Lipo only adequate?

[alten33]

My surgery is scheduled for this Tuesday and its liposuction only! The Liposuction+Excision surgery is the same price but the doctor has recommended lipo only; I'm concerned about this as it seems like lipo only results are usually not up to snuff. I don't have a severe case of gyne and am wondering if liposuction alone would be adequate?? Here are the pics.



Would rather not have to deal with the scars of excision if they aren't necessary

[RyanMace]

It's impossible to tell man. Although, I'd be worried. Surgeons that tend to do lipo only are often scared of doing excision, seeing as they don't master that field.

[MSJ108]

Lipo should do it if your areolas and nipples always look like they do in the pictures

[wilsjwilson]

I would get to a gyne specialist for an expert opinion.  I had lipo only 4 months ago, and the results are very disappointing.  The three PS I saw all said lipo only.  But I now I realize they were not gyne specialists.  I found this website too late.  Hopefully you didn't.

[tenncast]

I spent 4000 for lypo only about four years ago and had to do lypo and excision one year ago....after only the lypo i was very disappoointed in the results....

I would go see someone before i went with lypo only....a few more weeks and a few more dollars is no big deal for a whole life of a nice chest. I am on vacation this week and what a joy to walk on the beach with a nice chest.....

[tanny]

excluding thumb, with rest of your four fingers together press hard on your nipple and gently move the fingers around, if you can feel a soft or hard tissue then you need excision or if you feel the whole same as your side fat(under arm) then only lipo. But I still recommend you to see another surgeon before op.

[dr.darkmind]

mmm
think in puffy niples...
if you feel pain in that zone, or that looks like a bubble..
you should have glandular tissue..
go to the dr... he will tell you what is that...
anyway i would give you 3 de 10

[tenncast]

Many non gyno specialist will tell you that lypoalone will work...in many cases they are simply ignorant to what is required for a good gyno result. I went to two well known plastic surgeons and both said that lypo only would work for me. Problem was -- they just didn't know enought about the situation to really understand.

I later had excision and lypo and that is when it looked right. I don't always think you have to feel a small lump to need lypo. i believe that there can be gland thru out the breast that lipo alone simply can't get.....

good luck...

[MSJ108]

your case is really minor I am willing to bet lipo only would do it

[milesed1]

When I had my surgery, he said he'd start with a lipo tool he had designed with a  tip which would also cut up some of the gyne tissue. He thought that might do it but couldn't be sure until he saw what was left after the lipo Thankfully he didn't need to do open excision and I'm really happy. My scars are over on my ribs away from the nipples. My pics are in the photo section somewhere.

[DrBermant]

My surgery is scheduled for this Tuesday and its liposuction only! The Liposuction+Excision surgery is the same price but the doctor has recommended lipo only; I'm concerned about this as it seems like lipo only results are usually not up to snuff. I don't have a severe case of gyne and am wondering if liposuction alone would be adequate??
Would rather not have to deal with the scars of excision if they aren't necessary

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 Surgery