gland removal

[Azguy]

I met with a surgeon yesterday who recommends partial gland removal with lipo of some fat in the adjacent areas.  He says that complete removal of the glands will leave my breasts concave.

He has a technique that can soften the gland tissue enough so he can lipo some of the tissue and sculpt my chest resulting in a natural appearance.

Will total removal leave me concave?

Can a gland be partially removed? If so, is this a good idea?


Many thanks for your advice.

[DrPensler]

I am always wary of someone with a "secret" technique that purportedly does something that no one else can replicate.
Without any photos or significant information on your case I can only speak in generalities.The overwhelming majority of my patients (98%)require excision of glandular tissue. While gynecomastia correction is not a cancer operation which would require removal of the nipple to remove all of the glandular tissue the removal of approximately 98% of the glandular tissue is necessary to optimize the final result.The surrounding tissue is adjusted to prevent a saucer deformity which is the concave deformation you describe.

[Azguy]

Thank you for your reply.

This is how he would treat me:

1. will first use the Vaser (an Ultrasound liposuction device)  to break up the large fibrous glandular tissue. This device is far more gentle than excising the tissue and does not damage to the connective tissue.

2.Next we will then use the Body Jet device (water assisted liposuction tool) which will break down the larger boulders, if you will, of glandular tissue into pebbles to be suctioned out with the fat.

3. Then we will use the Laser assisted liposuction device to generate the heat needed to stimulate collagen which will tighten the skin.

Does this sound reasonable?  Is there anything I should ask him?

Thank you very much for your time.

[Dr. Elliot Jacobs]

These three machines are among the newest, most hyped and most expensive machines around.  For sure, he needs to pay for them.

I use none of them and I can get very good results with excision and lipo using simple, basic and extremely effective lipo machines.

As Dr. Pensler aptly said, there are no "secret techniques" amongst good surgeons, who share all their ideas and techniques at various medical meetings.

The "secret" to getting a good result without a crater deformity is to be aware of the possibility and prevent it during the actual operation -- sometimes by using adjacent fat flaps to make sure the contours are smooth.  As they say in football, "the best offense is a good defense."

Dr Jacobs

[Litlriki]

I agree with Drs. Pensler and Jacobs--Good technique will provide good results, and 3 different liposuction devices are hardly necessary in order to accomplish that.  I have used ultrasonic liposuction in the past, but neither the ultrasound, the ultra-jet, nor the laser-assisted liposuction options alleviate the need for gland resection, since the "gland" is not fat, and will not be removed with liposuction in most cases.  If gland is present, excision is required to remove it, and the liposuction is used to provide good contour without a "saucer" or "crater" deformity. 

If your surgeon is able to provide you with good pre- and post-op photos, and if you feel comfortable with his skills, he may indeed be the surgeon for you.  You might also ask about speaking with one of his patients, or ask around about him to get more objective feedback.

Rick Silverman

[Azguy]

I am 30 days post procedure and couldn't be more pleased with the results.  I have no way of knowing how quickly i would have healed with surgical excision, but using the method I described in August I needed pain killers for one day after the procedure and could have easily gone back to work (desk job)on the 2nd day. 

I did and still do have some swelling but nothing major and received lymphatic massage to help the healing process.

Remember, I didn't use the term "secret" technique, but it seems to have worked for me and at the came cost of surgical excision. 

The surgeon removed 350 cc from my left side and 250 cc from my right, consisting of fat and glandular tissue.