Gland tissue removing without liposuction ?

[lewi_hami]

Hello
I talked with two plastics surgeons and both giving me different options. One said that i have just mild case of gynecomastia and just removing that gland tissue will be enough. While other one suggest me to do the both (gland tissue removing + liposuction).
Tissue removing + liposuction is 3x more cost here, so i wanna ask (look my photo) will be enough just to remove the tissue to i have good looking chest or its much better when its done together ?
Right nipple is more puffier than that on left side

[lewi_hami]

This is how my chest look in the first half of the day
Nipples are not puffy and its very hard to say that i have gynecomastia, but in second half of the day (or when its hot) they look as first picture in the thread.
That's why i'm asking will just gland tissue removing helps or i need to do liposuction too..

[Dr. Elliot Jacobs]

You have puffy nipples as well as apparent excess tissue on your chest (ie gynecomastia).  The presence of puffy nipples indicates there is solid breast tissue just beneath the areola.  That would require gland excision in order to get the best possible result.

Good luck!

Dr Jacobs

[lewi_hami]

You have puffy nipples as well as apparent excess tissue on your chest (ie gynecomastia).  The presence of puffy nipples indicates there is solid breast tissue just beneath the areola.  That would require gland excision in order to get the best possible result.

Good luck!

Dr Jacobs

So gland excision is enough, there is no need for liposuction in my case (if i good understand you) right ?

Thanks Dr Jacobs! 

[Dr. Elliot Jacobs]

You may still need liposuction -- best to go to a surgeon who can do both procedures at one operation.

Dr Jacobs

[Dr. Schuster]

Thanks for the photo to review. I think that you have gynecomastia. In my experience I would treat this with a combination of liposuction, ultrasonic assisted lipouction and excision of the residual dense glandular tissue. The liposuction is very useful to get a smooth result throughout the whole chest. Good luck.

[Litlriki]

I would also use both liposuction and excision to address your situation.  Excision alone may not provide adequate contouring (increased risk of a crater), and liposuction alone is not usually enough when the nipples are puffy.