Do surgeons never remove all of the gland?

[slyblackdragon]

Indeed angiogenesis would create new blood vessels, but in order to "tie into" the blood stream they would need to attach to blood vessels found in the hypodermis. Removing the hypodermis completely would effectively leave that area devoid of blood supply greatly increasing the chances of skin necrosis.

[Dr. Elliot Jacobs]

The normal anatomy of the human male has ONLY breast tissue beneath the nipple-areola.  Gynecomastia results when there is EXCESSIVE breast tissue present.  Hence, in performing proper gynecomastia surgery, it is absolutely mandatory to leave some tissue to support the nipple/areola and to prevent it from caving in -- and that tissue is breast tissue.  Remember, gynecomastia is not breast cancer -- we do not have to remove everything for a "cure."  Properly performed surgery will remove the excess breast tissue and sculpt the remainder so that there is a smooth, flat chest.

Dr. Jacobs 

[moobius]

Indeed angiogenesis would create new blood vessels, but in order to "tie into" the blood stream they would need to attach to blood vessels found in the hypodermis. Removing the hypodermis completely would effectively leave that area devoid of blood supply greatly increasing the chances of skin necrosis.

you don't know wtf you're talking about... the hypodermis is used mainly for fat storage. removing the fat from this region does NOT hamper blood flow. any severed blood vessels regrow via angiogenesis (just like they do elsewhere in the body with other types of wounds).  when new blood vessels are created they "tie into" the blood stream automatically. that is the very definition of "blood vessel". why would the body create blood vessels that weren't tied into the blood stream? 

seriously... just give it up on this one. you lost.

[slyblackdragon]

I think we need to agree to disagree on this one as we have been bickering about it too long. Fact remains that the hypodermis functions in fat storage AND to attach the skin to underlying bone and muscle as well as supplying it with blood vessels and nerves. I believe the hypodermis has a function in skin health and you don't, let's just leave it at that.

[moobius]

I think we need to agree to disagree on this one as we have been bickering about it too long. Fact remains that the hypodermis functions in fat storage AND to attach the skin to underlying bone and muscle as well as supplying it with blood vessels and nerves. I believe the hypodermis has a function in skin health and you don't, let's just leave it at that.

the hypodermis does serve a function in skin health, but fat storage is not an essential function.  the fact still remains that damage to the hypodermis that causes blood vessels to be severed will be repaired via angiogenesis. 

you're trying to wiggle out of this argument by implying that my position is that the hypodermis is unecessary.... nice try, but i'm not gonna let you off that easy.  if one had the fat lipo'd from their hypodermis and severed blood vessels in that region, the blood vessels will grow back -- they simply will have less fat to grow through.  that region of the skin is still considered the "hypodermis". removing fat cells from that region doesn't magically make it disapear 

your argument is based on a fundamental lack of understanding of the topic at hand. no matter how many ways you try to twist it, the fact is you are wrong. there is no "we need to agree to disagree" here... you don't know wtf you are talking about, period.

you asked me before not to make you look like a fool, but everytime you try to bolster your argument here you do that for me