How much tissue should be left after gynecomastia surgery?

Question

I've had gyno surgery done a few days ago , the doctor decided to do lipo only since my gyno tissue was about 2.5-3 mm in diameter .It's been 5 days since the surgery and my chest looks exactly the same .should he have done an exision ?

Jed H. Horowitz, MD, FACS · Answer

Another issue with obese men is that they may have a degree of breast ptosis (droopiness) or even skin excess. From what it sounds like with your surgeon's diagnosis did not find any ptosis or excess. Now, you may have a certain amount of swelling from your surgery, so be sure to follow all of the post-op instructions you were given in able to ensure healthy healing. Good luck.

Scott W. Vann, MD, FACS · Answer

5 days post op liposuction, I am surprised that you are only as big as preop.  Liposuction swelling can be large and very firm, not soft at all.  During the first week the swelling can overwhelm the result. Wear your garment as directed and see your surgeon. You should start seeing your result in the next 1-2 weeks. Because of gravity your upper chest will get flat days and weeks before your lower chest. Good luck.

Robert D. Wilcox, MD · Answer

Dear robertcassy13,

I think it is first important to understand
the difference between fat deposits in the chest and true gynecomastia.
Medicine and surgery are easy once you have the correct diagnosis. Gynecomastia
means that the breast bud present in every man and woman at birth has been
stimulated with estrogen-type circulating hormones. This can be distinguished
from fat because it is firm to touch and palpation as opposed to the soft fat
of the abdomen. If you had true gynecomastia, liposuction will not correct that
and excision should have been done. Granted you are only five days from
surgery, and it may be hard to distinguish a difference right now because of
the swelling. Once the majority of the swelling is down, which should be the case
in six weeks, then I suggest the following: Tense your chest muscles. Feel the
thickness of fat that is between the skin and the muscle one inch below your collarbone.
That is the same amount of thickness that should be under your nipple and
areolae at six weeks’ time. If it is larger than that then there is likely
glandular tissue left behind that should still be excised.

I hope this has been helpful.

Robert D. Wilcox, MD

Vasdev Rai, MD · Answer

Plastic surgery is art and not math.  It is tactile judgement of surgeon and centimetric measurements of tissues that determine final outcomes in patients.

John D. Smoot, MD · Answer

Thank you for your question and without photos it is difficult to render an opinion but it is not unusual to have swelling for two to three weeks.  I would wait for six to eight weeks and then discuss this with your surgeon. If tissue needs to be removed it can still be done.

Steven Wallach, MD · Answer

At this point you are likely very swollen. In many cases, I prefer to go with liposuction because  with direct excision there is s higher risk of over resection and depressions.

How much tissue should be left after gynecomastia surgery?

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