Purpose of lipo?

[canadianmoobs123]

What's the point of doing liposuction in a gynecomastia surgery. Gynecomastia is having female like breasts, which means you have large mammary glands. So treating the gynecomastia is essentially removing that breast tissue(gland) with a surgical excision. Liposuction is unneccesary, cause the fat removed by the liposuction can be removed the same way by weight loss before and after the surgery. So if this logic is correct wouldn't you consider liposuction an unneccesary waste of money? Or is it strictly a choice by the patient?

[George Pope, M.D.]

Liposuction is an important part of the gynecomastia surgical procedure, but it is not necessary in all patients.  The female breast is not all gland tissue; there's a good bit of fat present too.  And as a woman ages, the glandular tissue is ultimately replaced largely with fat.  A man with gynecomastia has a similar situation.  There's usually a good bit of fat that can be suctioned away to improve chest contour, and the actual glandular tissue is often laced with fat; it's almost a fibrous type of fat that a conventional cannula can't remove - thus the need for direct tissue excision.

A plastic surgeon's expertise with a liposuction cannula to me serves as a big reason to seek a board certified plastic surgeon for gynecomastia surgery.  Many general surgeons will perform gynecomastia surgery by directly excising gland tissue, but most general surgeons have no experience with liposuction.

Dr. Pope, MD

[Dr. Elliot Jacobs]

Liposuction is an absolute necessity in performing gyne surgery.  Remember, gyne is not composed of solid breast tissue.  It is actually fingers of breast tissue interspersed with fat.  The purpose of liposuction is to remove as much of the combined fat and breast tissue as possible -- and then remove any additional firm tissue (which usually sits just below the areola).

Lipo also helps to re-distribute the skin over the entire chest.  Many guys who think they just have puffy nipples and can have it removed in a "minor" procedure oftentimes end up with residual puffy nipples because the surgeon has not used lipo to help re-distribute the skin.

Dr Jacobs

[canadianmoobs123]

Liposuction is an absolute necessity in performing gyne surgery.  Remember, gyne is not composed of solid breast tissue.  It is actually fingers of breast tissue interspersed with fat.  The purpose of liposuction is to remove as much of the combined fat and breast tissue as possible -- and then remove any additional firm tissue (which usually sits just below the areola).

Lipo also helps to re-distribute the skin over the entire chest.  Many guys who think they just have puffy nipples and can have it removed in a "minor" procedure oftentimes end up with residual puffy nipples because the surgeon has not used lipo to help re-distribute the skin.

Dr Jacobs

            Yes but wouldn't pre-op weight loss down to 8-9% body fat make lipo unecessary , therefore making the cost lower?

[Dr. Elliot Jacobs]

No matter how much weight you lose, there will still be the necessity of removing some fat.  The process of lipo also loosens the skin so that it re-distributes better across the chest.  Weight loss does not make the operation easier for the surgeon -- it is only healthier for you. 

Fees for surgery, in general, are standard rather than nit-picking exactly what work there is to be done.  For example, I charge one standard fee for my work -- and that work is to produce a trim, taut and sculpted chest. The patient is aware of that fee prior to surgery.  It doesn't matter how long it takes in the operating room or whether I do only lipo or both lipo and excision, the fee is the same -- it is the result that counts.  I think that is only fair.  How would you like to wake up and have the surgeon tell you that the operation took a bit longer than anticipated and that there would now be an extra charge??

Dr Jacobs

[Litlriki]

I deal with many patients in my practice, who develop their gynecomastia from steroid use, and many of these patients are quite lean.  I still do some liposuction in these patients for the reasons Dr. Jacobs and Dr. Pope have said, namely to provide contouring of the tissue around the excised "gland" so that there are smooth transitions, and to allow for re-draping of the skin.  Some of these patients live below 8 - 9% body fat, but the liposuction is still useful to provide a smooth and tight looking contour, which may not be achieved solely with excision.

Rick Silverman