Ultra-sonic liposuction?

[asap4500]

I had a consultation today.  The doctor told me that he uses a compound to stop bleeding, painkiller and also to breakdown tissue.  He said my prob is almost all breast tissue and ultra-sonic liposuction can be used to remove it.  The only cutting would be for the lipo.  He also said that this kind of lipo will kind of heat the skin to bring it back in to the new contour (I guess kinda like heat shrink?).  Does this sound right at all, should I be concerned?

[mmaman]

That does not sound right to me at all.  You better find another surgeon.  You never know.  Perhaps you will be the first person in history to have breast tissue removed by liposuction.  I wouldn't risk my money on it though. 

[manic91m9]

i had ultrasonic lipo combined with gland excision the ultrasonic melts the fat so its easier to suck out and is meant to be better for skin elasticity (which i think it was) haven't seen any good results for lipo only on gland except for power assisted lipo where they use a cutting tool. is  your surgeon board certified? how much experience has he had doing this operation? you might get a good result from him but the tried and true method seems to be gland excision combined with lipo.

[DrBermant]

I had a consultation today.  The doctor told me that he uses a compound to stop bleeding, painkiller and also to breakdown tissue.  He said my prob is almost all breast tissue and ultra-sonic liposuction can be used to remove it.  The only cutting would be for the lipo.  He also said that this kind of lipo will kind of heat the skin to bring it back in to the new contour (I guess kinda like heat shrink?).  Does this sound right at all, should I be concerned?

Liposuction Is Great for Sculpting Fat

Various types of ultrasonic and power assisted liposuction (UAL and PAL) have been around for quite sime time.  Each surgeon uses the tools and techniques he / she prefers.

There are studies claiming that ultrasonic liposuction does not break down gland cells, these were done to justify the safety in female liposuction breast reduction surgery.  Ultrasonic energy cannot be both ways, good for gland breakdown and safe not harming gland unless there is a difference between male and female breast gland tissue which has not been proven to my knowledge.

Tumescent liposuction is a form of anesthesia where fluid is placed in the tissues to be sculpted.  You can see very graphic pictures of the tumecent technique here.

Liposuction such as ultrasonic, VASER, power assisted, and sharp cutting cannula preferentially remove fat over gland.  Gland tends to exist under the nipple areola region.  When fingers of fat extend between fingers of gland, breast reduction can come from removing the fat and leaving gland behind.  On animation such as flexing the pectoral muscles or putting the arms over head, gland does not compress or move like fat.

When gynecomastia is from fat, liposuction works very well for contouring the chest.  I have seen many patients from other doctors who tried to use liposuction alone techniques that left gland behind that the patients just did not like for Revision Gynecomastia Chest Sculpture.

Here is an example of Revision Surgery after Liposuction alone.   Here is another revision after liposuction alone.

The problem is picking the right method for what actually is that patient's problem.  That is why I prefer my Dynamic Technique that permits what I find during surgery to guide my sculpture.  The incision at the edge of the areola  opens up my entire spectrum of artist's pallet of tools for my sculpture.  A remote incision robs me of many options and just does not looks as nice.

I have also seen patients with channel problems between remote access sites and the areola / nipple.  Scars, adhesions, and depressions can look terrible.  Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexion here to see what I mean.

Ultrasonic liposuction uses energy to help emulsify fat.  Power assisted liposuction uses mechanical vibrating devices to rapidly move the cannula back and forth.  Both PAL and Ultrasonic methods have been around for several years.  Many do not prefer what they do to the tissue.  Others like what they offer.  Both still preferentially remove fat over gland.  Both make the work of the surgeon easier.  Some feel ultrasonic liposuction can cause more swelling, bruising, and the increase the need for drains.

For me however, they also both remove the feel of the tissue sculpture.  I like the much better control I get with my cannula selection and personally I do not like either ultrasonic nor power assisted techniques.  None of the cases on my website used either PAL or Ultrasonic techniques. 

As any artist, I take my cannula selection very seriously and have evolved what permits me to achieve my results.  I have considered and evaluated many, many technologies.  The many different types of cannula I use have their own advantages and qualities.  I pick a subset of these cannula that varies for the many different types of gynecomastia male chest sculpture that I see.

Gland removal by any technique can still leave a depression when  a major part of the problem is from gland.  For gland removal, I prefer the greater precision of removal under direct visualization and feel.  This also give me access to many more elements for my artistic palette of my Dynamic Technique to sculpt the remaining tissues.

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat.  How tissues move is important.  The human body is beautiful in animation.  That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views.  Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor.  It is like an artist selecting a paint brush.  The results are what matters, not with what tool they sculpt.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[asap4500]

The Doc is board certified and performs 2-3 gyne operations per month.  I don't have the hard tissue that is usually explained as gland.  It looks like fat, feels like fat and moves like fat.  I was just confused when he said it was breast tissue and he'd use lipo to get rid of it.   thanks for the quick reply everyone, especially Dr. Bermant.

[skyhawk]

I researched ultra sonic lipo about a year ago. I had particular interest in the VASER because of the claims of better skin retraction, etc.  Dr. Delgado stated that its not the surgical tools but the skill of the surgeon that counts. I studied before and after photos of ultrasonic and traditional tumescent lipo in side by side comparisons. CONCLUSION: I witnessed no advantages in the final outcome of untrasonic lipo vs. traditional tumescent lipo in before and after photos. Surprisingly, the majority of regular tumescent lipo photos looked slightly better than Vaser and I saw no advantages of ultrasonic. It really is the surgeon and not the tools he chooses.     

[mmaman]

Asap, unless you're very overweight I would be very suspicious of a doctor who recommends lipo only for gynecomastia.  If you just need lipo because you are overweight, I doubt that you have what many consider to be gynecomastia.  I have never heard of anyone happy with lipo only surgery.  Unfortunately, I get the vibe that you are in a rush to get surgery and this will cloud your judgment.  You should see a few docs before you decide and at least look at pictures of his work.  It's your money. 

[asap4500]

Is it that obvious?  I didn't realize this was a condition or correctable until a few months ago.  I have the money and the vacation time I just need a Doc. that'll do it right the first time.