What is more difficult to remove: gland or fat?

[whatever]

So here's a simple question for the docs: is it simpler to remove glandular tissue or fat? I realize this is a fairly ambiguous question, so I will try and be more specific. Do patients with a very large amount of glandular tissue generally see better results than patients with relatively more fat tissue?

[George Pope, M.D.]

Fat is easier to remove than glandular tissue.  The fat can be removed with a lipo cannula.  The breast tissue is relatively easy to remove through an areolar incision, but the greater the amount of breast tissue, the harder it is to remove it through that small incision.  Just takes time.

Dr. Pope, MD

[whatever]

This is what I suspected. Thank you for the information Dr. Pope, it is greatly appreciated.

[DrBermant]

So here's a simple question for the docs: is it simpler to remove glandular tissue or fat? I realize this is a fairly ambiguous question, so I will try and be more specific. Do patients with a very large amount of glandular tissue generally see better results than patients with relatively more fat tissue?

Actually what is easier to remove depends on many factors such as the nature of the tissue, what instruments are used, and how much the surface exposure is limited. The smaller the access to the tissue, the more difficult to remove. But I like my tiny scars and the extra work is worth it. Soft fat comes out really easily with liposuction. Firm fat is much more difficult to remove this way. A dull liposuction cannula does not remove tissue as well as one that is still sharp. A surgeon doing enough of this will eventually dull the cannula. We go through quite a few cannula over time too keep them removing tissue well.  For gland, liposuction does not remove gland, it digs a hole in the fat around the gland as you can see in these Puffy Nipple Complications of Gynecomastia Surgery. Firm gland is easily removed through a small incision with good sharp scissors. Softer gland cuts easily but is harder to differentiate by feel from the surrounding fat. This makes the job of targeting gland first more difficult.

Patients with low global body fat tend to have much better results than those whose fat hides the contours of the muscles. Surgery is not an answer to contour problems that have a global fat component. For such patients, surgery becomes a compromise: breasts are smaller but still there. Patients with extremely low body fat can be more difficult to sculpt. I work with many Bodybuilders and Athletes with Gynecomastia. Some have so little fat on their body that reconstruction can be much harder. For these patients I ask them to let me sculpt them in their off season body fat so there is something to work with.

Hope this helps,

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