smartlipo for gyno * puffy* nips*

[logical1]

Hey to all,

I recently just came back from a consultation with a Dr. For my gyno problem, I'm 6 2 170 lbs , I have fat in my chest area with puffy nips , but its not a lot of fat I may add , anyway the doctor examine me and said that smartlipo should do the job,  he said that under my nipples was real soft and didn't really feel any tenderness , and said that he think that method would be best ? My question is to any one who had a similar experience? And what was the result ? I was thinkin I had a gland issue? But. He said differently?  I don't wanna do the procedure and still have big nips in the end ? Doctors if any tips or knowledge please help ? And to my fellow gyno peeps please shed light

[DeeDubStyle619]

From my understanding, puffy nipples is caused by glandular tissue directly behind the nipple. I also believe the best choice for removing the gland is through excision.

[Ibanez99]

I've always thought the same that puffy nips is due to gland. However I was proven wrong in my own case. I had really puffy nips and I was 100% sure I needed gland excision but I let my doctor make the decision and it turns out I just needed lipo.
check the pics here to believe me
http://www.gynecomastia.org/smf/index.php?topic=20965.0

[DrBermant]

Hey to all,

I recently just came back from a consultation with a Dr. For my gyno problem, I'm 6 2 170 lbs , I have fat in my chest area with puffy nips , but its not a lot of fat I may add , anyway the doctor examine me and said that smartlipo should do the job,  he said that under my nipples was real soft and didn't really feel any tenderness , and said that he think that method would be best ? My question is to any one who had a similar experience? And what was the result ? I was thinkin I had a gland issue? But. He said differently?  I don't wanna do the procedure and still have big nips in the end ? Doctors if any tips or knowledge please help ? And to my fellow gyno peeps please shed light

From my understanding, puffy nipples is caused by glandular tissue directly behind the nipple. I also believe the best choice for removing the gland is through excision.

The normal Anatomy of Gynecomastia consists of gland, fat, and skin. Male Breast Exam does not define what is gland vs. fat. Although gland tends to be firm and fat soft, gland can be soft and fat firm.

In Gynecomastia Anatomy, there are fingers of gland that run through fingers of gland. Liposuction all forms such as ultrasonic, vaser, power assisted, sharp cutting cannula, "smart," all preferentially target the softer fat before the firmer gland. The liposuction tends to dig a hole in the fat for the gland. Here is a drawing of Residual Gland After Liposuction First. Move your screen cursor over the link "Remaining Gland after Gynecomastia Surgery" to see that drawing.

Here are but a few of the many unhappy patients I have seen who were unhappy after surgery by other doctors:

• Revision Gynecomastia After Failed Liposuction By Other Surgeon
• Revision Puffy Nipple Gynecomastia After Failed Liposuction By Other Surgeon
• Revision Gynecomastia After Liposuction and Partial Gland Excision By Other Surgeon.
• Revision Gynecomastia After Partial Gland Excision
  

That is why with my Dynamic Technique, I prefer to target the gland first and then use the remaining fat as a resource to contour the chest. Even with going after the gland first, the fingers of gland spreading through the fat tend to make some of the gland extraction in pieces. You can see graphic examples of pictures of gland removed during gynecomastia surgery. For some the entire gland came out in one piece. For most, there were still firm component remaining in the chest that I added to the removed tissue. By not depleting the fat as a resource, I was able to remove this firmer distorting tissue and still end up with a smooth natural contour that looks good with arms at the side, over head, flexing, during animation, and with areola muscles relaxing. Click on the links on the gland gallery to go to that patient's before after pictures to better see what I mean.

For someone's claim that a technique works, they should be able to demonstrate many before and after photographs. You should check how tissues move, that is a telltale sign of excessive gland contour problems. A good looking chest should look good in a warm environment, at rest, and at play, not just in a limited set of photographic views. Be wary of examples that change those limited views from patient to patient so that the "best" view only is shown.

Hope this helps,

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

[Dr. Elliot Jacobs]

Smart lipo is a new and much hyped technique of performing lipo.  It's main claim to fame, though not scientifically proven, is that it tightens skin as well.  It uses a laser under the skin to "tighten skin" as well as to remove fat.  It makes NO CLAIM to removing breast tissue (gland).

I remain very skeptical about it.  It is a very expensive device and doctors who have it claim it does everything -- forget the fact that they have to help pay off this expensive device.

Sometimes tried and true methods work best -- or just as well as the newer and fancier (and more expensive) methods.  And in your case, if you have puffy nipples, then it is likely to be gland, which cannot be removed by smart lipo alone -- it would require concurrent excision.

If this doctor's method is so very superior, then ask to see some representative photos of his work.  Otherwise, get another opinion or two -- preferably from a doctor who does a lot of gyne surgery.  There truly is a difference!

Dr Jacobs

[Ibanez99]

Good morning Dr.Jacobs ! I wanted to ask you about this puffy nipples thing. As I've heard it's always the gland that causes puffy nips but why is it not so in my case? I hope you've seen my pictures in the link posted above. Before/after pics. How do you like the results ? Could you please comment on them.
Thank you so much!
Sid

[George Pope, M.D.]

Sid,

That's a nice result.  It certainly appears that you have glandular tissue in the preop photos, primarily because you appear to have puffy nipples.  Could you feel any firm tissue behind the nipples?  I've had cases where the tissue protruded like gland tissue, but it was fairly soft and lipo handled it.  If all of the tissue was soft, it could all have been fat.

Dr. Pope, MD

[Dr. Elliot Jacobs]

In medicine, there is no "all or none." 

When confronted with "puffy nipples", it is most often due to growth of firm gland directly beneath the areola.  And this usually requires excision.

But sometimes there is a mixture of fat and gland, which might be amenable to lipo only.  That is why my routine procedure is to perform aggressive lipo (with my own cannula) initially.  If the lipo is successful, then case done and no need for a peri-areolar incision. 

If I do detect gland under the areola however, then indeed excision is performed. 

This is a step-by-step approach to gyne surgery -- one stage dictating what the next stage will be.  Some doctors call this a "dynamic technique" to try to make it sound special, but truly this is what all doctors do during surgery.

Dr Jacobs

[Ibanez99]

Thanks Dr.George and Dr.Jacobs for replying. As you said my doctor told me the same that he did lipo first and he decided excision was not required so he didn't do it. But how could I have puffy nipples in the first case without gland? Pre op I think I could feel some tissue beneath the nipples but I'm not sure how hard it was cause I don't know what "hard" wud be defined as..It was not rock solid but harder than the fatty areas I'd say. So do you think it was basically fat that was giving me puffy nipples which was removed during lipo? I'm kinda confused. Also my nipples are a "bit" protruding out as u can see in the pics but that's normal my doctor said cause I don't want them to crease "inward" or get craters. So is this what it should look like ?
Also one more thing, doctor said I'd see my final results after 5months. So this could be swelling also? I mean how long does it take the swelling to reduce if only liposuction is performed? Or are these my final results and not gonna reduce any further?
Thanks again!
Sid

[logical1]

Thanks all for the advice, i went and had a second opinion and this doctor said i did have a lil bit of the tissue ( gland), so i will be having my surgery August 20th, 

i will post pictures soon !!!!!!!!!!!!!!!!!