Thinking of gynecomastia surgery. I was told Smart Lipo would be the way. How painful is the numbing with local?

The discomfort of the numbing process for lipo of the breast, male of female, is proportional to the density of the breast tissue. If it's very dense, it will be more uncomfortable than if it's very soft. The level of discomfort is rarely extreme, but if the tissue is dense and you are anxious or if you prefer to sleep through the whole thing, then ask your surgeon to have their anesthesiologist present to provide you with intravenous sedation. It's always an option in my practice. If they don't provide this service, shop around and go for more consultations.

Thank you for your question. I suggest that you consult with your board certified facial plastic surgeon.
Best wishes,

hello chico323 There are varying degrees of gynecomastia ranging from puffy nipple to severe breast enlargement and/or breast sag. The severity of the gynecomastia will determine which treatment option is necessary. In most cases, men suffer from standard gynecomastia, which can be surgically treated as an in-office procedure under local anesthesia. For more severe cases, it may be recommended that you have your procedure under general anesthesia at an outpatient surgery center. Your consultation will determine which option is best suited for treating your gynecomastia. #pain #anesthasia

Hi Chico,It depends on the amount of fatty vs glandular tissue that you have.  Vaser along with a microcannula fat removal technique has been my choice for removal of fat.  The Vaser can break down fibrofatty tissue in the male chest easily.  If you have any residual gland after vaser or smart lipo you may need a small incision to remove the rest of the gland.  Without pictures or an exam it will hard for me to tell you which modality you will need.The numbing is not painful as most of these procedures are completed with oral sedation or IV sedation.  Once the area is numbed it will feel like a  massage/vibration as the fat is being removed. My preferred method is to use twighlight sedation for these procedures to maximize fat removal and glandular excision (if needed).In the picture gallery there are before and after of men treated with both Smart Lipo and Vaser.  All depends on the composition of your chest tissue.

The amount of local anesthetic used should be ample for keeping you comfortable during your procedure. However, just keep in mind that Smartlipo can only remove fatty deposits; if excess glandular tissue is the cause of gynecomastia, then surgical excision may be the better option. Work with a cosmetic surgeon who offers both forms of treatment to be sure you're getting the recommendation that's most likely to help you meet your goals.

Thank you for your question. The numbing is very powerful and works well in my practise. Last several years I am doing under local anesthesia and pt satisfaction is really good. Good Luck with your surfer

The answer is simple in my mind and I've done hundreds of these under local -ALWAYS!  The key to Smartlipo from our perspective is the experience of the surgeon. I feel uniquely qualified to discuss this having done 9000 Smarlipo procedures.   Choose a physician that has extensive experience with tumescent anesthesia and Smartlipo and you should do just fine.  Understanding how to remove the breast bud during these procedures is vitally important to prevent recurrence.

Best of luck

i personally like to give almost all of my patients oral sedation (which means they need a driver) which makes it more pleasant. however, some patients, prefer to drive themselves and don't bother taking any oral sedation and they do fine. as long as your surgeon injects slowly, it should be quite easy. Personally, even though i have done almost 800 Smartlipo cases, i prefer generally to do direct excising for most of the gynecomastia patients that i treat. david berman md