do hip to hip tummy tucks??? if so how much?? and is thermage a good alternative??

We do perform tummy tucks. You need to send your pictures or come for consultation. Thermage is usually not one of the alternatives.

[RLT09]

Dr. Blau, does a patient have to make seperate visits for the consultation and the actual procedure? This might be a problem coming from down south.

[playmate]

Hello I have a question for you I am 36 years old 5'4" and have size 38 DDD breast I have been thiking of having them reduced I feel they would be covered by my insurance due to the symptoms I have which are indentions in my shoulders, neck and shoulder pain with some upper back pain, sometimes get very bad rashes underneath them, I want to start training and it gets very complicated to do some of the exercises due to the size and weight of them the last time I had them weighed they were around 20Lbs. each. My question to you is if I have them reduced is the scarring very prominent? Are there different ways it can be done to reduce the scarring I want to train to compete one day and scarring would be a problem with that I am afraid. Any help you can give would be so apprecitated. Thanks Bridget

[DrBlau]

Are there any supplements or medications that can reduce gyno?

not that I know.

[DrBlau]

dr. blau do you do hip to hip tummy tucks??? if so how much?? and is thermage a good alternative??

Thermage a not a good alternative to tummy tuck. We do perform full TT.

[DrBlau]

Dr. Blau,

I'm 52 years old (natural for life). As I age my pecs are getting flabbier... and when I get lean my skin doesn't snap back like it used to. If I have the surgery will you be able to tighten the skin in my chest area? If so, will it stay pretty tight for at least a few more years?
I still look pretty good for an old guy (the pic in my avatar is less than a year old) but these flabby pecs are really bothering me.

You should to be examined by a Plastic Surgeon who has experience with Gynecomastia surgery. I have performed surgery on people older then yourself and they were happy with their results.

[DrBlau]

Dr. Blau, does a patient have to make seperate visits for the consultation and the actual procedure? This might be a problem coming from down south.

You can email photos that will be reviewed and then have a telephone consultation , Call MaryAnn at 914-428-4700 .

[DrBlau]

Hello I have a question for you I am 36 years old 5'4" and have size 38 DDD breast I have been thiking of having them reduced I feel they would be covered by my insurance due to the symptoms I have which are indentions in my shoulders, neck and shoulder pain with some upper back pain, sometimes get very bad rashes underneath them, I want to start training and it gets very complicated to do some of the exercises due to the size and weight of them the last time I had them weighed they were around 20Lbs. each. My question to you is if I have them reduced is the scarring very prominent? Are there different ways it can be done to reduce the scarring I want to train to compete one day and scarring would be a problem with that I am afraid. Any help you can give would be so apprecitated. Thanks Bridget

Breast reduction Surgery will result in scars and nobody can predict how the scvars will look. For an general information you can go toour web site: www.cosmetic-md.com

[bishop]

Dr Blau

I am scheduled to have surgery on the 17th of July. Is their anything special I should be doing to prepare for the surgery? Also how long do I refrain from aas use post surgery?

Thank you

[Knuckles]

Hey Dr. Blau,
I am extremely interested in having my gyno removed by you in the near future. I am saving money to pay cash for the procedure, so I feel I have a few more months until I am ready. I was overweight when I was younger and have gotten lean multiple times while still retaining fat deposits in my low back and abdominal area. I would be interested in a combined procedure of lipo/gyno removal, and was wondering how important it is to lean out in preparation for surgery. Are you able to take more fat and contour better if I would be a lower body fat percentage? I know the areas I am prone to quickly gain weight in(more fat cells there) and I would want to make sure that if I was dieted down a little that the cells would still be removed. When I diet hard the areas shrink considerably, but when I eat carbs the cells volumize quickly. My fear would be that I may look good dieted post-op, but would gain a few pounds to find the problem areas pop up again because I was contoured while leaner. Sorry to draw the question out, but I wasn't sure if the contouring is better at a stable weight or a depleted, leaner state. Thanks in advance Dr. Blau.

[bigoso]

DR. Blau....do you have much experience doing gyno surgery on blacks. I ask because I have had surgery in the past and I have a tendency to develop keloids..this of course would be very unattractive to have on my chest post surgery. Is there an option that would help with this...such as a different entry point for the surgery?

[Dr Blau]

Dr Blau

I am scheduled to have surgery on the 17th of July. Is their anything special I should be doing to prepare for the surgery? Also how long do I refrain from aas use post surgery?

Thank you

Those are questions that you should ask your Gynecomastia Surgeon.

[Dr Blau]

Hey Dr. Blau,
I am extremely interested in having my gyno removed by you in the near future. I am saving money to pay cash for the procedure, so I feel I have a few more months until I am ready. I was overweight when I was younger and have gotten lean multiple times while still retaining fat deposits in my low back and abdominal area. I would be interested in a combined procedure of lipo/gyno removal, and was wondering how important it is to lean out in preparation for surgery. Are you able to take more fat and contour better if I would be a lower body fat percentage? I know the areas I am prone to quickly gain weight in(more fat cells there) and I would want to make sure that if I was dieted down a little that the cells would still be removed. When I diet hard the areas shrink considerably, but when I eat carbs the cells volumize quickly. My fear would be that I may look good dieted post-op, but would gain a few pounds to find the problem areas pop up again because I was contoured while leaner. Sorry to draw the question out, but I wasn't sure if the contouring is better at a stable weight or a depleted, leaner state. Thanks in advance Dr. Blau.

You can call our office for a phone consultaion with Dr Blau 914-428-4700. If you can email us Photos it can be very helpfull -cosmeticdr@gmail.com.

[Dr Blau]

DR. Blau....do you have much experience doing gyno surgery on blacks. I ask because I have had surgery in the past and I have a tendency to develop keloids..this of course would be very unattractive to have on my chest post surgery. Is there an option that would help with this...such as a different entry point for the surgery?

I performed Gynecomastia on hundreds black people and so far no one had keloids.

[Ninja Loco]

Dr. Blau, I live in Dallas. How would one go about cunsulting with you for a diagnosis on facial work?

[Arthur Early]

would insurance cover a TT if i had a hernia that need to be repaired as well??

[gohome]

Dr. Blau:

I had the gynecomastia surgery almost 2 years ago. While I look much improved from before, there is still some tissue that I notice under the nipple. I just saw my surgeon last week, who actually thinks I look perfect. He explained that he could not remove all of the tissue because it would result in a concaved (depression) look, and that ultimately the surgery is a sculpting a shaping exercise - not a full removal. Do you agree? I have heard Dave say that bodybuilders usually get all tissue removed. While I don't have a big bodybuilder chest, I definitely have some muscular pecs from years of training.

Anyway, do you remove all gland tissue for all patients or just oversized bodybuilders? Do you think second surgeries are too much risk for scarring?

[babybull]

Quick question:

You say you have 100% success rate of non-returning gyno. If that is the case do you have any kind of gaurantee on that? I have had mine removed and it came right back so Im very curious!

[DrBlau]

Dr. Blau, I live in Dallas. How would one go about cunsulting with you for a diagnosis on facial work?

Call MaryAnn at 914-428-4700 and ask for a telephonec onsultation with Dr Blau,

[DrBlau]

would insurance cover a TT if i had a hernia that need to be repaired as well??

No.

[DrBlau]

Dr. Blau:

I had the gynecomastia surgery almost 2 years ago. While I look much improved from before, there is still some tissue that I notice under the nipple. I just saw my surgeon last week, who actually thinks I look perfect. He explained that he could not remove all of the tissue because it would result in a concaved (depression) look, and that ultimately the surgery is a sculpting a shaping exercise - not a full removal. Do you agree? I have heard Dave say that bodybuilders usually get all tissue removed. While I don't have a big bodybuilder chest, I definitely have some muscular pecs from years of training.

Anyway, do you remove all gland tissue for all patients or just oversized bodybuilders? Do you think second surgeries are too much risk for scarring?

We remove as much as 95% of the glandular tissue. some people do need second surgery.

[DrBlau]

Quick question:

You say you have 100% success rate of non-returning gyno. If that is the case do you have any kind of gaurantee on that? I have had mine removed and it came right back so Im very curious!

During the last ten years we did not have any reccurence of the glandular tissue. There will be no surgeon fee for correction of a reccurence.

[Bolan]

During the last ten years we did not have any reccurence of the glandular tissue. There will be no surgeon fee for correction of a reccurence.

This man guarantee's his work!!!

[babybull]

During the last ten years we did not have any reccurence of the glandular tissue. There will be no surgeon fee for correction of a reccurence.

That is awesome...and the reason that you are the only gyno surgery option out there!

[comebackid]

I agree I had surgery with Dr. Blau a while back and I would not even consider anyone else from all the research I did, he truly is the best at this. I will try to find my before and after pics to post up.

[latman]

Along with the gyno surgery do you every do pec implants for men to correct the symmetry along the lower and outer pecs.

[comebackid]

I had gynecomastia surgery with Dr. Blau about a year ago, he is the only Dr. that I would consider for this procedure, it was a very easy experience, if anyone has any questions about it I would be happy to answer them just pm me.

[Powerdome]

Hi Dr Blau

Diff question here regaring hair transplant surgery. These days there are a lot of doctors offering hair transplants, do you have any that you could recommend?

FUT is the gold standard........FUSE is a newer one..........what would be your recommendations with hair transplants.

[Larry C]

Hey doc, I've got a small cyst on my forehead that I'm going to get removed surgically in April. Do you know roughly how long it could take to heal?

[DrBlau]

I do not perform pec implant Surgery

[DrBlau]

Gynecomastia should be performed in patients that suffer from physical or psycological problems.

[DrBlau]

Hey doc, I've got a small cyst on my forehead that I'm going to get removed surgically in April. Do you know roughly how long it could take to heal?

About one week.

[TheForce]

Dr. Blau, I always wondered what you do to the gynecomastia gland after you had excised them out?

I know this may sound gross but does some of your patients keep them as some sort of momento to show people? Can they keep them?

[coaltrain]

Dr. Blau,

Do you know any Dr.'s you could recommend for gyno surgery that practice in Washington?

[bigw0rm71]

dr blau, have u ever performed areola donut pexy or do u not like this practice...if u do perform it, is the scarring always permanent or can it heal???

[NYJetsFan80]

Greetings Dr.Blau and Happy Holidays!Where are you located at Dr.Blau and do you have to pay all at once for the total procedure lipo and gland removal or can I pay half and then monthly payments?I desparetly need to have this surgery done but I only have around 4 grand right now.

[huge285]

Here's Dr Blau's latest Q&A......

QUESTION: Dr. Blau, I always wondered what you do to the gynecomastia gland after you've excised them out? I know this may sound gross but does some of your patients keep them as some sort of momento to show people? Can they keep them?

ANSWER: The specimen has to go to the lab. It's a New York State law that anything removed from the breast must be sent and checked for malignancy. While it's extremely unlikely that a malignancy would exist in a typical case of gynecomastia, the laws are clear that anything removed from the body must be analyzed for irregularities.


QUESTION: Dr. Blau, have you ever performed areola "donut pexy" or do you not like this practice...if you do perform it, is the scarring always permanent or can it heal?


ANSWER: With regard to gynecomastia surgery, I try to avoid "donut pexy" procedures because the scarring can be permanent and usually very pronounced. Whenever that much "cutting" is involved, the results may not look as natural as the patient would like. In the majority of cases, standard glandular removal will produce the desired results the patient is looking for.


QUESTION: I had my gynecomastia removed about a year ago and the doctor told me that he had to leave a small amount of tissue under the nipple or else the nipple would collapse. Now it seems as though my gyno has come back. I have noticeable lumps under my nipples. What should I do? Was the surgeon wrong to leave that small amount of tissue in?

ANSWER: Without knowing your exact history or examining you it's impossible for me to make an accurate assessment of the situation. I also have no knowledge of how much gynecomastia tissue was actually removed from your chest. I cannot speak for other physicians. In my practice we have not had a recurrence in the last twenty years. Especially with regard to bodybuilders, the key is to ensure that you remove all the glands the first time around so that a second surgery is never required.


QUESTION: How long should a typical gynecomastia surgery take. I went for a consult with a physician in New Jersey and he told me it takes 2 to 2.5 hours. He also told me I must be put out with general anesthesia. How long does your typical surgery take? Can it be done with a local or must I be asleep?

ANSWER: The typical gynecomastia surgery takes me between 60 and 90 minutes. I don't use general anesthesia in the majority of patients. In fact, I use local anesthesia in 50% of my patients. This greatly reduces the cost of requiring an anesthesiologist and it reduces the discomfort following surgery (from the side effects of the general anesthetic). In fact, most of my patients feel so "good" following surgery that I have to remind them to take it easy and not move around too much in days following surgery to prevent bleeding.

[huge285]

QUESTION: Dr. Blau, what do you know about this new technique that supposedly uses a laser to melt the gynecomastia? It supposedly uses a very small incision and the recovery is supposed to be faster. Does it really get rid of all the glands?

DR BLAU: The laser technique for gynecomastia is not new. It has been around for 5 years. Unfortunately the results did not justify the technique because the recurrence rate is very high. It's nearly impossible to ensure that you get all the glands out and, for a bodybuilder, that's a nightmare scenario that I'm not willing to risk. My current excisional procedure has produced fantastic results in 100% of my patients.


QUESTION: Dr. Blau, is it possible for a man to have breast cancer in one of the glands that are removed? By having gynecomastia surgery, does that make you immune to potential future breast cancer?

DR BLAU: Breast Cancer in men is extremely rare. Out of the thousands of gynecomastia cases I've done, I have only seen 2 patients (both over the age of 50) that, upon removing the gynecomastia, turned out to be breast cancer. They were referred to and treated by an oncologist. Removal of the mammary glands in men may indeed reduce the chance of having this rare cancer.


QUESTION: How many days do I need to stay out of the gym after gynecomastia surgery? Can I start doing cardio (no upper body movements) after a few days?

DR BLAU: Cardio can be started about 2-3 weeks after surgery (depending on the severity of the case). Weight training can be resumed about 3-4 weeks after surgery (also depending on the recovery rate).


QUESTION: Do you insert temporary drains while doing gynecomastia surgery? How long do these drains need to be in place? Do they leave a scar?

DR BLAU: It's extremely rare that I insert drains following surgery. With the unique excisional procedure I use, there never seems to be a need for them. No drains also mean no additional scarring. On occasion when drains are warranted, scarring is usually very minimal (if at all).


QUESTION: Are there any medications that should be stopped prior to getting gynecomastia surgery?

DR BLAU: Prior to surgery for gynecomastia, my office send every patient an extensive list of prescription and over-the-counter medications and nutritional supplements that they should avoid 10-14 days prior to surgery. I formulated this all-inclusive list so that the surgery will be effortless and the healing/recovery process will be as speedy and efficient as possible.

Aspirin Medications to Avoid

4-Way Cold Tabs, 5-Aminosalicylic Acid, Acetilsalicylic Acid
Adprin-B products, Alka-Seltzer products, Amigesic
Anacin products, Anexsia w/Codeine, Argesic-SA
Arthra-G, Arthriten products, Arthritis Foundation products
Arthritis Pain Formula, Arthritis Strength BC Powder,Arthropan
ASA, Asacol Ascriptin products
Aspergum Asprimox products Axotal
Azdone Azulfidine products B-A-C
Backache Maximum Strength Relief Bayer Products BC Powder
Bismatrol products Buffered Aspirin Bufferin products
Buffetts 11 Buffex Butal/ASA/Caff
Butalbital Compound Cama Arthritis Pain Reliever Carisoprodol Compound
Cheracol Choline Magnesium Trisalicylate Choline Salicylate
Cope Coricidin Cortisone Medications
Damason-P Darvon Compound-65 Darvon/ASA
Dipentum Disalcid Doan's products
Dolobid Dristan Duragesic
Easprin Ecotrin products Empirin products
Equagesic Excedrin products Fiorgen PF
Fiorinal products Gelpirin Genprin
Gensan Goody's Extra Strength Headache Powders Halfprin products
Isollyl Improved Kaodene Lanorinal
Lortab ASA Magan Magnaprin products
Magnesium Salicylate Magsal Marnal
Marthritic Meprobamate Mesalamine
Methocarbamol Micrainin Mobidin
Mobigesic Momentum Mono-Gesic
Night-Time Effervescent Cold Norgesic products Norwich products
Olsalazine Orphengesic products Oxycodone
Pabalate products P-A-C Pain Reliever Tabs
Panasal Pentasa Pepto-Bismol
Percodan products Phenaphen/Codeine #3 Pink Bismuth
Propoxyphene Compound products Robaxisal Rowasa
Roxeprin Saleto products Salflex
Salicylate products Salsalate SalsitabDavid Palumbo
Scheduled on 1/24/2011
...........................
Scot-Tussin Original 5-Action Sine-off Sinutab
Sodium Salicylate Sodol Compound Soma Compound
St. Joseph Aspirin Sulfasalazine Supac
Suprax Synalgos-DC Talwin
Triaminicin Tricosal Trilisate
Tussanil DH Tussirex products Ursinus-Inlay
Vanquish Wesprin Willow Bark products
Zorprin


Ibuprofen Medications to Avoid

Actron Acular (opthalmic) Advil products
Aleve Anaprox products Ansaid
Cataflam Clinoril Daypro
Diclofenac Dimetapp Sinus Dristan Sinus
Etodolac Feldene Fenoprofen
Flurbiprofen Genpril Haltran
IBU Ibuprin Ibuprofen
Ibuprohm Indochron E-R Indocin products
Indomethacin products Ketoprofen Ketorolac
Lodine Meclofenamate Meclomen
Mefenamic Acid Menadol Midol products
Motrin products Nabumetone Nalfon products
Naprelan Naprosyn products Naprox X
Naproxen Nuprin Ocufen (opthalmic)
Orudis products Oruvail Oxaprozin
Piroxicam Ponstel Profenal
Relafen Rhinocaps Sine-Aid products
Sulindac Suprofen Tolectin products
Tolmetin Toradol Voltaren


Other Medications to Avoid

. 4-Way w/ Codeine A.C.A.
A-A Compound Accutrim Actifed
Anexsia Anisindione Anturane
Arthritis Bufferin BC Tablets Childrens Advil
Clinoril C Contac Coumadin
Dalteparin injection Dicumerol Dipyridamole
Doxycycline Emagrin Enoxaparin injection
Flagyl Fragmin injection Furadantin
Garlic Heparin Hydrocortisone
Isollyl Lovenox injection MacrodantinScheduled on 1/24/201........................
Mellaril Miradon Opasal
Pan-PAC Pentoxyfylline Persantine
Phenylpropanolamine Prednisone Protamine
Protein Shake Pyrroxate Ru-Tuss
Salatin Sinex Sofarin
Soltice Sparine Stelazine
Sulfinpyrazone Tenuate Tenuate Dospan
Thorazine Ticlid Ticlopidine
Trental Ursinus Vibramycin
Vitamin E Warfarin


Tricyclic Antidepressants Medications to Avoid

Adapin Amitriptyline Amoxapine
Anafranil Asendin Aventyl
Clomipramine Desipramine Doxepin
Elavil Endep Etrafon products
Imipramine Janimine Limbitrol products
Ludiomil Maprotiline Norpramin
Nortriptyline Pamelor Pertofrane
Protriptyline Sinequan Surmontil
Tofranil Triavil Trimipramine
Vivactil


Herbal Medications to Avoid

Echinecea Food Supliments Ginkgo Biloba
Ginseng Herbs Protein Shake
St. John's Wort

[SallyAnne]

[patrickfoster]

I fractured my left collarbone in two places when I was 15 now i got muscle growth problems it has affected my left deltoids left pec left trapezium left lat left tricep and left biceps and my left forearm is over growing it seems like its taking the weight off the shoulder area and over growing the shoulder area feels like its loose compared to my right side.Im thinking about getting the collarbone reset I wanted to know if any one has had there collarbone reset and did it fix the problem ?

[dbow196]

Dr. How would a patient in Texas see you for treatment. Short of that do you have a Doctor in Dallas/Austin/Houston you would refer to?

[2hot4u]

sent the dr a pm do you know how often he is on here???

[Baldiewonkanobi]

Dear Doctor,

Have you ever filled in the divot left behind after a successful pec reattachment after rupture from humerous bone?

Thsnx,

Bill Mortimer

[Qster]

Can you fix cauliflower ear?