Did I need glandular excision in addition to lipo? Nipples still protruding. (photos)

A little more than a week ago I received liposuction of the chest. The doctor said he didn't feel I needed any excision. However, my gynecomastia started at puberty and began as swollen nipples. Before and after the lipo I could feel hard lumps under each nipple. Should I have had glandular excision and do I need it now to achieve the results I want? And if I do need revision surgery, will it cost as much as the lipo? Because I've paid a lot of money already.

Doctor Answers 5

Direct tissue excision

Sometimes direct excision of tissue is necessary. At this point, you are best to allow things to heal and wait about 4-6 months.  Good luck.

New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Did I need glandular excision in addition to lipo? Nipples still protruding

It is too early to tell as there is likely a lot of swelling and I cannot feel the tissue to tell you more. If in 3-6 months as the swelling subsides, you still feel the lumps behind your nipples, an excision can be done at that time. The fees for that will need to be discussed with your surgeon though. If it is a very small area it can possibly be done in the office under local anesthesia

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.7 out of 5 stars 21 reviews

Secondary gyne surgery to remove glandular tissue

Hi There, 

Thank you for posting your concerns, questions, and photos here on Real Self. 

It is really much too early in the healing process to know if a secondary surgery would be needed. I'm sure you have quite a bit of swelling since you are just over a week post-op. Hopefully, liposuction alone will yield the result you were wanting. The healing process will take a few weeks, so be patient and follow your surgeons instructions. If he has advised you to wear a compression garment for proper healing, be diligent with this as it is a very important component for optimal healing.  I would also urge you to express your concerns with your plastic surgeon. Communication is key. 

About the Gynecomastia Surgical Techniques

Several common factors can cause gynecomastia including excessive levels of #estrogen, natural #hormone changes, use of recreational drugs or alcohol, medications and their associated side effects, and, various health conditions. Also, there are different types of #gynecomastia.

There are three types of surgical #treatment #options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you.

The excision technique is used on cases of #gynecomastia where excess skin and glandular breast tissue must be removed and the areola or nipple needs reduction and repositioning to create a natural looking appearance. The incision patterns are determined by the specific condition of the patient. The doctor will recommend this procedure which combines the liposuction technique and excision technique to create a natural look. Patients are given specific instructions for the recovery period. 

Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.

The most important decision to be made before performing any surgical procedure is determining whether you are an ideal #candidate.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

Gynecomastia treated with liposuction


Thank you for your question and your photos.  Liposuction alone is frequently used to treat gynecomastia, with good results.  Its hard to know whether the liposuction successfully removed the glandular tissue since you are swollen.  I would suggest waiting al least 2-3 months to allow the swelling to dissipate as you might be happy with the results.  You should however discuss your concerns with your plastic surgeon.

Good Luck,  Beverly Friedlander, MD

Beverly Friedlander, MD
Short Hills Plastic Surgeon
4.7 out of 5 stars 13 reviews

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.