Do I NEED to have the fat on my chest liposuctioned?

[someIrishGuy]

Hi folks,

I have recently resolved to do something about my gynecomastia. I am researching my options and I am searching for an experienced surgeon to perform the procedure. 

I hear a lot of people talking about getting the fat liposuctioned away as well as getting an excision to remove the gland. My question is, do I require the lipo to remove the fat? Can I just continue to eat healthily and workout to eventually remove this fat? As it is I just want the gland removed, I am not too bothered about getting the lipo if it is something I can work on myself.

Does the lipo remove anything else left by the gland that would otherwise be impossible to get rid of from good diet and workout alone?

[Litlriki]

Liposuction is usually a necessary adjunct to excision of gynecomastia to help provide a good contour in the area and avoid a crater deformity, as well as to remove stubborn fat.  Typically in patients who have gynecomastia, the fat of the chest tends to be resistant to fat loss as compared to fat elsewhere.  This is similar to "saddle bags" or "love handles," where the fat is resistant to weight/fat loss and sticks around in spite of adequate dieting.  As a result, I do both liposuction and excision in nearly all gynecomastia patients. Continued weight loss after the procedure will give a better outcome, but it might not adequately reduce the fat evenly if liposuction is not performed at the time of the surgery. 

[Dr. Elliot Jacobs]

Agree with Dr. Silverman.  Liposuction is an integral part of appropriate gynecomastia surgery.  Fat on the chest is one of several areas on a male body where weight loss doesn't do much good.  Wouldn't it be great if we could diet and tell our bodies where we want the fat removed and where it is best left alone?  That is the Holy Grail -- as yet unanswered.

Dr Jacobs

[someIrishGuy]

Thank you both for the very informative answers. I have an appointment with my GP to discuss my options for surgery within Ireland tomorrow.