Is the whole gland removed during gynecomastia surgery? (Photos)

This is a great question. If you remove all the gland then you reduce the risk of recurrence of gynecomastia but increase the risk of developing a crater like appearance (also called saucerization) and vice versa. If your surgeon is experienced in this procedure he/she will be able to judge this during surgery. It is important to have a blended appearance of the chest which can be achieved with tissue remodelling during the op and with liposuction.

Dear Ddubw,
Thank you for your question and photos. It is difficult to say for sure without an in-person consultation, but from looking at your photos, you appear to have grade 2a gynecomastia. With surgery, removing all of the gland may be an overcorrection of the problem, sometimes known as “saucer-like deformity”. In order to help to avoid deformity in that area, some of the tissue can be left behind, which may provide better contour. I suggest that at this current time, you schedule a virtual consultation with a board-certified plastic-surgeon. Good luck and stay safe!

I appreciate your concerns, however essentially I agree with your surgeon. Most forms of gynecomastia consist of both fat and breast tissue. Over resection of both of these tissues can result in a deflated, concave appearance which is not attractive in a young muscular male. It appears from your photographs that you are a reasonable candidate for just expert traditional liposuction contouring of your chest region, removing excess tissue and maintaining appropriate anatomy. Consult with your board-certified plastic surgeon to confirm my advice. Good luck.

Dear ddubw,
it is hard to tell for sure without an examination. Generally speaking, surgeons use different surgical techniques to get the best results. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

In gynecomastia surgery, the extent of gland removal can vary depending on the severity of the condition and the surgical technique used. In some cases, the entire glandular tissue may be removed, while in others, only a portion of it is excised. The surgeon will assess the patient’s specific condition and determine the appropriate approach during the procedure. It’s important to consult with an experienced plastic surgeon to discuss the details of your surgery and understand what to expect in your particular case.

Crater deformity, or saucer deformity can be caused by excessive removal of breast tissue The entire gland can be removed. What is important is to not remove too much fat. The surgery must be perfomed with finesse, leaving some fat to provide structure and shape to the chest and to the Nipple areola complex so you will not be left with contour deformities. 
Many patients I see do not want to see or feel gynecomastia any more. I have had two cases where the post-operative apprearance of my patient was aesthetically ideal but the patients were concerned because they could feel a small amount of residual breast tissue. I revised the procedure for them, and I have learned to completely remove all of the patients glandular breast tissue. 
Gynecomastia is too often considered a simple and straightforward surgery. It requires surgical expertise and experience. I perform too many gynecomastia revision procedures. Look for a plastic surgeon with many, many before and after images as evidence of their experience. 

Hi and thanks for the question and sharing your images.
The priority is to create an improved contour and reducing the chances of an indentation also known as a "Saucer Deformity. Therefore, typically a combination of liposuction and resection is performed. 
This may sound a little strange but it's not critical to remove every bit of breast tissue. In fact, it is rare to do that because of the risk of deforming the chest. The presence of breast tissue is not the problem - it is the presence of excess glandular tissue that is causing your gynecomastia (also known as man boobs or puffy nipples). 
The technique I like which reduces the chances of over resection or a saucer deformity is called the Pull Through Technique.
This special technique involves a tiny incision away from the breast, concealed in an area of natural shadow, and through that incision we first liposuction all the fatty tissue and then use that same incision to remove the rubbery glandular tissue from behind the nipple. The scars are quite imperceptible and heals great. 
Chest Compression Garments/Vests should be worn around the clock for the first 4-6 weeks to help get the skin to heal down and contract. 
Best of luck,
Dr. Karan Chopra
★★★★★
Minneapolis Plastic Surgeon
Face ⨀ Breast ⨀ Body Expert
Johns Hopkins Trained
Cosmetic Fellowship Trained

Thanks for your question and uploading photos - the photos are really helpful. In gynecomastia surgery, your surgeon will be able to determine with the in-person consultation the amount of tissue to remove and what technique will be best. In order to have a smooth contour though, some tissue is routinely left behind so there is not an indentation. Good luck.

Hi ddubw,
Thank you for sharing your images and concerns. After carefully assessing them, you are a suitable candidate for Gynecomastia combined with Vaser Liposuction. The opening will be via the nipple and the remaining little breast tissues will be removed as well.

Having a physical consultation is also important in cosmetic surgeries. Thus, please keep in mind to book an in-person consultation with a board-certified plastic surgeon.

I hope this helps.

An examination is necessary to assess whether this is glandular or fatty tissue. If fatty, liposuction may be sufficient. If glandular, the entire gland is not respected as this would result in concavity of the chest.