lazer lipolysis

[chipsmagee]

 hello all, newbie here. ive been considering surgery to rid me of gynecomastia when i stumbled across lazer lipolysis treatment, im told its done while your awake, its painless and there are no side affects. anyone had any experience with it or know anyone whp has had it done at all? thanks..

[DrBermant]

hello all, newbie here. ive been considering surgery to rid me of gynecomastia when i stumbled across lazer lipolysis treatment, im told its done while your awake, its painless and there are no side affects. anyone had any experience with it or know anyone whp has had it done at all? thanks..

Just answered this question on lazer lipo :

hi just wandarin if this can be used for gyno! has anyone had this done

 
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, Laser, 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.  The incision at the edge of the areola  opens up my entire spectrum of artist's pallet of tools for my sculpture.  A remote incision robs me of many options and just does not looks as nice.

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.

Laser Liposuction ("Smart Liposuction") is just another variation of trying to destroy fat cells while in the body using laser light energy.  There are no reliable studies that it will also destroy gland well.  If it did, it would also destroy connective tissue, fascia, and dermis all closely related to light absorption in the body.  I have seen disasters from patients who had been told that the method would help their gland.  Some had defects I could not help.

For a liposuction cannula to remove gland, it can also remove connective tissue and other structures which can lead to more bruising and scars.  I have seen so many patients who were unhappy from doctors that used "special cannula to remove gland," that I just prefer to go directly to the problem itself.  Primary surgery is usually better than needing a revision.  All male breasts have gland.  With access to the gland directly, I can peel it off the areola muscle, minimize bruising and bleeding with direct control of the tiny blood vessels, and then reconstruct the contour.

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, Ultrasonic, nor sharp cutting cannula 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 Surgery

[Dr. Elliot Jacobs]

Laser lipo (Smart Lipo, Cool Lipo, etc) is being hyped about being better, less invasive, less bruising and leaving tighter skin.  THERE ARE NO PEER REVIEWED SCIENTIFIC STUDIES TO BACK UP THESE CLAIMS!!

Fact:  laser lipo can melt fat -- not gland -- and the liquified fat still has to be vacuumed out with a standard cannula.  And when it is used to try to tighten skin, it does so my coming close to the undersrface of the skin with a very hot laser -- and there have been burns of the skin due to this (they don't tell you that in their ads!)

Fact:  no matter what, there may be swelling and bruising -- but these are temporary and innocuous -- they do not impact the final result.

Fact:  some small gynes can be done under local anesthesia, but the larger cases cannot.

Remember:  these laser lipo machines cost around $170,000 -- the surgeons are hyping them because they have to pay for them.  While I always give new technology a thorough evaluation, I also have the wisdom to recognize when the older, tried, true and safe methods still offer excellent results.

Dr Jacobs

[belfastmale]

i had gland excision and lipo done 8 months ago, but not 100% happy as not enough lipo was done. i have been reading about vaser or laser lipo. all the gland was removed in my first surgery, so i know my problem now is just excess fat. would this type of lipo be suitable for someone like myself?

[Dr. Elliot Jacobs]

If "all the gland was removed" and all that remains is fat, then virtually any type of lipo will work -- yes the fancy ones like vaser and laser lipo will work (perhaps a bit more expensive), so too will traditional lipo or power assisted lipo.  It's your choice at this point.

Dr Jacobs

[belfastmale]

yeah my surgeon who did my first surgery told me that all the gland was removed apart from a tiny bit behind the nipple, he says this is to stop the nipple having a crater defect, so i know that my problem is fat only. the reason im interested in the vaser lipo is its supposebly easier on the body, can be done under local and quicker recovery times.

[DrBermant]

yeah my surgeon who did my first surgery told me that all the gland was removed apart from a tiny bit behind the nipple, he says this is to stop the nipple having a crater defect, so i know that my problem is fat only. the reason im interested in the vaser lipo is its supposebly easier on the body, can be done under local and quicker recovery times.

Actually techniques that destroy the fat cells in the body are harder on healing comfort and evolution of tissues.  Vaser, laser, and other such techniques burst the cells and depend on the liposuction to remove the damaged material.  There is still a great deal of this damaged material left for the body to manage.  Try to find Pictures of Swelling and Bruising After Male Breast Reduction Surgery for any specific technique to see what I mean.  You should also look for Comfort After Gynecomastia Surgery to better understand how much damage / pain patients experience with that method.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery