Lipo can remove scattered breast tissue?

[Squish33]

So I had my first visit with my plastic surgeon today and he assessed my chest to be a mild case of gyno. I have no 'grape like' hardness under my nipple but it is puffy and the rest of my chest area sticks out and is fatty/ breast like. I am within a healthy weight range and 19. And he just told me that is the way my body distributes my fat. I do have some smallish lumps around my nipple, but not directly under and sometimes they can be sensitive.

Now to my question. He recommended just lipo in my case and believes he can remove the small breast lumps scattered around my nipple via lipo.
Anyone heard of this/ have any suggestions?

[TheCorrectedOne]

does he have good skills?

[Squish33]

I sure as hell hope so hahaha.

Here is a link to my pictures
http://www.gynecomastia.org/smf/index.php?topic=21737.0

[mtlgyno]

Who is your surgeon? Thta's the most important thing. If it's a no-name guy with little gynecomastia experience, seek someone else. Believe me. I made the same mistake. He said all I needed was lipo, I believed him, 6 months later I'm getting my 2nd surgery.

Get it done right the first time by a competent surgeon is what I'm telling you.

[Squish33]

I'm from Australia.
His name is Dr James Gaffield and he supposedly specializes in the breast region. He is from America tho.

I think his main issue was my breast tissue lumps aren't that bad were I need incision and possible risk of scaring/ craters. But in saying that I have seen some who have had the incision with small lumps and their chest still looks great.

[DrBermant]

So I had my first visit with my plastic surgeon today and he assessed my chest to be a mild case of gyno. I have no 'grape like' hardness under my nipple but it is puffy and the rest of my chest area sticks out and is fatty/ breast like. I am within a healthy weight range and 19. And he just told me that is the way my body distributes my fat. I do have some smallish lumps around my nipple, but not directly under and sometimes they can be sensitive.

Now to my question. He recommended just lipo in my case and believes he can remove the small breast lumps scattered around my nipple via lipo.
Anyone heard of this/ have any suggestions?

Liposuction is fine for fat but will not help with gland.  Clinical exam alone does not differentiate gland from fat.

If someone can back up such claims that liposuction managed gland with images including multiple angles, arms down, arms up over head, and flexing muscles such as my Standard Photographs for Revision Gynecomastia or Standard Videos After Gynecomastia Surgery, then perhaps I might believe. It would also be nice to see gland on suctioned fluid showing it was removed during the canula's work. This portion is normally discarded so that may not be realistic demonstration. To date such I have yet to see such proof anywhere. However, I see just too many patients unhappy after such claims were made. I recently reviewed over 600 patients unhappy after other surgeon's techniques over the past few years. The largest segment was from those who were told by their surgeons that liposuction alone will manage the problem.

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.

Leaving this gland behind would not be a problem if it did not affect the contour on animation. That is why judging results while living life such as playing volleyball, football, swimming all with the chest exposed is the final answer as to if a technique works. Be wary of a doctor's claim without such documentation. Look to see how the results move!  If there is a contour problem after surgery, you will be like the hundreds of others I have seen in the past angry after spending money on other surgeons and still seeking a decent result.

I have posted how to pick your gynecomastia surgeon here:

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

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia

[Squish33]

Thanks for your reply doctor. But from your experience is it usually only patience with grape-like gyno under their nipples that need incision? Or in my case if I just have scattered lumps around the outside of my nipple is this a) breast tissue (gyno) or b) just normal tissue that everyone has. And does this also require incision. Or is it  just that every case is different?

[mtlgyno]

Dude, my first surgeon said that I had gland "marbled" and "spread out" a little bit everywhere in there. I had a minor case he said. He only did lipo.

6 months later a plastic surgeon who specializes in this type of surgery told me I had quite a bit of gland and that I had a moderate case, and he removed two glands the size of a small cell phone each and an additional 400 cc's of fat (1 lb of fat).

And I'm not fat, 6'0 190 lbs.

I would find a surgeon that insists on doing gland removal, trust me you won't regret it man.

[DrBermant]

Thanks for your reply doctor. But from your experience is it usually only patience with grape-like gyno under their nipples that need incision? Or in my case if I just have scattered lumps around the outside of my nipple is this a) breast tissue (gyno) or b) just normal tissue that everyone has. And does this also require incision. Or is it  just that every case is different?

It is my experience that the clinical Exam of the Male Chest is just not reliable to determine gland vs. fat. Although fat tends to be soft and gland firm, gland can be soft and fat firm. That is why I evolved my Dynamic Technique that uses the feel during the Placement of the Tumescent Fluid to guide me as to how big to make the edge of the areola incision. The tumescent cannula goes through fat easily. When it encounters gland, it bangs into it and does not move well.  Placement of my only incision at the edge of the areola for the tumescent fluid or liposuction means one incision each side, not 2 or more. It also permits me to target the gland first so that I can then get more gland out and use the remaining fat for sculpture.

Hope this helps,

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

[dakks12]

Grow up!!!  Liposuction removes gynaecomastia tisse if it is mainly distributed around the breast.  I know you surgoen and he would only have recommended excision had you had eough tissue there. He is more than experienced.  Why try for more radical surgery than what youe require??

[Squish33]

Grow up!!!  Liposuction removes gynaecomastia tisse if it is mainly distributed around the breast.  I know you surgoen and he would only have recommended excision had you had eough tissue there. He is more than experienced.  Why try for more radical surgery than what youe require??

O.K so thanks for your reply.... but I honestly don't believe this is the type of place where you can go dissing people by telling me to 'grow up' this is a serious concern to me and I felt it to be a valid question; if I am unsure about the doc's opinion. Where else am I suppose to ask besides here? and I am getting a second opinion. I'm not doubting Dr Gaf's surgical knowledge/ abilities but my gut instinct and from what research I've done I feel I need excision. By your grammar and logic it tells me you are rather young so I don't mind your response.

[Dr. Elliot Jacobs]

It is difficult, even with the hands of an experienced gyne surgeon, to tell how much of your chest is breast tissue and how much is fat.

Lipo alone may, in fact, do the job.  But oftentimes direct excision is also required.  My approach to gyne surgery is to do the lipo first, and if satisfied with the results and contours, then I quit there.  But many times, direct excision is necessary and is done.  Thus, the operation is determined by what is found during the actual procedure -- I do not pre-determine exactly what is to be done prior to surgery and stick to it only.

In my opinion, any surgeon embarking on gyne surgery should be ready and capable of doing any maneuver necessary in order to achieve the optimal post-operative result.

Dr Jacobs