excision before lipo - is this possible?

[spaceace]

Is it possible to have an excision and then lipo (if needed) afterwards as opposed to the other way around?

[Bradley07]

yes and that's how i'd recommend it. most people who have lipo only are not happy because lipo doesn't remove the gland. if you have glandular excision, that almost always gets rid of the gyno but if you have extra fat you want to get rid of them lipo can help with that. but lipo alone won't get rid of gyno i'd say a good 9 out of 10 times. go with excision or excision and lipo, but not lipo alone.

[spaceace]

I don't have a noticeable lump under my nipple but rather diffuse glandular gynecomastia.  I'm curious why Dr. Fielding would want to do lipo first even though there's not a ton of fat there.  I just want the excision.  I don't want any lipo.

[Bradley07]

well, if he wants to do excision AND lipo then i don't see a problem. but don't go for lipo only. it's your body. tell him that you'd prefer to just do excision if that's how you feel. have you asked your doctor the same question you're asking us? my guess is no.

[spaceace]

I did ask if i could just do excision and he said that he only does that if there is very low body fat.  I'm about 14% body fat.  Is this not low enough to just have excision only and to decide on lipo only months after having surgery?

[Mr_Nip]

I would want an agreement with my PS that both lipo and excision would be used if needed during the first surgery.   In fact, I had that discussion with my PS before my surgery date.   The need for lipo and/or excision is evident to a gyne-skilled PS while you're on the operating table.  Why not just take care of all of it then?

[DrBermant]

Is it possible to have an excision and then lipo (if needed) afterwards as opposed to the other way around?

I prefer my Dynamic Technique where  I select from an artist's pallet of different techniques which can vary from patient to patient and often from one side to the other for each individual.  I let what I find during each operation guide me to what needs to be done.  To minimize recurrence, I target gland first leaving fat as a reconstructive option to permit more gland to be removed.

When there is very little gland involvment, sometimes I just need to perform liposuction alone. However, most men with gynecomastia have both gland and fat as part of the problem.  When there is a small button of gland under the areols, I typically remove that gland to minimize the problem of residual "Puffy Nipples".

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[spaceace]

So it is possible to remove gland and then see what happens 6-12 months later to determine if some lipo is necessary?

[spaceace]

I would want an agreement with my PS that both lipo and excision would be used if needed during the first surgery.   In fact, I had that discussion with my PS before my surgery date.   The need for lipo and/or excision is evident to a gyne-skilled PS while you're on the operating table.  Why not just take care of all of it then?

I'd prefer not having someone sculpt my body but rather using something like UltraShape to destroy targeted fat cells.  It's been working for me so far, I think.  If it works I'll be sure to post pics when all is done.  

[Bradley07]

well, if you have gyne then you probably have excess breast tissue, which will probably not go away without excision.

[DrBermant]

So it is possible to remove gland and then see what happens 6-12 months later to determine if some lipo is necessary?

No, with my Dynamic Technique the different sculpting elements are done at the same operation.  Why don't you take some time and review the links discussing the technique and the many results that have proven its value over the years.

I'd prefer not having someone sculpt my body but rather using something like UltraShape to destroy targeted fat cells.  It's been working for me so far, I think.  If it works I'll be sure to post pics when all is done.  

This is just a computer moderated external ultrasound device that targets fat, not gland.  External ultrasound will destroy fat cells by blasting them with sound energy leaving the gland behind,  the blasted remains are left in the body to be absorbed.  Sorry, I have seen some disasters with this technique already from other doctors.  

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

[spaceace]

This is just a computer moderated external ultrasound device that targets fat, not gland.  External ultrasound will destroy fat cells by blasting them with sound energy leaving the gland behind,  the blasted remains are left in the body to be absorbed.  Sorry, I have seen some disasters with this technique already from other doctors.  

Are you saying you've seen pictures of these results?

I already had one session and had no complications.  I may require one more.  I was planning on having the excision 6-8 weeks afterwards.

I have a very minor case of gyne.  I suspect that it is more fat than gland.  This is why I want to get rid of the fat through UltraShape first and then get rid of the gland last.  Like I said previously, it seems to be working just fine in my case.  

[spaceace]

Trust me you'll want it excised and lipod all at once. Why would you want to pay for 2 surgeries along with having to undergoe the risks of a second surgery as well as recovery time ?  I'm not sure what Ultra Shape is but I have never heard of anything that spot reduces fat that ACTUALLY WORKS.  Most are set up to part you from your $$

Excision would be covered by OHIP (Candian medicare).