Pseudogynecomastia revision ?

[Vpnrt]

Greetings from Belgium,
Three weeks ago I had gynecomastia surgery.
The clinic I used asked I provide pre-op photos to determine if I was a candidate for the surgery. I was accepted and set a surgery date.
Prior to the surgery, I was provided with a medical questionaire. The surgeon never looked at the questionaire. He also did not examine my chest to determine if I had gland tissue or not (pinch test).
He vaguely went over the procedure which I was going to undertake and never marked me prior to surgery.
Once the surgery was completed he told me I had little gland tissue and mostly fat.
After three weeks of recovery, I noticed my chest was flat in the Zone 1 area, but Zones 2 and 3 were untouched, leaving a somewhat deformed effect. I asked the clinic about this and they replied that Zone 2-3 areas were a seperate surgery.
What I don't understand is why a pre-examination wasn't conducted to determine if I had gynecomastia or pseudo-gynecomastia. Certainly, if there was little gland, why wasn't lipo chest sculpturing wasn't chosen by the surgeon? Why weren't Zones 2-3 liposculpted/suctioned?
What do you think of this scenario?
Isn't it standard practice to do all three areas?
Thanks for your advice/insight.

[Litlriki]

Without photos and your surgeon's insight, it's difficult to comment on your situation.  As a surgeon, I address the fat and glandular tissue of the chest comprehensively with a combination procedure in nearly all routine cases (this may be different if skin removal is required).  If you only had fat, then liposuction might be effective without gland excision. If you're super lean with only a small amount of gland, perhaps excision alone would work.  But in most cases, the combination is beneficial, and all areas of the chest should be addressed, including toward the axilla.  

[Vpnrt]

Thanks for your reply Dr. Silverman.
I may contact you for a consultation before coming back to NH for a family visit.
Best,
Phil