Is it standard to remove all of the gland tissue in gynecomastia surgery?

Gynecomastia is like a female breast reduction in that some, but not all breast glandular and ductal tissue are removed.  There are some ducts and glandular tissue associated with the nipple areola complex so unless the nipple is removed, there is still a little glandular tissue present after gynecomastia surgery.  Unless the patient is very thin, I usually leave some varying amount of glandular tissue directly beneath the nipple/areolar area to make sure the thickness is similar to the rest of the chest sub-Q thickness, and to prevent unsightly nipple retraction due to scarring that can retract to the underlying chest wall.  

The excision technique is used on cases of #gynecomastia where excess skin and glandular breast tissue must be removed and the areola or nipple needs reduction and repositioning to create a natural looking appearance. The incision patterns are determined by the specific condition of the patient. The doctor will recommend this procedure which combines the liposuction technique and excision technique to create a natural look. Patients are given specific instructions for the recovery period. Men who suffer from large #areolas may notice that after breast surgery, the skin of the chest muscles will tighten, causing the areolas to tighten and diminish in size. This is a result of the removal of glandular and/or adipose tissue.

Thank you for your question.  In order to prevent nipple retraction or tethering to the underlying pectoralis muscle, a small amount of glandular tissue is left behind the nipple areola complex.  If you are recently out from surgery, consider scar massage therapy to try and free the tethered nipples.