Getting lipo during gyne surgery-- it's fat, so wont' it grow back?

[Fat-Elvis]

It seems almost everyone who gets gyne surgery gets excision and lipo.  While excision gets rid of gland which should be permanent, wouldn't fat taken out from lipo just grow back?  So wouldn't that mean, unless you have really low body fat, your chest wouldn't look as good as it does post-surgery after a while?

[dcvet]

It seems almost everyone who gets gyne surgery gets excision and lipo.  While excision gets rid of gland which should be permanent, wouldn't fat taken out from lipo just grow back?  So wouldn't that mean, unless you have really low body fat, your chest wouldn't look as good as it does post-surgery after a while?

Your body virtually has a certain amount of fat cells.  When you get "fatter" it is because the fat cells are expanding and getting larger, not because you are creating more fat cells.  Once you have lipo done, those fat cells are removed, therefore thay cannot grow.  HOWEVER, if you keep gaining fat, fat cells in the area can increase in size quite a bit and it may appear as it did before.

I feel that lipo should not be a substitute for a healthy bodyfat percentage.  Now, I am getting surgery next week which includes excision and lipo, but the way i store fat is quite unproportioned.  I can be at about 7% with visible abs, as well as visible vascularity in my chest, and still have some fat around my nipples...  Currently Im at about 13% and have just a little more fat in the nipple area.

[DrBermant]

It seems almost everyone who gets gyne surgery gets excision and lipo.  While excision gets rid of gland which should be permanent, wouldn't fat taken out from lipo just grow back?  So wouldn't that mean, unless you have really low body fat, your chest wouldn't look as good as it does post-surgery after a while?

I caution each of my patients that surgery does not typically stop male breast growth.  If there is a problem with growing breasts, recurrence can happen.  Any of these medical problems and or these medications can cause gynecomastia. So, if you want to get worried about regrowth, you could get yourself evaluated for each of these conditions to see if they could be a factor.

Surgery also does not prevent weight gain in the chest.  Men tend to put weight on the belly and chest regions.  I educate each of my patients that this surgery will not prevent further breast growth.  It is like changing/fixing a tire with a nail.  Fixing/changing the tire will not prevent you from getting a new nail in that tire.

I take care of many patients with gynecomastia, as many as 8 in one day alone.  With all the gynecomastia surgery I have done, it is very rare to have regrowth for patients I have sculpted.  One patient (who had surgery on only side by another doctor) came to me with pro hormone induced gynecomastia that only came back on the side that had no surgery.  His growth was massive on the one side and none on the other.  His surgery by that other doctor had left a massive crater - the skin was adherent against the chest wall with normal fat surrounding the ugly deformity.  One side looked like the deformity seen here.  The other side was almost a B cup breast so tender that I could barely examine it.  As with each patient who presented to me with current breast growth, he was referred for an endocrinology evaluation and stabilization before considering surgery.  I do not know if such radical surgery was a factor or not.   Even if it did, removing all fat under the skin just gives an unnatural look.

I prefer to target the gland first with my Dynamic Technique. This permits me to remove most of the gland and then sculpt the remaining tissue to minimize contour problems.  Any surgery technique, even radical breast mastectomy for male breast cancer can leave gland behind.  The problem is that there are fine fingers of gland that dissect between fingers of fat and can extend quite far into the chest.

You can see what I mean by fingers of gland here.

By concentrating on the gland first I am able to minimize the chance of breast regrowth.  It is very rare for my patients to have recurrence.  With my techniques and red flag before surgery evaluation system, I have only a few patients over the many years I have been doing surgery that I know have regrown.  However, gynecomastia surgery does not stop breast regrowth.  For patients having breast growth, I have advised for many years that they should get their problem under control before surgery.  There are exceptions, such as young men with massive breasts that have not stopped growing.  That is why each case needs to be individually evaluated. 

Prevention of gynecomastia, when possible, is much better.

Secondary Surgery is often an option for those who had prior surgery.  Such issues are better discussed during a consultation with your surgeon or someone who can advise you about your options.  We help patients explore such issues during consultations or preliminary remote discussions.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[Fat-Elvis]

Thanks for the responses.

So have you ever operated on a gyne patient who's in really good shape (low bodyfat), but still had to do lipo for fat in the chest?  I have fairly low bodyfat (and a mild-moderate case of gyne), but I'd just be concerned if I go in for surgery and it turns out it's mostly fat in my breasts.

[DrBermant]

Thanks for the responses.

So have you ever operated on a gyne patient who's in really good shape (low bodyfat), but still had to do lipo for fat in the chest?  I have fairly low bodyfat (and a mild-moderate case of gyne), but I'd just be concerned if I go in for surgery and it turns out it's mostly fat in my breasts.

Yes, I have operated on many patients with low and very low body fat. I operate on many professional athletes, marathon runners, bodybuilders and others.  You can see some of the many examples on site collected in this Body Building Gallery. Other examples are scattered around my site.

Liposuction is one of my Artist's Pallet of tools I use during my Dynamic Technique Male Chest Surgery Sculpture.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture