Does lipo remove gland or just fat cells?

[spaceace]

Does lipo remove gland or just fat cells?

[Mr_Nip]

Liposuction is effective in removal of fat, but not gland.  

[shyboy]

the (pal) technique power assissted liposuction removes fat and small amuont of gland,for larger pieces of glan the doctor has developed a new way of cutting out larger gland tissue from the same incision as the lipo.the only doctor that i am aware of usng this techniue is Dr.Lista in Mississauga,ontario.

[nogyne29]

i think that sometimes there can be strainds of gland in the breast region. these small- fingerlike stems of gland most likely can be removed by liposution. however, the majority of the gland that is a solid mass will still remain. so there is a chance that these small  "stems of gland" might return in time.

[Give me Life]

Lipo can not remove the gland. Dr. Lista has his own techniques of doing LIPO but at the end he also mentioned on the website or in his counsltation than if needed, he do incision to remove gland.

I think if you have just a fat, that can be removed by LIPO or even doing some Gyme activites. For better result, I think one should go for both. It's only matter of few scars on the body. Then one should think. What's important? Life without boobs or few scars which eventually disappreas???

[turbojoe]

I agree lipo does not remove gland just fat ,therefor drs. that do only lipo have much more complains in this board by not satisfied patients.

[DrBermant]

Does lipo remove gland or just fat cells?

Liposuction Is Great for Sculpting Fat

Various types of ultrasonic and power assisted liposuction (UAL and PAL) have been around for quite sime time.  Each surgeon uses the tools and techniques he / she prefers.

There are studies claiming that ultrasonic liposuction does not break down gland cells, these were done to justify the safety in female liposuction breast reduction surgery.  Ultrasonic energy cannot be both ways, good for gland breakdown and safe not harming gland unless there is a difference between male and female breast gland tissue which has not been proven to my knowledge.

Tumescent liposuction is a form of anesthesia where fluid is placed in the tissues to be sculpted.  You can see very graphic pictures of the tumecent technique here.

Liposuction such as ultrasonic, VASER, power assisted, and sharp cutting cannula preferentially remove fat over gland.  Gland tends to exist under the nipple areola region.  When fingers of fat extend between fingers of gland, breast reduction can come from removing the fat and leaving gland behind.  On animation such as flexing the pectoral muscles or putting the arms over head, gland does not compress or move like fat.

When gynecomastia is from fat, liposuction works very well for contouring the chest.  I have seen many patients from other doctors who tried to use liposuction alone techniques that left gland behind that the patients just did not like for Revision Gynecomastia Chest Sculpture.

Here is an example of Revision Surgery after Liposuction alone.   Here is another revision after liposuction alone.

The problem is picking the right method for what actually is that patient's problem.  That is why I prefer my Dynamic Technique that permits what I find during surgery to guide my sculpture.

I have also seen patients with channel problems between remote access sites and the areola / nipple.  Scars, adhesions, and depressions can look terrible.  Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexion here to see what I mean.

Ultrasonic liposuction uses energy to help emulsify fat.  Power assisted liposuction uses mechanical vibrating devices to rapidly move the cannula back and forth.  Both PAL and Ultrasonic methods have been around for several years.  Many do not prefer what they do to the tissue.  Others like what they offer.  Both still preferentially remove fat over gland.  Both make the work of the surgeon easier.  Some feel ultrasonic liposuction can cause more swelling, bruising, and the increase the need for drains.

For me however, they also both remove the feel of the tissue sculpture.  I like the much better control I get with my cannula selection and personally I do not like either ultrasonic nor power assisted techniques.  None of the cases on my website used either PAL or Ultrasonic techniques.  

As any artist, I take my cannula selection very seriously and have evolved what permits me to achieve my results.  I have considered and evaluated many, many technologies.  The many different types of cannula I use have their own advantages and qualities.  I pick a subset of these cannula that varies for the many different types of gynecomastia male chest sculpture that I see.

Gland removal by any technique can still leave a depression when  a major part of the problem is from gland.  For gland removal, I prefer the greater precision of removal under direct visualization and feel.  This also give me access to many more elements for my artistic palette of my Dynamic Technique to sculpt the remaining tissues.

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat.  How tissues move is important.  The human body is beautiful in animation.  That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views.  Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor.  It is like an artist selecting a paint brush.  The results are what matters, not with what tool they sculpt.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[jc71]

I think most everyone here who's had the surgery would agree that the scarring from glandular excision from under the areola is minimal.

A skilled surgeon can remove the gland tissue and after a couple months of healing, leave the apperarnce of no scars.

Concerns about scarring receive way more attention than is warranted.

[spaceace]

I think most everyone here who's had the surgery would agree that the scarring from glandular excision from under the areola is minimal.

A skilled surgeon can remove the gland tissue and after a couple months of healing, leave the apperarnce of no scars.

Does the excision have a relatively low chance of producing an undesireable cosmetic result over lipo?