Gynecomastia Surgery, I had this problem from my early 20’s, need recommendations for doctors.

Vaser is a good instrument for gynecomastia if it is INCLUDED with glandular excision.  Glandular tissue is unlike fat.  It won't "melt" like fat melts.  While Vaser alone will help with reducing volume in the chest, it won't completely alone fix gynecomastia.

                  The
surgical management of gynecomastia varies from patient to patient. This
variation depends on the severity of the problem and the type of gynecomastia
present.

                  When
glandular tissue is present surgical excision is usually necessary. This is
usually accomplished through a peri-areolar incision. The breast tissue is
first separated from the skin and subcutaneous tissue. Once this is
accomplished the breast tissue is separated from the underlying muscles and
removed as a single unit.

                  When
the breast tissue is predominately made of fat, liposuction can be utilized.
This technique involves passing a canula through the breast tissue repeatedly
while suction is applied to the canula. Cores of fat are removed and the area
is effectively sculpted.

                  In
some cases glandular and fatty components are present, and
combination procedures are necessary. Following surgery patients wear a
compression garment for four to six weeks. This helps remodel the tissue and
minimize complications.

                  It’s
important to realize that no two patients are alike and treatment should be
individualized. If you’re concerned about gynecomastia, consultation with a
board certified plastic surgeon would be appropriate. 

Gynecomastia is NOT just Liposuction (but it can be). Know who is doing it and what is involved.

Most important is not the technology but the surgeon:

• Verify Board Certification by American Board of Plastic Surgery (do this online)

• Member of American Society of Plastic Surgery (requirements beyond Board Certification)
• Member of American Society of Aesthetic Plastic Surgery (indicates extensive experience in aesthetic surgery - see below link)
• Look at online review sites - like RealSelf, Health Grades,RateMDs, Google, etc
• Look at Before and After photos
• What is my instinct or "gut reaction" as to who I relate to better, answers my questions more fully and who I basically trust the most.
• Finally ask yourself - if I was to have a complication, who would be the best to take care of me.

Procedure Description
General, Intravenous or local anesthesia are used for this procedure depending on the severity and type of procedure(s) selected by your plastic surgeon. It is performed on an outpatient basis.  For males with very large breasts staged procedures (more than one procedure) may be required. For example, the first procedure may be liposuction, then several weeks to months later after skin contraction has occurred, a separate procedure is done to remove excess skin. By doing a staged procedure, often the final scars are less.

Oftentimes, specific types of liposuction cannulas are used and often in conjunction with direct removal of excess breast glandular tissue through small incisions for mild to moderate gynecomastia. This can be the Vaser, Ultrasonic liposuction, or Power Assisted liposuction devices for better results. I prefer the Power Assisted liposuction device by Microaire. Other specific techniques can reduce the areola when needed or reposition the nipple to create the appearance of a more natural contour.

Larry Nichter, MD, FACS