70% FAT 30% GLANDULAR

[oakley]

just had my consultation and the surgeon said i had 70% fat and 30% glandular im 21 and have had moobs since i was 12 so i finally thought it was about time to stop it ruling my life! my querie is what would 30% glandular look like though? would i still have moobs or will it look normal?

[Dr. Elliot Jacobs]

These are always rough "guesstimates."  The important thing is that all the excess tissue (whatever ratio it is) should be removed in appropriate gynecomastia surgery.

Remember, it is not what you have that counts -- it is how much is removed and how much is left to provide a natural contour.

Dr Jacobs

[Miguel Delgado]

For a personal evaluation you are invited to visit Dr. Miguel Delgado’s new website www.gynecomastiaspecialist.com
After viewing his extensive website, if you are interested in a phone consultation, you may email photos along with your phone number to the email address listed on his website. He will then contact you to discuss your concerns and options. If requested you will be given a quote specific to your case. There is no charge for this service.
 
Thank you for your interest,
Janice Nunez
Patient Coordinator to Dr. Miguel Delgado Jr., M.D.

[headheldhigh01]

no, not really.  in fairness, a lot of questions do require a personal exam, and the docs who sign up as site sponsors both help keep it going and often contribute useful professional insights that the rest of us don't have.  it's not as common for a staff person to jump in, but remember a ps doesn't have all that much time to spend constantly on the boards anyway, and i'm impressed with the time many of them do.  and when it comes to gyne, a knife is probably your friend  

oakley, with respect to your case, i don't see why you'd be left with the 30% unless you did lipo only, but why would you do that, i assume you want all of it out or close to it.  you wouldn't look normal with that, but you shouldn't be left with it, so you'll probably get as close to normal as can be expected. 

[DrBermant]

just had my consultation and the surgeon said i had 70% fat and 30% glandular im 21 and have had moobs since i was 12 so i finally thought it was about time to stop it ruling my life! my querie is what would 30% glandular look like though? would i still have moobs or will it look normal?

Here is a series of Drawings of the Anatomy of Gynecomastia that shows different size gland fat ratios. Actually, without taking an unnecessary  male mammogram, determining fat vs. gland ratios by Clinical Examination of the chest alone is just plain not accurate.  Although fat tends to be soft and gland firm, fat can be firm and gland soft.  You can find many examples of my clinical estimates of gland on my website before surgery markings and plan (the inner circle is my guess for the firmer gland component).  You then can find the results with the removed gland sitting on the patient's chest in the operating room.  That is why I prefer my Dynamic Technique Male Chest Contouring that adapts to what I find in the operating room as to what elements of my artist's pallet of surgical tools I sculpt each chest I use.

Hope this helps,

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

[oakley]

im going for just lipo as i cant find anywhere around my area that does everything! is lipo just a waste of time and money? the surgeon is michael d graham he has a website if anyone wants to check him out?

[DrBermant]

im going for just lipo as i cant find anywhere around my area that does everything! is lipo just a waste of time and money? the surgeon is michael d graham he has a website if anyone wants to check him out?

Here is a post I put up on how to pick a gynecomastia surgeon:

http://www.gynecomastia.org/smf/index.php?topic=16474.0

Have you even looked at that surgeon's website for gynecomastia surgery?  How many gynecomastia patients posted? How many views for each patient?  Quality of the results?

We see many UK gynecomastia patients who prefer my techniques.

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 a liposuction cannula to remove gland, it can also remove connective tissue and other structures which can lead to more bruising and scars.  I have seen so many patients who were unhappy from doctors that used "special cannula to remove gland," that I just prefer to go directly to the problem itself.  Primary surgery is usually better than needing a revision.  All male breasts have gland.  With access to the gland directly, I can peel it off the areola muscle, minimize bruising and bleeding with direct control of the tiny blood vessels, and then reconstruct the contour.

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, Ultrasonic, nor sharp cutting cannula 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