Lipo ONLY without gland removal...???

[the_bull]

I keep reading that lipo and gland together provide the best results....however I've met a surgeon I feel comfortable with and he tells me that I should opt for lipo ONLY. He says I can see about a 50% reduction with removing approx. 300cc from left breast and 200cc from right through ultrasound lipo.

Here are my pics, what do you think of getting ONLY lipo without gland removal?? http://s722.photobucket.com/albums/ww224/The_Bull75/

[BakedBeanz]

Ive been giving the same option too, its hard to make a decision.

[Dr. Elliot Jacobs]

I have done many many gyne procedures, and even with my experience, I cannot (in most cases) predict whether lipo alone or lipo and gland excision will yield the best result.  I inform all my patients that I will try to get them as smooth and contoured as possible with lipo first (I use special, sharp instruments of my own design) -- but if I find during surgery that I cannot get all the tissue out, then I will proceed with gland excision.  It is, in essence, a "game time" decision.

I do not agree that anyone who is having gyne surgery should decide in advance of the operation whether one or the other technique should be the only technique used -- and I certainly do not feel that one should embark on surgery with the anticipation of getting it "better" and not going for the gold in one procedure.  I have seen too many patients who were operated upon by other docs who got an "improvement" -- but who were not satisfied until virtually all of the tissue was removed and they were smooth, flat and contoured. They therefore needed a second operation, which in my opinion, could have been avoided in the first place.

Dr Jacobs

[monsterclean]

To the doctors on the forum:

What about ultrasound liposuction?  I was told that this procedure can effectively remove both fat and gland (provided that the gyne is mostly fat).

Any thoughts?

[Dr. Elliot Jacobs]

Ultrasound assisted lipo will only remove fat -- it does not remove gland -- PERIOD!

Dr Jacobs

[the_bull]

Dr. Jacobs, thank you for your insight on this...With ultrasonic liposuction removing fat and then through the same (armpit area) incision I'm told it can be possible to remove some or all breast tissue (gland) with a special instrument. The PS said this will avoid the incision and scarring of the nipple area and allow him to pull out the the gland (if necessary) from the same axillae incision...What is your opinion on this method?

Thank you..

[monsterclean]

Yes, I was also told the same thing.  The ultrasound can be used to fragment the glandular tissue and remove it without a nipple incision.

Thoughts?

[mizuno]

Dr. Jacobs,
Your special design canula is ablt to remove the gland via liposuction ?
And average how many times have you had to remove via direct incision?
I would prefer that the P.S. do direct incision but your repution makes me feel
confident that you can achieve maxuim results but you can see why many of
us are sceptical.

[as400]

I have yet to read on here someone who has had ultrasound and been pleased with the results...I have read many accounts of conventional procedures though with excellent results.

this idea that you can zap a laser and hay your man boobs have gone is I think deceptive at best.

[Dr. Elliot Jacobs]

My sharp cannula enables me to sculpt gyne from a remote nick in the skin approximately 50% of the time.  The instrument is not perfect and in the other 50% of the cases (and probably a higher percent in adolescents), I do have to make a peri-areolar incision to complete the removal of tissue.

Many guys here are very concerned with the peri-areolar incision -- understandably so.  But if it is made properly and sewn up with care, it usually heals to be a fine white line that is very difficult to see (at least in my hands). 

Surgeons often have to make decisions about incisions vs best results -- and oftentimes an incision will be needed to get the very best result possible.

Dr Jacobs

[Dr Kapoor]

I keep reading that lipo and gland together provide the best results....however I've met a surgeon I feel comfortable with and he tells me that I should opt for lipo ONLY. He says I can see about a 50% reduction with removing approx. 300cc from left breast and 200cc from right through ultrasound lipo.

Here are my pics, what do you think of getting ONLY lipo without gland removal?? http://s722.photobucket.com/albums/ww224/The_Bull75/

There's no doubt that you wouldn't get a significant improvement with liposuction alone, but in my opinion, about 80-90% of men in my practice will benefit from some type of gland removal. I think looking at your photos, I would probably recommend BOTH gland removal and liposuction. Like Dr Jacobs says, the scar, if closed properly, will heal very well and be nearly imperceptible. Furthermore, ultrasonic liposuction DOES NOT remove glandular tissue - this needs to be directly excised or shredded in some manner with a sharp instrument as Dr Jacobs points out.

One more thing to mention, in many cases where i felt liposuction alone was adequate, but i ended up removing glandular tissue, I have been VERY SURPRISED by the amount of glandular tissue there actually is and was much happier with my final results.