HELP, Do I need excision OR lipo only ?

[hotguuy]

my ultrasound report.  hypodensity noted in both breasts, measuring 5 X 18 mm * on  L,  6 X 16mm on R.

I met a plastic surgeon. He said anything less than 20mm is not gyno. It won't affect the appearance. So, he recommend vaser liposucion ONLY. No need nipple excision.  He said my breast tissue is so small & not worth the risk to leave a scar &  concave .

My main concern is protuding pointy & big  nipples.  Thanks , doctor
Here is the pic attached

[Dr. Elliot Jacobs]

If you have pointy or puffy nipples, it can ONLY be produced by breast tissue (gland) under the areola.  Liposuction alone cannot treat this because the instruments are dull (not sharp) and can only remove fat, not breast tissue.  Not even Vaser can remove breast tissue, which is a common misconception.  Virtually every gyne operation requires both lipo and excision.

Your surgeon may be advising lipo only because he is rightly concerned about possibly leaving a crater deformity.  However, this poses no problem to an experienced gyne surgeon.

You may want to get another opinion from an experienced gyne surgeon before proceeding with this elective surgery.  If you go thru the lipo only route, you may end up being disappointed and need a revision at additional expense.

Good luck!

Dr Jacobs

[hotguuy]

Thanks , doctor.

So, based on the pic & data given, according to your professional opinion,  I need excision too ? 
Thanks.

bcoz according to my ps, he said anything below 20mm, shouldn't consider gyno, & won't cause cosmestic diffrence, most likely its the fat ....

[Dr. Schuster]

Experienced gynecomastia surgeons all know that a combination of lipo and excision of glandular tissue is required in most cases. The surgeon must be prepared to remove glandular tissue directly beneath the nipple in order to adequately get rid of the gynecomastia. I use VASER all of the time and it is still not enough to remove all the glandular tissue in the majority of cases. Be careful.