Woman's Breast vs. Gynecomastia

[absec9]

I know that Gynecomastia is essentially a woman's breast growing on a man, but I had a question about the make-up of the breast tissue.  I understand that the glandular tissue grows from underneath the nipple, but what about all the other part?  It's made up of fat and some connective tissue, etc.  Is this "stuff" (non-glandular, but still in the breast tissue) liposuctionable?

I am asking this because I went to a consultation and he told me not to worry and that I would be able to get it all liposuctioned out.

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Real gynecomastia is caused by enlarged breast tissue.  While the rest is made of up fat and connective tissue, liposuction is almost never an answer to the whole problem.  The breast tissue, or glands, must be removed via surgery.

So yeah, the fat can be liposuctioned but you'll still be left with enlarged breast glands.  Liposuction is more of a solution for those with pseudogynecomastia(a dubious term to begin with), because the boobs are caused just by being overweight.

[DrBermant]

I know that Gynecomastia is essentially a woman's breast growing on a man, but I had a question about the make-up of the breast tissue.  I understand that the glandular tissue grows from underneath the nipple, but what about all the other part?  It's made up of fat and some connective tissue, etc.  Is this "stuff" (non-glandular, but still in the breast tissue) liposuctionable?

I am asking this because I went to a consultation and he told me not to worry and that I would be able to get it all liposuctioned out.

The Anatomy of the Female Breast and the Anatomy of Gynecomastia are the same. It is the same structure in both sexes of mammals, the breast. It will consist of fat, gland, and skin.

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.

• Revision Gynecomastia After Failed Liposuction By Other Surgeon
• Revision Puffy Nipple Gynecomastia After Failed Liposuction By Other Surgeon
• Revision Gynecomastia After Liposuction and Partial Gland Excision By Other Surgeon.
• Revision Gynecomastia After Partial Gland Excision
  

I see so many individuals unhappy after liposuction surgery done elsewhere where the surgeon reportedly claimed their liposuction would manage the gland component.

One common form of residual gland after liposuction alone is the Puffy Nipple Complication After Gynecomastia Surgery. This page explains why targeting gland first is so important. If the gland is trivial, leaving it behind will not be a problem. This is not cancer surgery. However, gland does not compress like fat. Performing liposuction first tends to dig a hole for remaining gland. What may appear as a flatter contour, puffs out further as the pectoral muscles flex, arms raise overhead, or the areola muscles relax. It explains the reasoning behind my Dynamic Technique. The key to this Dynamic Technique is to target the gland first. It is not just simply evolving what happens during surgery based on what is found. The Dynamic Technique also means that the results should look good on animation, playing sports, living life.

Recently I have been reviewing requests for help from men unhappy after other surgeons' gynecomastia surgery. There were over 500 requests for my help! Many were for residual contour problems from failures of liposuction alone or partial gland excision with liposuction.

But in the end, each surgeon has the methods he / she prefers. However, words alone saying it works are not enough. It is the result that counts. Check for actual examples from many different angles and demonstrating how tissues move to see if there is any remaining firm tissues showing. A good result should include:

• be more than just one or 2 views of the result, (be wary especially if this limited view choice changes from patient to patient)
• that a patient does not need to keep his arms down or not flex his muscles to hide deformity,
• a result that looks good from many different views and looks good even on animation while living life no longer hiding the chest with clothing,
• look for movies of the result, videos are even more revealing of animation issues than flexing photos,
• and a result that does not typically need so much bruising, swelling, and discomfort to get to the other side.
  

Hope this helps,

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

[Dr. Elliot Jacobs]

I know that Gynecomastia is essentially a woman's breast growing on a man, but I had a question about the make-up of the breast tissue.  I understand that the glandular tissue grows from underneath the nipple, but what about all the other part?  It's made up of fat and some connective tissue, etc.  Is this "stuff" (non-glandular, but still in the breast tissue) liposuctionable?

Gynecomastia is composed of breast tissue and fat -- and the exact ratio varies from person to person and actually from the left to the right side on the same person.  All men have a small amount of pure breast tissue located directly under the nipple.  When gyne is present, the breast tissue has expanded in depth and also sideways so that there are tongues of breast tissue interspersed with fat.  The breast tissue gradually attenuates towards the periphery of the enlarged breast, so that fat predominates.

Sometimes fat can be suctioned -- but thicker gland cannot be suctioned.  I don't know about your surgeon, but even my hands, with several thousand gyne operations under my belt, cannot tell if lipo alone will suffice or if further excision will be necessary -- until I am in the middle of the operation.  Therefore, I would be careful to choose a surgeon who is not married to one particular technique (to the exclusion of other techniques).  Rather, one should choose a surgeon who is proficient in all techniques needed to get a great result -- and a great result should be the ultimate goal -- not just "better."

Dr Jacobs