Is ultrasound lipo (UAL) now the best?

[herewegoagain]

Is the new ultrasound lipo method the best?

In other words, would it be wise for some of us who are considering gyno surgery to wait until the ultrasound method is the new standard?

I've read that some doctors are using it, but very few so far.

Thanks

[Grandpa Bambu]

Is the new ultrasound lipo method the best?

Dude...  the term is 'Ultrasonic' Liposuction.

Is it the best, well that all depends on the person having the surgery and what their personal needs are. See, the end result is the same, however there is less trauma to the body and therefore less bruising occurs. For someone who wants little to no bruising, then sure, UAL would be preferable.

It's a gamble really... I had worries that I would not heal very well from my surgery. However, the swelling and bruising was gone by day 12 post-op  . For some, the swelling and bruising lasts much longer.

Should you wait.... that all depends on how manageable life with Gyne is for you. Personally, I had no concern over the 'technique' used to rid me of my moobs. I just wanted to be Gyne free and to be able to walk down the street in a t-shirt without being stared/laughed at. Even if it took 6 months for the swelling and bruising to subside, I still would have had the surgery. I survived 31 years with Gyne, what's another  1, 2, 6 months before you can go topless...

Dude, do what feels 'right' for you....  

John.

[wasatchm]

hey john,

nices photos.  results looks outstanding.   so how long after surgery til your skin stopped tightening.  my gyne might be similair to yours on one side.    any idea how much breast tissue was removed.  I'm really worried that my skin will not tighten near as much as it needs to (although your before and after pictures give me hope).  I have one breast with moderate gyne and one breast with major gyne (see pic below.).  it looks pretty bad in the pic (might actually look at little worst than it actually is... plus I have lost 17 lbs since I took that pic).   my major gyne side breast sticks out about 1 5/8 inches.  any idea how far yours stuck out.  just trying to get an idea of what I might look like 6 months after surgery (if I looked as good as you I'd be in heaven I think).  

BA  

[wasatchm]

hey john,


oops,  here is the photo I forgot to link in the previous message

http://www.geocities.com/bray19702004/frontviewpic4

[Grandpa Bambu]

wasatchm....

Yeah, I'm happy with the results...

I never had any sagging skin post-op. The pics that you see after the bruising and swelling subsided, is the way my chest looks today. There is still a bit of fatty tissue that I and going to talk to JCF about but it's nothing major.

Sorry, don't know how much JCF took from me.

Skin can contract more than most people think. Don't worry about it Dude. Just have the proceedure and if you require a bit of excess skin removed, then so be it. My Gyne was more like your LHS but larger. Your RHS has some 'sag' to it. Don't know if that would result in excess skin post-op. All you can do is hope for the best my man.

Get a consultation with a PS and see what he/she says about your RHS.

Sorry, I don't know how much my Gyne protruded. Never measured it.

John.

[wasatchm]

thanks for the info

I have surgery booked for Oct 27th in Salt Lake City where I live.  I just found out my PS does do ultrasound lipo.  I haven't asked him about it's benefits or risks yet. my PS said he could remove some excess skin on one the one side but I told him I wanted to hold off (and see how much my skin tightens).  he agreed that is probably the best choice.

to be quite honest, even if I end up with  a bunch of loose skin on the one side I think I will look a lot better.  not sure if I would even have the excess skin removal surgery (unless I happen to have some excess money).

BA

[Grandpa Bambu]

Not sure if I would even have the excess skin removal surgery (unless I happen to have some excess money).

BA

Yeah, I hear ya there Broh!

John.

[DrBermant]

Is the new ultrasound lipo method the best?

In other words, would it be wise for some of us who are considering gyno surgery to wait until the ultrasound method is the new standard?

I've read that some doctors are using it, but very few so far.

Thanks

Various types of ultrasonic liposuction 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, 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.  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