Ok, I've been reading and reading everyone's input on a lot of these boards and I would welcome some constructive input. I am 52 years old, weigh 175lbs, 5"9" and in very good physical shape healthwise. I am posting these pics taken recently(down from 190lbs. in 2 months). I always seem to carry this puffy chest no matter how slim I get. It is not as pronounced as this if I lose even more weight, but still seems to persist. I thought I could work it out from the inside out by lifting weights and doing pushups, but hell, I don't want to do that forever. Besides it didn't seem to make THAT much difference anyway. I am on my way down to about 160 or 165 lbs hopefully. I went to see a PS and he said he would recommend that I use a PS with an Ultrasonic Fat Suction machine, but he did not spend very much time with me at all and did not charge me for consultation and I was not able to glean much info out of him. I consulted another PS over the internet and he said that machine was actually not in favor anymore and that he could do just as good a job without that particular machine. Any thoughts on that subject? Anyway here are my pics. What do you pros think?? Should I go to see an endocrinologist first or not at my age?? Do I even have gyne?? Hope I did the pics insertion correctly. IF not, I'll try again. Thanks
Each surgeon used the tools and techniques he / she prefers.
There are studies claiming that ultrasonic liposuction does not break down gland cells, these were done to justify the safety in female liposuction breast reduction surgery. Ultrasonic energy cannot be both ways, good for gland breakdown and safe not harming gland unless there is a difference between male and female breast gland tissue which has not been proven to my knowledge.
Tumescent liposuction is a form of anesthesia where fluid is placed in the tissues to be sculpted. You can see
very graphic pictures of the tumecent technique
here.
Liposuction such as ultrasonic, 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. The problem is picking the right method for what actually is that patient's problem. That is why I prefer my
Dynamic Technique that permits what I find during surgery to guide my sculpture.
I have also seen patients with channel problems between remote access sites and the areola / nipple. Scars, adhesions, and depressions can look terrible. Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexion
here to see what I mean.
Ultrasonic liposuction uses energy to help emulsify fat. Power assisted liposuction uses mechanical vibrating devices to rapidly move the cannula back and forth. Both PAL and Ultrasonic methods have been around for several years. Many do not prefer what they do to the tissue. Others like what they offer. Both still preferentially remove fat over gland. Both make the work of the surgeon easier. Some feel ultrasonic liposuction can cause more swelling, bruising, and the increase the need for drains.
For me however, they also both remove the feel of the tissue sculpture. I like the much better control I get with my cannula selection and personally I do not like either ultrasonic nor power assisted techniques. None of the cases on my website used either PAL or Ultrasonic techniques.
As any artist, I take my cannula selection
very seriously and have evolved what permits me to achieve my results. I have considered and evaluated many, many technologies. The many different types of cannula I use have their own advantages and qualities. I pick a subset of these cannula that varies for the many different types of gynecomastia male chest sculpture that I see.
Gland removal by any technique can still leave a depression when a major part of the problem is from gland. For gland removal, I prefer the greater precision of removal under direct visualization and feel. This also give me access to many more elements for my artistic palette of my
dynamic technique to sculpt the remaining tissues.
This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat. How tissues move is important. The human body is beautiful in animation. That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views. Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor. It is like an artist selecting a paint brush. The results are what matters, not with what tool they sculpt.
Hope this helps,
Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture
Topic: Opinions Wanted-Constructive (Read 2976 times)
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