Gynecomastia via Vaser lipo and glands removal problem

Question

I agreed with surgeon before the operation to remove both glands and fatty tissues, but after one day from my surgery and during check I found only one incision a little bit far in the direction of my armpit. Is it feasible to VSER liposuction to melt the gland completely? What do you recommend to tell my surgeon about this issue frankly? Is it feasible to do another surgery to remove the whole gland remaining tissues? And after what time? Thanks

Alexander Q. Ereso, MD, FACS · Answer

Hello and thanks for your question. I find that the VASER is useful to improve skin contraction. While it also breaks up the fat globules, I do not find any utility in being able to "melt" the gland. In patients where the the protuberance is caused by fatty tissue alone (lipomastia), liposuction alone is adequate as a treatment. However, if you feel that you are incompletely corrected, then glandular excision should have been performed in conjunction with liposuction. I recommend you address this directly with your surgeon. It sounds as if the operative plan you made beforehand was to perform both liposuction and gland removal surgery so this deviation from the plan should be discussed openly and honestly. It is feasible to perform a second surgery after the area has fully healed. I like to wait several months before performing a revision.

Robert Caridi, MD · Answer

Vaser will shrink the harder tissue but it still needs removal. This is done from a tiny incision around the areola. This can be done at any time.

J. Michael Morrissey, MD (in memoriam) · Answer

Thank you for your question. At our center we use a similar incision toward the armpit to address gynecomastia. Ultrasonic liposuction (VASER) helps to disrupt the fibrous components and melt some of the gland. This in conjunction with excision of the gland helps to nicely recontour the male chest. By not using an incision around the areola, distortion of the areola is avoided. Thinning the subareoalr tissue in this way helps the areola shrink in size as well.  Ask your surgeon how he or she addressed the gland. If it was only with the vaser and liposuction, the excision was likely incomplete.Best wishes,Dr. Morrissey

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