Can True Gynecomastia (Glandular Tissues) Be Cured by Liposuction?

I have puffy nipples and I went to see a government plastic surgeon. After scanning she told me that the glandular tissue is about 2.5cm. She recommended that I skip the surgery as it is very mild. And if I really insist on doing it, it will be removed by liposuction and a "divider" to shave the tissues. No incision will be done. 1. Should I do the surgery? 2. Can liposuction really remove glandular tissues? 3. What is the size of the normal male breast tissue? 4. will there be scars?

Doctor Answers 27

Gynecomastia (male breast tissue) can be treated with liposuction and/or excision

Male breast development, or gynecomastia, can cause feelings of self-consciousness and embarrassment for some men. 

Gynecomastia can be treated by a number of methods, primarily liposuction and/or excision of excess breast tissue.

Gynecomastia is "graded" from Grade I (mild) to Grade III (significant breast development, including droop and excess skin).  The type of treatment is dictated by the extent of the condition and its severity.

To answer your specific questions: 

I have puffy nipples and I went to see a government plastic surgeon. After scanning she told me that the glandular tissue is about 2.5cm. She recommended that I skip the surgery as it is very mild. And if I really insist on doing it, it will be removed by liposuction and a "divider" to shave the tissues. No incision will be done. 1. Should I do the surgery?

The decision to have surgery or not is a very personal one.  This can only be answered by YOU, after you have done all your homework and researched the options, including experienced Board Certified Plastic Surgeons. 

2. Can liposuction really remove glandular tissues?

One type of liposuction is usually used for gynecomastia, as the tissue is more firm and fibrous than regular tissue.  The method is called ultrasonic-assisted liposuction, or UAL.  A common brand name machine is  called "VASER". 

Whether or not liposuction alone will remove all the tissue depends on your body.  I usually reserve the right to also make a small incision if needed, based on the results during surgery. 

3. What is the size of the normal male breast tissue?

The size of breast tissue in males varies significantly.  Factors associated with an increased amount of breast tissue include being overweight, having hormone imbalances, some medication or drug use, and puberty.  Rest assured that gynecomastia is quite common, and does not need to be treated if it is not of concern to you. 

4. will there be scars?

With ANY Plastic Surgical procedure, there are scars.  The location and degree of scarring will be minimized by "hiding" incisions in areas that are not visible in most situations.  Genetics plays the number one role in determining the quality of your scars.  Look to other areas of your body to see how your scars heal. 


San Francisco Plastic Surgeon
4.0 out of 5 stars 8 reviews

Gynecomastia

Typically fat is removed via liposuction and glandular tissue is removed via direct excision.To optimize the result both components need to be addressed.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.5 out of 5 stars 12 reviews

Puffy Nipples Often Can Be Treated With Liposuction Alone

In my personal experience, many patients with “puffy nipples” can be treated solely with liposuction.  There are 2 reasons for this:
  1. Some patients with “puffy nipples”, have a purely fatty enlargement of their breasts, rather than a tough, rubbery glandular and fibrous tissue found in others.
  2. Others with “puffy nipples” can have primarily fatty enlargement, with only a minor component of firm, glandular tissue lying beneath

In the majority of these patients, I have had much success in using “Power-Assisted Liposuction” or PAL to completely treat their “puffy nipple” condition, resulting in a flat, normal appearing male chest.

In other more difficult cases, I have combined PAL with special “cutting” or “grating” liposuction cannulas, which literally chop up the firm breast tissue and remove it through suction. 

In a small subset of patients, the above techniques do not result in a completely flat chest.  In these patients, I perform a “stealth excision”, in which I make a several millimeter “stab” incision within the areolar skin, and then remove the stubborn breast tissue with a clamp and scissors.  A dissolvable stitch or two is used to close the tiny incision, leaving an imperceptible scar.

The normal male breast is usually not palpable, but “normal” is considered to be less than 2.5 cm in diameter by most physicians.
 
I hope that this answers your questions adequately.  Good luck!

Gynecomastia Surgery with Liposuction Alone

Hi ihategyne,

Thanks for the post. The short answer is no. Patients with true gynecomastia typically do not get ideal results with just liposuction. In true gynecomastia there is an excess of breast tissue which is not similar in consistency and texture to fatty tissue. Whereas liposuction is useful in removing fatty tissue, it is rarely successful in removing breast tissue.

I would recommend being evaluated by a plastic surgeon who specializes in gynecomastia surgery. There is no normal size of male breast tissue as each person is different. Also, there will be scars but in experienced hands these incision tend to heal very well.

Sincerely,

Dr. Dadvand

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 19 reviews

Glandular tissue

It is important to understand liposuction removes fat and surgery removes glandular tissue (which is firm, more dense).  Gynecomastia can be observed if it isn't bothersome.  It's a cosmetic procedure.  Anytime there is surgery there will be scars.  The scars are generally well hidden or camouflaged around the areola. 
This is the trade-off.  So in very mild cases, it may make more sense to wait.

Tim Neavin, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 13 reviews

Can True Gynecomastia (Glandular Tissues) Be Cured by Liposuction?

Liposuction is an effective technique to treat gynecomastia.  It there is significant skin excess, additional skin excisions techniques may be needed. 

John T. Nguyen, MD, FACS, FICS
Double Board Certified Plastic Surgeon

John Nguyen, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 38 reviews

When Gynecomastia is Caused by Growth of Glandular Breast Tissue, Surgical Excision is Usually Necessary to Correct the Problem

                  When gynecomastia is caused by growth of glandular breast tissue surgical excision is usually necessary to correct the problem. In contrast, when breast growth occurs because of fat deposition, liposuction is the treatment of choice.

                  Glandular tissue tends to be thicker and more fibrous than fatty tissue. When breast tissue is present it can be very difficult to pass a liposuction canula through the tissue. For this reason, liposuction is rarely effective when glandular tissue is present.

                  Glandular tissue usually requires surgical excision. This can be performed through a periareolar incision with minimal scarring. Consultation with a board certified plastic surgeon should help determine what specific option is best for you.

Surgery for Gynecomastia

Gynecomastia comes in many sizes. Apparently you have a very mild form where your nipple is prominent and maybe there is some fullness of the breast itself.  The nipple prominence is caused by the breast bud which is breast glandular tissue that is generally palpable behind the nipple as a rubbery firm ball almost like a seed in a soft fruit.  That firm tissue cannot be liposuctioned, it has to be removed surgically.  Normal male chests have palpable breast buds but so long as they remain invisible nobody cares.  Most patients with gynecomastia that request treatment will have a combination of excess of fat as well as palpable glandular tissue.  Some patients particularly after massive weight loss will also have excess of skin with folds that require extensive resection and nipple relocation in the form of a free nipple graft.  For everybody in between that and your case Liposuction alone or a combination of Liposuction and glandular resection will produce the desired effect.   

Juan A. Brou, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 29 reviews

Gynecomastia Surgery

Thank you for the question.

I have found that gynecomastia is often best treated with  partial excision of the prominent glandular tissue  as well as liposuction surgery of the peripheral chest area.  If the prominence of the chest wall is caused by adipose tissue, then liposculpture surgery alone may suffice.

I would strongly suggest that you make sure you are working with a well experienced board-certified plastic surgeon. 

I hope this helps.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.