My surgeon advised liposuction although i have pure glanduler gyno?

[puffynipplezz]

Hey doctors,
I've had puffy nipples for a long time. I recently started consulting plastic surgeons.
I had an ultrasound and visited 4 surgeons. Ultrasound shows bilateral breast tissue and no additional fat tissue: I am realy skinny (6' , 152 lb) , I have nearly no fat around my pectoral muscles and I look like this guy: https://upload.wikimedia.org/wikipedia/commons/6/62/Puffynipple2.jpg My only concern is my areola.

Anyway, the first three doctors said i need incision below my areola to remove the extra breast tissue and there's no need for lipo. The last surgeon i consulted said that laser liposuction right behind the breast tissue will help, removing the fat there (which is very small) will create connective tissue which will "hopefully" pull and shrink my nipple.

Of course i was shocked with this approach becouse it sounds like just a matter of luck but my PS insisted that there is a great chance of success and no risk of inverted nipples or keloids. He also said i should give this a chance becouse i have "nothing to lose" and incision surgery will always be there as an option if i wont statisfy with the result of lipo.

I think this is a temporary solution at
best becouse if i continue some lifting after surgery, the hypertrophy of pectoral muscle will make my nipples pop out, am i right? I realy wonder what other doctors think about this surgery technique.

[Miguel Delgado MD]

I agree with the three other doctors.  If you have true gynecomastia the gland has to be reduced and ultrasound will not accomplish this.  This is a fact.

[George Pope, M.D.]

Dr. Delgado is absolutely right.  You need tissue excision, and from the way you describe your chest appearance and at your height and weight, you shouldn't need lipo at all.
Dr. Pope, MD

[DrPensler]

Without any question you need surgical excision. As an aside there are many doctors  who profess to have significant experience with gynecomastia but the reality is very few physicians have any substantial experience and expertise.

[Dr. Schuster]

True gynecomastia requires near complete excision of the gland. There are a number of techniques that do this but usually liposuction, traditional / UAL / Laser, will not be enough on it's own.

[Dr. Cruise]

As my fellow doctors have mentioned, liposuction will not give you the result you want. The best advice I can give you is to do this right the first time, so you don't have to look back w/ regret or the need to spend more money to fix the problem.  Surgery to correct puffy nipple is really quite straight forward if performed by a surgeon with expertise in this area. 
It's great you posted on this to do further research before making your decision.
All the best,  Dr. Cruise

[Litlriki]

One more vote for excision of your gynecomastia.  I use liposuction as well to help to contour the chest and avoid any sort of crater, but the fat component of your gynecomastia will be minimal.