Most gynecomastia surgery I do involves liposuction alone since a good part of gynecomastia is secondary to fatty deposits. Breast tissue is not amenable to liposuction and other methods must be employed to remove significants amounts of it. Once liposuction is completed and there is still residual breast tissue, I actually use a different device that "chews" up the breast tissue through the same small liposuction incision. Once the breast tissue is free, I then perform liposuction again to remove it. This avoids having to make a larger incision and cut it out directly. In rare cases, there is also significant skin excess which must be removed. If gynecomastia surgery is done well, it should not leave you with a totally flat chest as this is not natural. You should still be left with some contour that is virtually lump free. Of course, lumps are possible, but this is not common. Hope this helps you.
Dr. Singer
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