Why are plastic surgeons not recommending gland removal for my gynecomastia procedure? (photo)

Question

Hi Doctors! I got gynecomastia from puberty (about 15 years ago). This week I spoke with multiple plastic surgeons to discuss options to remove my gynecomastia (picture below). 4 out of 5 surgeons all said that I do not have gland to justify gland removal. They all recommend only liposuction. Is this normal? My main concern are my puffy nipples. My nipples feel empty behind the puffiness. Can liposuction alone solve my gynecomastia? I thought only gland causes puffy nipples. Thank you!

Scott W. Vann, MD, FACS · Answer

I do a lot of gynecomastia surgery and find that I can resolve all the volume with liposuction only in about 70% of cases. The other 30% require some fibrous gland removal usually right under the nipple which I do at the same time as soon as I finish the suction. I cannot always tell before I do the suction if gland excision will be needed, but I am simply prepared to proceed every time as needed. Find a plastic surgeon who does a lot of these procedures. Good luck.

Dallas Homas, MD · Answer

In my experience, liposuction does help reduce the size of the male breast, but usually, an excision of the breast tissue itself is required to achieve the desired contour.  While excess fat can be removed pretty effectively with liposuction, the breast tissue is more dense than the fat.  This makes it difficult to remove using standard liposuction.  Some advanced liposuction units add laser or heat energy to help "melt" the breast tissue, allowing it to be removed more easily with the liposuction cannula.  Good luck!

Sean Doherty, MD, FACS · Answer

In my experience, patients with puffy nipples almost always need some kind of gland excision. Make sure that you are seeing board certified plastic surgeons (can find the ones in your area on the American Society of Plastic Surgeons website) who have a lot of experience treating gynecomastia. Hope this helps and best of luck.

Babak Dadvand, MD · Answer

Hi erzfdjf,Thanks for the post and photo. In my experience, patients who developed gynecomastia during puberty who have puffy nipples and are of normal body weight will absolutely require excision as part of their treatment plan. If someone doesn't have excess fat in other parts of their chest, why would they have fat just under the nipples? The answer is that they don't and it is most likely breast tissue.Sincerely,Dr. Dadvand

Robert Caridi, MD · Answer

That's a great question. In almost all cases that I have treated it was beneficial to remove some gland/residual fibrous tissue beneath the areolas so they won't be puffy after treatment. This incision is TINY to remove this tissue so why wouldn't you do this? I believe that treatment with liposuction alone "sounds" less invasive and therefore it's a good selling point.

Why are plastic surgeons not recommending gland removal for my gynecomastia procedure? (photo)

Answers (9)

Answer: Gynecomastia Surgery

Answer: Gynecomastia Surgery

Answer: Liposuction alone treatment for gynecomastia?

Answer: Liposuction alone treatment for gynecomastia?

Recommended reading

Everything you need to know about Gynecomastia Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

Why are plastic surgeons not recommending gland removal for my gynecomastia procedure? (photo)

Answers (9)

Answer: Gynecomastia Surgery

Answer: Gynecomastia Surgery

Answer: Liposuction alone treatment for gynecomastia?

Answer: Liposuction alone treatment for gynecomastia?

Browse related questions

Recommended reading

Everything you need to know about Gynecomastia Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.