when is lipo not needed and gland excision only suffices

[april24th2007]

Is lipo always needed for contouring or other purpose?

How often do surgeons only do gland excision and are the results usually good or are revisions needed.

For instance, many thin guys Ie. 5'9" & 158 lbs, have gland but are thin. 

Could the doctors please share some insight on this subject.  Thank you.

[DrPensler]

If you have ever painted ( something I did in college for a summer )it's a similar sitution. If you are paitning and repairing a wall ,lets say an area the size of  basketball needs to be repaired. You spakle ,prime then paint the area. It is important, even if you are using the same can of paint that was originally used to paint the wall, to feather or blend the area painted into the surrounding area. The situation is similar here. If you only resect the gland it tends to produce a saucer deformity. A saucer deformity is just like the saucer under a teacup,indented a bit.In order to avoid the indentation and blend the resection into the surrounding tissue liposuction is often utilized.

[Dr. Elliot Jacobs]

In cases of very thin guys with puffy nipples, I will still do excision and some limited lipo.  Sometimes, I use the lipo cannula without suction -- merely to help the surrounding skin re-distribute itself.  If this isn't done, then sometimes the areola can still appear puffy because the skin around the edge is still tethered and thus the areolar skin has nowhere to go except to puff out.

Dr Jacobs

[Litlriki]

I also do some liposuction in nearly every case, even in lean men, in order to provide a smooth transition between the excised area and the adjacent non-excised area.

Rick Silverman

[april24th2007]

Thank you again.

This lipo without suction..is it better?  less pain, less swelling?  Or more bruising and longer recovery plus scars?

[Dr. Elliot Jacobs]

It is not a question of better or not.  Basically it serves to undermine the surrounding skin so that it can re-distribute.  If there is minimal to no surrounding fat, it makes no sense to suction that little bit of fat.  But it does make sense to loosen the skin -- hence non-suction "liposuction."

Dr Jacobs

[april24th2007]

Thank you for clarifying.
I am going to put up some very recent photos on here tonight.  Please have a look and let me know if they help in analysis.  Thanks.