Negative effects of lipo ony techniques ?

[Needsomeadvice]

Hello.

Let me ask everyone a question

Is a guy normally suppose to have any fat in his chest area or if you went to a doctor who did smart Lipo to remove all the fat, would you still look ok?

In other words, do you  need  a certain level of fat on your chest to look normal or is there no suck thing as removing too much? 

Is it possible to remove too much fat and cause a deformation by an inexperience doctor or are the surgical errors probably by not removing enough fat?

Is there ever a fear of looking deformed by removing too much fat or is the more fat removed the better?

Please let me know.

Thanks.

[rdy4chng]

Hi,

I'm in good shape, low body fat and I had all the fat removed.  I was wondering the same thing you are, but decided to trust my doctor and it looks great.

I consulted four doctors before choosing.  All but one, said they would remove all the fat, then I think the one that initially said he wouldn't changed his mind and said he would.  Anyway, I think it depends on your current fitness.  If you are fat (sorry lack of a better word) they will not take all the fat out and they will "sculpt" the fat to make your chest look proportionally correct.  On the other hand if you are lean, why would you want any fat there? You want your skin and nipple to rest on your muscle showing your definition, you don't want large sections of fat being defined as well.

[DrBermant]

Hello.

Let me ask everyone a question

Is a guy normally suppose to have any fat in his chest area or if you went to a doctor who did smart Lipo to remove all the fat, would you still look ok?

In other words, do you  need  a certain level of fat on your chest to look normal or is there no suck thing as removing too much? 

Is it possible to remove too much fat and cause a deformation by an inexperience doctor or are the surgical errors probably by not removing enough fat?

Is there ever a fear of looking deformed by removing too much fat or is the more fat removed the better?

Please let me know.

Thanks.

Removing all of the fat looks terrible.  The body needs a layer of fat between the skin and underlying fascia for natural motion.  I have seen horrible extended Crater Deformity Complications where all the fat was removed and the skin scarred down to the muscle. 

Scar Adhesion Complication From Excessive Liposuction by surgery by other doctors.  Bad Scar Adhesion Complication Too Much Removed.  Unfortunately I have seen much worse.  There are often no good options for such disasters.  Prevention is a much better option.

I have also seen problems when doctors did not remove enough.  That is why doctor selection is so important.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Male Breast Reduction

[rdy4chng]

Hi Dr. B. 

I'm sort of confused when I look at those photos you have on deformities.  When I look at those it looks like the result looks deformed as a result of the surgeons ability or skill.  Not necessarily that they "took out too much fat".  For instance, the patient looks like he has a lot of fat in the mid chest (above his nipple) but then from the surgery you see a "deformity" under the nipple area where I presume the fat was removed.  I also would presume that how much fat you remove depends on the frame and size of the person you are working on. 

[Dr. Elliot Jacobs]

There should always be a layer of fat preserved under the skin -- it serves as a glide plane for the skin.  If you take out all the fat, the skin can adhere to the underlying muscle and create dimples, etc.

Best guide is to remove sufficient fat so that the pinch of skin and fat, from the collarbone down to the lower ribs, is a thin and consistent pinch.  This will then allow for differences in a body frame.  If you are heavy, then your pinch under the collarbone will be thicker and hence the surgeon should leave something similar over the balance of your chest.  If the pinch is very thin, then the surgeon should leave the same.

The proper assessment of how much fat to take and how much fat to leave will vary with the experience of the surgeon -- that is the artistry of performing this surgery.

Dr Jacobs

[rdy4chng]

Dr. J,

Thanks, your explanation makes sense.  My surgeon, in the general terms, said he removed all fat but he described pinching the areas to determine the amount to remove so I'm guess he took the same precautions as you mentioned.  I'm lean, so I think there is not much fat under there.  In the area that I do have a depression, small one, it seems like it's caused by the area near the insertion point which is still swollen. I'm 5 wks post and gradually seeing the swollen areas decrease in size.

Thanks.

[Dr. Elliot Jacobs]

Please be a patient patient -- it sometimes looks rough at the beginning but things tend to heal well as time goes on.

Dr Jacobs

[DrBermant]

Hi Dr. B. 

I'm sort of confused when I look at those photos you have on deformities.  When I look at those it looks like the result looks deformed as a result of the surgeons ability or skill.  Not necessarily that they "took out too much fat".  For instance, the patient looks like he has a lot of fat in the mid chest (above his nipple) but then from the surgery you see a "deformity" under the nipple area where I presume the fat was removed.  I also would presume that how much fat you remove depends on the frame and size of the person you are working on. 

Actually these patients had essentially no fat left after the over aggressive liposuction by the prior doctor.  The skin was directly adherent to the underlying fascia and muscle.  Did you check out the Crater Deformity Video the adhesion? 

Here is another video of a Crater Deformity Adhestion.

In real life during examination, they really looked worse.

I remove fat from each patient to achieve a contoured pinch test of remaining fat.  I try to leave about the same level of fat that the surrounding regions have.  The amount of fat that comes out varies for each breast of each patient.

But yes you are right, judgment of how much to remove is part of the art of this sculpture.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery

[MyName]

I am 6'1" and weigh about 185. Have always been pretty lean but developed puffy nipples as a teen. Prior to surgery I went to a Dr. in Manhattan who said that i had breast tissue that needed to be lipo'd. My left nipple was larger than my right and after surgery I can visibly see on the left that I have a "void" where the lipo was done. Not as much on the right
I never had a problem with my chest muscle, just the puffy nipples.
So what I am saying is that it is possible, in my experience, to remove too much.

[Needsomeadvice]

I am 6'1" and weigh about 185. Have always been pretty lean but developed puffy nipples as a teen. Prior to surgery I went to a Dr. in Manhattan who said that i had breast tissue that needed to be lipo'd. My left nipple was larger than my right and after surgery I can visibly see on the left that I have a "void" where the lipo was done. Not as much on the right
I never had a problem with my chest muscle, just the puffy nipples.
So what I am saying is that it is possible, in my experience, to remove too much.
[/quote

When you say breast tissue, do you mean the gland or the fat tissue? Usually, I hear Lipo being used for gland but the gland.

Please let me know

Thanks

[MyName]

Sorry for the late response...haven't been on in on line for a while. I don't think the gland (under nipple) is lipo'd. That is normally cut out and some left to avoid indent. Lipo is done on the area around nipple.

[DrBermant]

I am 6'1" and weigh about 185. Have always been pretty lean but developed puffy nipples as a teen. Prior to surgery I went to a Dr. in Manhattan who said that i had breast tissue that needed to be lipo'd. My left nipple was larger than my right and after surgery I can visibly see on the left that I have a "void" where the lipo was done. Not as much on the right
I never had a problem with my chest muscle, just the puffy nipples.
So what I am saying is that it is possible, in my experience, to remove too much.

Showing Standard After Gynecomastia Surgery Pictures that has views to emphasize animation and multiple views can help others better understand your concerns.

Hope this helps,

Michael Bermant, MD
Learn More About Revision Gynecomastia and Chest Surgery