Full or partial removal? I see conflicting opinions regarding gland removal for gynecomastia?

Question

I understand that the gland must be removed in order to have long lasting effects however some doctors say you must remove the WHOLE gland so it can never return. Others say that most of the gland tissue should be removed but some tissue will remain (to avoid deformity) and for the condition to return is rare but possible. I also noticed in many videos that some doctors cut up the tissue and then pull it out while others pull the whole gland out through the incision. Does it make a diff?

Ronald Schuster, MD · Answer

The gland should definitely be nearly completely removed in order to get hte best results. A very small amount should be left directly beneath the nipple in order to avoid depression and retraction. How it is removed is not really important and can be done a number of different ways. I prefer the Lateral Pull Through technique which avoids the scar along the areola.

Miguel Delgado, MD · Answer

The technique used will vary depending on the individual's unique situation. Over or under resection of breast tissue will lead to gynecomastia revision. Some tissue remains in order to sculpt the chest in a normal fashion. If too much or all the breast gland is removed you may end up with a "crater deformity." It is very rare for the breast tissue to grow back. Good luck.

Stuart A. Linder, MD, FACS · Answer

I prefer in most cases do perform a partial tissue removal through direct excision and Lipo of the chest to avoid a chest wall deformity result.

Tom J. Pousti, MD · Answer

Thank you for the question. Leaving a small amount of glandular tissue in place is important in my opinion;  otherwise, you would be at risk for contour ("saucer") deformity complications.  In the end,  you will be happier with the outcome if you do not have a "surgical look" resulting from over resection.   Best wishes.

Tim Sayed, MD, MBA, FACS · Answer

Most surgeons try to leave a cuff of subareolar tissue right under the areolar skin to avoid a depressed "saucer" deformity of the nipple region. This cuff can be 1-3cm or so in thickness depending on your overall breast skin and fat thickness vs the amount of gland that is bulging the central area. The majority of the gland is removed but by definition at least a small amount will remain unless the surgeon were to completely resect all the way to the undersurface of the nipple, which would be risky from the standpoint of blood supply compromise to the nipple as well as increase the risk of saucer deformity. Most of the time the tissue is removed "en bloc" as a mass from the incision without mincing it into pieces as this is the more elegant and surgically precise way to do it. Additionally, it is common to send this tissue to pathology for analysis to make sure it is benign gynecomastia. Liposuction is also used in most patients to blend the transition from the subareolar region to the rest of the breast.

Full or partial removal? I see conflicting opinions regarding gland removal for gynecomastia?

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Answer: Full or partial gland removal for gynecomastia?

Answer: Full or partial gland removal for gynecomastia?

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Answer: How much of the breast gland should be removed in #gynecomastia reduction surgery?

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Full or partial removal? I see conflicting opinions regarding gland removal for gynecomastia?

Answers (7)

Answer: Full or partial gland removal for gynecomastia?

Answer: Full or partial gland removal for gynecomastia?

Answer: How much of the breast gland should be removed in #gynecomastia reduction surgery?

Answer: How much of the breast gland should be removed in #gynecomastia reduction surgery?

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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.