Is Liposuction Alone Bad???

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Ok so I just had my surgery two weeks ago. I feel like a million bucks and my chest is looking pretty good. However my surgeon opted to stick with just liposuction for surgery when they had me in the operating room.

Am I at risk of reoccurance? Its just that it seems like liposuction with gland removal seems to be the favored technique by most surgeons. My surgeon informed me that if he felt it was necessary he would do the same. However when i woke up I had only had liposuction.

Will my tissue regrow. For the doctors on the board, why is it that you think my surgeon made this choice? I guess what i really want to know is am i doomed to have to go in for another surgery down the line to "have it done right?"

What I am the most hopeful of is that there is at least some doctors or members on the board have had favorable results with liposuction. Please let me know your out there. Somebody that is in the same boat as me.

I am happy with my results just wondering if I should be worried down the line.

[Dr. Elliot Jacobs]

No reason to worry -- I do about 40% or more of my cases with "lipo alone."  That being said, I use my own-designed cannula to remove fat and gland.  However, in some cases, my cannula cannot do everything.  It is in those cases that I elect to perform direct excision of gland from beneath the areola.

In essence, it is an operation in which I seek to limit scars while trying to get the best result possible for the patient.  Thus, in roughly 40% of my cases, the entire procedure is performed through a tiny nick in the skin on the side of the chest.  It heals to be a minor blemish.  If indeed a gland excision is done, then the peri-areolar incision is made -- that too tends to heal very well -- but it is an additional scar which needs to heal.

Basically, it is an operation where decisions are made during the procedure -- not ahead of time.  The important thing is that the patient is left with a thin, uniform pinch of skin and fat, from the collar bone down to the lower ribs, including the areola.  When that occurs, I am satisfied with the result -- and I don't leave the operating room until I have achieved that.

If your surgeon was prepared to do whatever it takes, and decided not to perform an excision, then more than likely he was satisfied with the result from "lipo" alone.  Trust him. Best that you wait it out to see the results -- you are not doomed to return for more surgery to remove gland.

Dr Jacobs

[DrBermant]

Ok so I just had my surgery two weeks ago. I feel like a million bucks and my chest is looking pretty good. However my surgeon opted to stick with just liposuction for surgery when they had me in the operating room.

Am I at risk of reoccurance? Its just that it seems like liposuction with gland removal seems to be the favored technique by most surgeons. My surgeon informed me that if he felt it was necessary he would do the same. However when i woke up I had only had liposuction.

Will my tissue regrow. For the doctors on the board, why is it that you think my surgeon made this choice? I guess what i really want to know is am i doomed to have to go in for another surgery down the line to "have it done right?"

What I am the most hopeful of is that there is at least some doctors or members on the board have had favorable results with liposuction. Please let me know your out there. Somebody that is in the same boat as me.

I am happy with my results just wondering if I should be worried down the line.

Liposuction is a great tool for fat based gynecomastia surgery. Here are examples of some of the many patients I have seen who came to me complaining of:

• Residual Gynecomastia after Liposuction Alone
• Revision Puffy Nipples after Liposuction Alone
• Redo Surgery for Remaining Gland after Liposuction

all after other surgeons' work. I have seen many many other patients unhappy after contouring from other doctors who claimed that their liposuction alone was enough to manage the gynecomastia. In the Anatomy of Gynecomastia there are fingers of gland that run through the fat.  Unfortunately all forms of liposuction, Vaser, Ultrasonic, Power Assisted, "Smart," sharp cutting cannula all preferentially will target the softer fat first. Suck out the fat first, and the fingers of gland condense behind. On this page of Puffy Nipple Anatomy, hold your screen cursor over the link "Remaining Gland after Gynecomastia Surgery" to see residual gland that can be left behind when working using liposuction from a remote site that depicts on common problem I have seen in such cases. Then look at the gland / scar tissue complex in each of the revision cases I have posted to see what I mean.

With my Dynamic Technique I prefer to  target the gland first and then contour the remaining defect. By waiting until I find out how much gland should come out first, remaining fat can be contouring tool. Even subtle Puffy Nipple Gynecomastia can detract from a cut look on the male chest.

When I start the Tumescent Infiltration Anesthesia and find the gland component trivial, I will only use liposuction to contour the chest. This results in a tiny scar hidden at the edge of the areola. Unfortunately, I find significant gland contributions in so many of my patients. You can see some of the Gland Component of Gynecomastia I removed from typical cases.

If the final contour is not being hidden by swelling (which can hide deformities), looks good with the areola muscles relaxed Puffy Nipple Deformity Can Be Hidden by Areola Muscle Stimulation, and looks good on animation (arms up, muscles tensing, and in motion), then that is a good result.  Fine male chest sculpture should look good from all angles and while exposed living lift, not just in a few select pictures taken in a cold room the angle of view seems to change based on what looked better on that patient.

Unfortunately, gynecomastia surgery does not prevent recurrence. Shreds of gland remain behind with any technique. If there are any Medical Problems Causing Gynecomastia or Medications That Cause Male Breast Growth, these remaining gland cells will grow. That is why it is so critical to work on stable conditions. I also like to target gland first so that there is less tissue for any hormonal imbalance to influence.

Hope this helps,

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

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Thank you so much too doctor Jacobs for quelling my anxiety about the effectivness of my surgery procedure. My surgeon did explain it just as you had described it but i was approaching it from the angle where I assumed something MUST have been left over lipo couldn't get anything. I had a more sever case of gynecomastia then most but when i was able to see my chest I was very happy with the results.

My greatest fear was that there would be residual tissue left over like Dr. Bermant stated and I was more than willing to take longer to heal with the gland excision as long as it was done the first time through. Obviously when in the Operating Room my surgeon made a judgement call and with luck there won't be anything left over.

Thanks again. Now i have some hope.