Excision vs. lypo

[Drastic99]

I was examined yesterday and was told that he think my case of gyne is 95 percent gland versus 5 percent lipo. Is that better? He told me I don't even really need lipo at all. My upper body is pretty tight and there isn't a lot of a fat at all on my back, shoulders, arms etc. Does this mean I can expect an excellent result because of this? He said he just has to take it out. Not all of it but almost so the nipple won't go in.

Any ideas? Thanks.

[nothingworse]

He may be correct. I had the same thing about being mostly glandular but, they still sucked out about 12oz of fiburous fat. Go with both to be safe. Enough so that the nipples are stabilized. It would be best to get both.

[Drastic99]

Oh i plan to have both. I'm just asking does it affect the result since he mostly has to just cut out the gland? I'm thinking it must since it's less "artisty" with the lipo.

[nothingworse]

Well, the lipo would help with getting any stubborn or excess fat in that area. You may have a tight chest but, you still probably have a bit of fat there. And by getting the lipo the results will probably be a bit better. But, if he just removed the gland and gland was causing the problems then it should look much better. But, the full deal and your results will be at 100% or your best chance at the best results is getting both. The surgeon may give you a diagnosis on what they think but, when they open you up it could be a bit different. The first doctor I saw said I had more fat then gland. Then the second doc which I had surgery with said I had quite extensive glands and he was a gyne expert. He opened me up and cut out an impressive 2.15 pounds of gland. He said that was a huge amount for my size. I also had 12 oz of stubborn fiburous fat. Basically what I am just trying to say is don't take any chances. You are paying for the surgery get all you can get. Just tell your surgeon you want both. Maybe your chest will be even tighter after a little excess fat and mostly gland is removed. Results should be good with both.

[Paa_Paw]

nothingworse is correct.

This is an old discussion and has been brought up many times.

Sometimes, glandular tissue can seem quite soft.  Equally, fatty tissue can sometimes seem quite fibrous.    In spite of their skill and best intentions,  even the best surgeons can be fooled either way.

Leave your surgeon the option to do what is needed based on what is found after the surgery commences.  Do not handcuff the surgeon by limitations such as Lipo only.

[Drastic99]

You guys aren't reading what I write lol.

I'm not trying to choose between the two of them. I'm asking that since it's mostly gland according to him, will that make the result better since i don't need much lipo? I will have BOTH done but since it's not like 50/50 I would think it would be a better result?

[Paa_Paw]

One Sculptor might prefer to work in marble while another prefers to make clay models which are later cast in bronze.  A well rounded artist could probably do either.

Your surgeon is an artist,  the skill of the artist over-rides the medium.  There should be little to no difference in the result.

[DrBermant]

I was examined yesterday and was told that he think my case of gyne is 95 percent gland versus 5 percent lipo. Is that better? He told me I don't even really need lipo at all. My upper body is pretty tight and there isn't a lot of a fat at all on my back, shoulders, arms etc. Does this mean I can expect an excellent result because of this? He said he just has to take it out. Not all of it but almost so the nipple won't go in.

Any ideas? Thanks.

It can be very difficult to tell fat / gland during a clinical exam.  Although gland tends to be firm and fat soft, I have found many patients with soft gland and firm fat.  That is why I prefer my Dynamic Technique that permits what I find during surgery to guide what needs to be done.  I pick from a artist's pallet of sculpting tools.  Liposuction and excision are both common tools frequently used during my dynamic technique.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[markashleigh1979]

i would go with both just to make sure

[uk2000]

hey gruff boy havnt see u for a while on here. where u been hiding??

hows all dat scar tissue, still massaging away?

[tonysoprano]

Jees, someone answer the question...

Yes, if it turns out your gyne is almost all gland then I think it's fair to expect a much better surgery result than some McDonalds sponsored blubber whale who needs 2 litres of fat sucked from his chest.

The reason for this is fairly straightforward, it's a far more difficult surgery if there's a fair bit of fat to suck out. It requires carefull, blending in, taking the right amounts of fat from the right places and getting it to blend in with a natural look to the rest of your physique. Also the more you remove the more you swell afterwards (usually), the slower the recovery process and debatably the higher the risk of scar tissue forming. There's certainly a higher chance some can be missed if there's a lot of fat, and a higher risk the skin won't be particulary tight in the chest area if you've just had a large amount of fat removed.

Yes i agree with your question, I also think a gland excision is probably far less 'artistic' than a major chest resconstruction that the extensive lipo the chubbies need, and therefore is more likely to produce a bad result.

Only downside with being too lean and having excision only is, if there's really no fat in there then i've heard the areola area can end up 'sticking' to the pectoral muscle, and when there's movement it all looks fukked up: as the nipples dont move and skin stretches and flexes around the areola's. Although i've never seen this myself - so i'm not entirely sure it's true, or much of a risk. Either way i've heard it's why the surgeon will sometimes leave a little 'button' of gland in there to seperate the nipple area from the pec.

Overall I think in an ideal world the surgeon would have just enough fat to play with; to balance out the contours of the cavity formed by the gland being removed, but not enough to have to stick on a mask and snorkel and play find the gland.

O.K your boring me now, just try not to form to many expectations in your mind about what it will look like afterwards. Take before and after photo's. The road of post-op is filled with doubts and mood swings on 'is it better' 'yes it's great' one day, then 'no it isn't' the next, 'did he remove enough?', 'yes', 'no', "maybe so. Take photo's so you can stay objective, be patient and don't look at it every 5 minutes and be hyper critical.

Gruff

But even if theres no 'lipo' being done as such, theres always some lipo right?

I mean, even if the gyne is all gland, still .. some fat (not excess fat, just fat) needs to be dragged across/re-contoured in the are behind the aerola...

not so much lipo as fat being sucked out , but more fat being redistributed to fill the sub-aerola void that has been created through excision...

[Bakajin]

In bodybuilders you need only excision .   Massive weight loser you usually need  lipo.   In most  you need both.

I was just wondering, why is it people who lose massive amounts of weight need lipo?  I thought skin reduction/lift was the main surgery such people (like myself) need?