My surgeon says glands removed w/ lipo only. Everything I’ve read says you need excision. Does he know something others don’t?

There are many surgeons who attempt to remove glandular tissue with different types of liposuction. More than 40% of my gynecomastia practice is redo surgeries, many to correct lipo only surgeries done elsewhere. I have found it is not possible to get the type of sculpting I like for my patients with liposuction alone. For breast tissue I find excision is necessary. Good luck.

Healthy male patients with excess breast tissue or unwanted breast 
development who have no underlying breast disease.Men who desire 
improved physical and aesthetic appearance should have realistic 
expectations based on their condition and the procedure performed. You 
should meet with a board certified plastic surgeon to be able to get a 
formal diagnosis and to be able to decide on a course of treatment if 
necessary.

I do a lot of gynecomastia surgery. I always do a very aggressive liposuction which gets rid of most of the tissue. In maybe half the cases I can still feel a small amount of fibrous gland tissue just below the nipple which I then remove with direct excision with an incision along the lower areola edge. Once you are fully healed at 3-4 months you will be able to see the final result. Slight puffiness to the nipples is normal and preferable to over resection and an inverted nipple. After you are fully healed, assess your result with your surgeon to see if you need any revision. Good luck.

Thanks for your questions.  In my experience it is impossible to remove the glandular tissue with lipo alone.  Excision is almost always necessary for the best possible result.  If you have firm tissue remaining behind your areola, then you likely have glandular tissue remaining.  Discuss a revision with your surgeon (you should not have to pay for this) or explore a second opinion. Best wishes!Daniel Brown, MD, FACSBoard Certified, American Board of Plastic SurgeryMember, American Society of Aesthetic Plastic SurgeonsMember American Society of  Plastic SurgeonsCastle Connolly Top DocReal Self Top 500