Marvin F. Shienbaum, MD

Yes, fat is often removed during gynecomastia surgery. The procedure aims to reduce the size of enlarged male breasts, and this enlargement can be due to a combination of factors: Excess fat: This is often referred to as pseudogynecomastia. Excess glandular tissue: This is the actual breast tissue growth, known as true gynecomastia. Excess skin: In more severe or long-standing cases, the weight of the excess tissue can cause the skin to stretch. How fat is removed during gynecomastia surgery: Liposuction: This technique is commonly used to remove excess fat from the chest area. Small incisions are made, and a thin tube called a cannula is inserted to break up and suction out the fat. Liposuction alone may be sufficient when the enlargement is primarily due to fatty tissue. Excision: When there is a significant amount of glandular tissue and/or excess skin, surgical excision is necessary. This involves making incisions to directly remove the tissue and trim excess skin. The incisions are often placed around the areola (the dark area around the nipple) or in the natural creases of the chest to minimize visible scarring. Combination: In many cases, surgeons use a combination of liposuction and excision to achieve the best results, addressing both excess fat and glandular tissue. The specific techniques used will depend on the individual's anatomy, the primary cause of the gynecomastia, and the desired outcome. A thorough consultation with a board-certified plastic surgeon is essential to determine the most appropriate surgical approach. They will assess the proportions of fat and glandular tissue present and recommend a plan to effectively reduce the breast size and contour the chest. Brandon, FL, USA  •  Update location

Yes, it is absolutely possible to have liposuction performed only on the flanks (love handles) and waistline. This is a very common and effective approach for targeting stubborn fat deposits in these specific areas. Here's why it's feasible: Liposuction is site-specific: Liposuction is designed to remove fat from targeted areas of the body. Surgeons routinely perform the procedure on isolated regions like the flanks and waist. Customized treatment: The procedure can be tailored to address your specific concerns and aesthetic goals for these areas. Effective for localized fat: The flanks and waistline are common areas for localized fat accumulation that can be resistant to diet and exercise. Liposuction can directly address this. What to expect: The surgeon will make small incisions in the targeted areas. A thin tube called a cannula will be inserted to break up and suction out the excess fat cells. You'll likely need to wear a compression garment after the procedure to help with swelling and contouring. Recovery time is typically a few days to a week for most normal activities, with swelling and bruising gradually subsiding over several weeks to months. Results can be significant in terms of reducing fullness in the flanks and defining the waistline. Important Considerations: Liposuction is a body contouring procedure, not a weight loss solution. Ideal candidates are typically at or near their target weight with localized fat deposits. The amount of fat that can be safely removed in a single session is limited. Maintaining a stable weight after liposuction is crucial for long-lasting results. To determine if liposuction of the flanks and waistline alone is the right option for you, it's essential to consult with a board-certified plastic surgeon. They can assess your individual anatomy, discuss your goals, and create a personalized treatment plan.

It's absolutely possible to place a breast implant over the muscle. This placement is known as subglandular or over-the-muscle placement. Here's a breakdown of what that entails: Placement: The implant is positioned directly behind the breast tissue and in front of the pectoralis major muscle (the chest muscle). Suitability: This approach can be suitable for individuals who have enough existing breast tissue to provide adequate coverage of the implant, which helps to achieve a more natural look and feel. It's also often preferred by very active individuals as there's less chance of muscle movement affecting the implant's appearance. Potential Advantages: Less Invasive: Generally considered a less invasive procedure with potentially shorter recovery times and less post-operative discomfort compared to under-the-muscle placement. No Muscle Interaction: The implant won't be affected by the movement or contraction of the chest muscles, which can sometimes cause animation deformity (distortion of the breasts during muscle flex). Potentially More Natural Look: In individuals with sufficient breast tissue, it can create a very natural-looking result. Good for Active Patients: Implants are less likely to move or distort during physical activity.

The most effective procedures for addressing loose skin in the lower face and chin area are surgical options that directly lift and tighten the underlying tissues and remove excess skin. Here are the primary procedures: 1. Facelift (Rhytidectomy): A facelift is a comprehensive surgical procedure that addresses signs of aging in the face and neck, including the lower face and chin.   How it works: It involves making incisions (typically around the ears and potentially under the chin), lifting the skin, tightening the underlying muscles and tissues (including the SMAS layer), and redraping the skin to a more youthful contour. Excess skin is then removed.   Benefits for the lower face and chin: A facelift can significantly improve: Sagging jowls along the jawline.   Loose skin under the chin (sometimes referred to as "turkey neck"). Deep creases along the nose and mouth (nasolabial folds).   Marionette lines (lines running from the corners of the mouth down to the chin).     Variations: There are different types of facelifts, including traditional, mini, mid-facelift, and deep plane, which can be tailored to address specific areas and levels of laxity. A lower facelift specifically focuses on the bottom third of the face, including the jowls and jawline.   2. Neck Lift (Platysmaplasty or Lower Rhytidectomy): A neck lift specifically targets the signs of aging in the neck and can significantly improve the appearance of the chin and jawline.   How it works: Incisions are typically made around the ears and sometimes under the chin. The surgeon may tighten the platysma muscle (the superficial muscle of the neck), remove excess fat, and redrape the skin to create a smoother, more defined neck and jawline.   Benefits for the lower face and chin: A neck lift can address: Loose, sagging skin in the neck.   Vertical neck bands. Excess fat under the chin (double chin).   Indirectly improve the definition of the jawline.   Combining Facelift and Neck Lift: Often, a facelift and neck lift are performed together to achieve a harmonious and comprehensive rejuvenation of the lower face, chin, and neck. Since these areas age together, addressing them simultaneously can yield the most natural and balanced results.   Non-Surgical Options (Provide More Subtle Improvements): While surgery is the most effective for loose skin, some non-surgical treatments can offer mild to moderate improvement: Dermal Fillers: Can add volume to areas that have lost support, indirectly lifting the surrounding skin and improving contours along the jawline and chin. Results are temporary. Thread Lifts: Involve inserting dissolvable threads under the skin to lift and tighten the tissue. Results are less dramatic and long-lasting than surgery.   Energy-Based Skin Tightening (Radiofrequency, Ultrasound): These treatments can stimulate collagen production and provide some skin tightening over time, but the results are typically subtle and best for mild to moderate laxity.   Injectable Fat Dissolvers (e.g., Kybella): Primarily target excess fat under the chin but can sometimes improve the contour and appearance of mild skin laxity in that area. Recommendation: For noticeable and long-lasting improvement of loose skin in the lower face and chin area, a facelift, a neck lift, or a combination of both are the most effective treatments. The best course of action is to consult with a board-certified plastic surgeon experienced in facial rejuvenation. They can assess your specific anatomy, the degree of skin laxity, and your goals to recommend the most appropriate procedure or combination of treatments for you.

Abdominal Liposuction What it addresses: Abdominal liposuction is designed to remove excess fat deposits from the abdomen, helping to improve the contour and create a flatter, more toned appearance. It is not a weight-loss procedure but rather a body-contouring one.   How it's performed: Small incisions are made in the abdomen, and a thin tube called a cannula is inserted to suction out the fat. Different techniques exist, such as tumescent liposuction (where a solution is injected to help break up the fat), ultrasound-assisted liposuction (UAL), and laser-assisted liposuction (LAL).   Ideal candidates: Individuals who are at a stable weight, have good skin elasticity, and have pockets of fat that don't respond to diet and exercise are typically good candidates. Recovery: Expect swelling, bruising, and discomfort for several days to weeks. You'll likely need to wear a compression garment.   Results: Noticeable results are usually seen within a few months as swelling subsides.   Thigh Lift (Thighplasty) What it addresses: A thigh lift removes excess skin and fat from the thighs, tightens the underlying tissues, and reshapes the thighs. It's often performed after significant weight loss or to address sagging due to aging.   How it's performed: The procedure involves incisions on the inner or outer thighs (or both), depending on the areas being treated. The surgeon removes excess skin and fat and tightens the remaining skin. Different techniques include medial (inner) thigh lift, lateral (outer) thigh lift, and spiral thighplasty.   Ideal candidates: People who have excess skin and sagging in their thighs, are at a stable weight, and are committed to maintaining a healthy lifestyle are generally good candidates.   Recovery: Recovery can take several weeks, with swelling, bruising, and potential for scarring.   Results: Results are visible soon after surgery, with continued improvement as swelling resolves.