Is the liposuction what causes most of the swelling/bruising?

[nyce]

Is it the liposuction procedure that generally causes most of the swelling and bruising?  I'm sure there's good reason for recommending liposuction, but can good/great results be obtained by excision only?  If I get my butt in gear and lose some weight post surgery and recovery?  I've seen pictures of incision-only patients with very little in the way of bruising.  I realize that gynecomastia surgery carries rather low levels of risk, but I'm admittedly a little nervous as my surgery date nears.  My surgeon recommend some liposuction for my case, but primarily excision of glandular tissue.  I will follow up with him tomorrow with these questions as well.  Thanks in advance. 

My pictures:  https://www.gynecomastia.org/smf/index.php?topic=22999.0

[DrBermant]

Is it the liposuction procedure that generally causes most of the swelling and bruising?  I'm sure there's good reason for recommending liposuction, but can good/great results be obtained by excision only?  If I get my butt in gear and lose some weight post surgery and recovery?  I've seen pictures of incision-only patients with very little in the way of bruising.  I realize that gynecomastia surgery carries rather low levels of risk, but I'm admittedly a little nervous as my surgery date nears.  My surgeon recommend some liposuction for my case, but primarily excision of glandular tissue.  I will follow up with him tomorrow with these questions as well.  Thanks in advance. 

My pictures:  https://www.gynecomastia.org/smf/index.php?topic=22999.0

Investigation of what a surgeon actually has for swelling and bruising after surgery can be critical in understanding this issue. That is why I choose to document and demonstrate the bruising, swelling, and how my patients evolve after surgery. Check out the bruising and swelling seen with the various forms of gynecomastia with my techniques to better understand what I am talking about. The minimal swelling and bruising seen are typical for my patients and that involves my Dynamic Technique that almost always will have both excision and liposuction components of the sculpture.

Excision alone does not manage gynecomastia well. I have seen too many unhappy patients coming for my help after surgery done elsewhere. I coined the term Crater Deformity and Defect to describe this contour and posted years ago examples to demonstrate the problem.

There are many factors that goes into just how much bruising and swelling that happens after surgery. knife, scissors, needle, cautery, and cannula all cause injury and swelling. All can also cause bruising, yes even cauterization technique can be a factor in this issue. Technique of using the tools of the surgeon's trade, skill of the surgeon, preparation before surgery, after surgery instruction, compression garments all can be critical factors. It has been the documentation of the progression of tissues after surgery and then analysis that have permitted me to evolve my surgical sculpture to what you can see demonstrated on my site.

To better understand just what your surgeon's methods will have for swelling and bruising, you will need to investigate to see similar documentation for his or her own patients. If that detail is not on that doctor's website, then use the search function of this forum to see if any prior patients have posted pictures early after surgery. Here is this forum's Search Tool

https://www.gynecomastia.org/smf/index.php?action=search

I like using the Search Order tool selecting Most Recent Topics First or Oldest Topics First to see how something has changed over the years.

Hope this helps,

Michael Bermant, M.D.

[Dr. Elliot Jacobs]

For most patients, appropriate surgery will include direct gland excision as well as liposuction for the surrounding areas.

You must remember, any surgery is a controlled injury.  Techniques will vary between surgeons and between individual patients as well.  Swelling and bruising do occur -- that goes with the territory.  Sometimes it is minimal and sometimes there is more -- but in 100% of cases, the bruising and swelling will disappear fairly soon after surgery.  There is no surgeon on this planet who can guarantee none (or minimal) bruising on every case.

I would not make your decision about a surgeon based on how much swelling or bruising he usually gets after surgery -- for you could be the one case that bruises a lot.  Nor would I insist that the surgeon only do a certain part of the procedure (ie excision alone).  The surgeon should be free to do whatever is necessary to get the best possible result for you.

Remember, Mother Nature plays an important -- and independent -- role in the healing process.

Dr Jacobs

[DrPensler]

Most patients require a combination of excision and liposuction. The degree of swelling and bruising is a function of the procedure and the patient. The primary goal is to optimize the final result. I often utilize liposuction to blend the transition of the glandular tissue into the surrounding area. Every surgeon does what in their experience provides the best result.
Jay Pensler,MD