Excision vs liposuction

[cabrower]

Hi I wanted to get the forum's opinion on Excision vs liposuction. I just had my consultation and the Dr told me he uses liposuction primarily and then if needed he will make the excision on the aureole to remove any other gland left over. Have any of you had liposuction done? He explained to me that he fills the area with a fluid which dissolves the gland and breaks it up. He then sucks the tissue/gland out. Also he uses ultrasonic vibrations/waves to break it up further.

The reason i ask is, i was at another consultation where the Dr only mentioned excision. Any thoughts on this?

[budking]

I'm 44 and thought excision was the way to go. A local P.S. convinced me to have lipo and this was done two weeks ago. From my left side 800cc and my right, 700cc was removed. Swelling is still and issue, but I'm much flatter. I didn't think lipo could remove the gland/fat tissue but it did. Find a good P.S. and listen to him.

[MSJ108]

Its good when the doc says he will lipo first BUT IS OPEN TO do an incision and remove gland. The PS is saying they will do what they need to do once they get in there. My PS said the same thing. I only needed lipo for puffy nips. results are great (except for scar tissue issue  )

[rammy1394]

it de4pends how bad your gyne is i got both lipo and incision and my gyne was slight but to remove the hard stuborn gyne you need to cut it out.

[Dr Kapoor]

Hi I wanted to get the forum's opinion on Excision vs liposuction. I just had my consultation and the Dr told me he uses liposuction primarily and then if needed he will make the excision on the aureole to remove any other gland left over. Have any of you had liposuction done? He explained to me that he fills the area with a fluid which dissolves the gland and breaks it up. He then sucks the tissue/gland out. Also he uses ultrasonic vibrations/waves to break it up further.

The reason i ask is, i was at another consultation where the Dr only mentioned excision. Any thoughts on this?

It really does depend on how much of your breast consists of fat vs glandular tissue. If you truly have glandular tissue, ultrasound assisted liposuction (UAL) will not break up the gland, nor will fluid dissolve it - that part is primarily for the liposuction component. It's true that UAL is good for fibrous tissue and such and will yield some improvement, but it will not remove / break up the gland. For this you need direct excision, no matter how small the glandular component. I probably end up opening (doing an incision) under the areola 80-90% of the time nowadays.

[alexander27]

I've had lipo done. That was about 2 years ago. My gynochemastia is basically back to normal and after reading around about the debate between liposuction vs excision, I'd go with excision. I'm new to the boards here, so let me know if there are any 'unspoken' rules.

[cabrower]

How severe was your case? Do you have pictures? I am really nervous about the procedure as i have seen people with concave chest and seen people where the dr didn't remove it all.

[ichthus70x7]

I had the same question, so thanks for asking.  My first consultation Dr immediately stated excision, where as the second(the one I chose) said what yours said.  I go in for surgery next Friday, so I will let you know if the primary use of lypo with the potential use of excision, if needed, works.  I do have the "puffy" nipples and breast tissue, not much fat.

[DrBermant]

Hi I wanted to get the forum's opinion on Excision vs liposuction. I just had my consultation and the Dr told me he uses liposuction primarily and then if needed he will make the excision on the aureole to remove any other gland left over. Have any of you had liposuction done? He explained to me that he fills the area with a fluid which dissolves the gland and breaks it up. He then sucks the tissue/gland out. Also he uses ultrasonic vibrations/waves to break it up further.

The reason i ask is, i was at another consultation where the Dr only mentioned excision. Any thoughts on this?

I know of no fluid that will dissolve gland. If a fluid did, it would also destroy the connective tissue, dermis, skin, muscle, fat, and other structures of the body.  Check out the Anatomy of Gynecomastia.
 
Unfortunately I have seen many patients who have come to me with Crater Deformity Defect Complications after Gynecomastia Surgery that the doctors' used excision alone.   Puffy Nipples After Liposuction Alone for Gynecomastia can also be an issue with some techniques.  That is why I evolved my Dynamic Technique Gynecomastia Surgery where I select from an Artist's Pallet of Surgical Tools for each patient.  I let what I find during surgery guide as to what needs to be done.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia Surgery

[MSJ108]

My docotor said the same thing.  He did not mention any liquid though.  He said he will use lipo and then remove the gland if he needed.  My case is pretty bad, im nervous that he wont remove enough.

its better to have a ps remove to little than to much! he/she can always go back in for more. However, adding to an area where to much is removed is tough

[ichthus70x7]

My surgery with Dr. Turowski turned out great!(so far)  I was a little nervous that he would not take out enough of the tissue, but he definitely did what he needed to do to make me look good.  A little lipo here, a little excision there, and walla, I am boobless. 

I do not believe that he used any dissolving fluid. He never mentioned that to me.

[MSJ108]

My surgery with Dr. Turowski turned out great!(so far)  I was a little nervous that he would not take out enough of the tissue, but he definitely did what he needed to do to make me look good.  A little lipo here, a little excision there, and walla, I am boobless. 

I do not believe that he used any dissolving fluid. He never mentioned that to me.

any updates?