Details of Repeat Gynecomastia Gland Excision and Male Breast Contouring - (gynecomastia, suction lipectomy, liposuction, liposculpture)

Explore revision chest contouring surgery for gynecomastia - male breast deformity with surgery and liposuction. Plastic and cosmetic surgery by Dr. Michael Bermant, MD.

Michael Bermant, MD
Board Certified by the American Board of Plastic Surgery

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Surgical Details of Secondary Gynecomastia Male Breast Reduction Surgery - Gland Excision and Chest Contouring

Warning:

The following material on this page is graphic in nature. Please skip if explicit surgical details bother you.

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Revision Gynecomastia Surgery - Dynamic Chest Sculpture

and Gynecomastia
Male Breast Reduction

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There are many possible problems of male breast surgery that secondary gynecomastia sculpture can address. It is easier to remove tissue than replace it. Not all deformities after gynecomastia surgery have good surgical solutions. Depressions can sometimes be filled by moving fat back under the depressed region. Dr. Bermant blends many possible techniques for each problem, best determined during an in office consultation.

During his normal primary surgery, Dr. Bermant sculpts the fat after the excision and liposuction by moving the surrounding fat back under the areola and nipple. Dr. Bermant avoids the need for secondary gynecomastia surgery with an intense attention to detail for each patient. This patient had prior gynecomastia surgery by another doctor. More details about this patient.

In this particular case, the patient needed the gland removed, surrounding fat liposuction, and the remaining fat sculpted into the void under the areola and nipple.


A thin cannula is used to inject the tumescent anesthesia.	Anesthesia fluid is placed under the skin above the chest muscles.

Tumescent Anesthesia minimizes bruising and bleeding. In secondary gynecomastia reductions, there can be significant scars in this layer when the prior surgeon used liposuction surgery. This can result in more tugging and pulling during the administration of the anesthetic. Dr. Bermant prefers sedation for his patients to increase comfort during this surgery.

Photographs of repeat contouring for gynecomastia deformity

Excision of the glandular mass starts with a small incision near the areola. Sometimes the a prior skin scar can be revised during this operation.

Another surgeon had operated on this patient previously with liposuction alone. While fat is easily suctioned, dense gland can be very difficult to remove with suction lipectomy alone.


The gland under the areola is dissected from surrounding tissues.	A larger gland can be removed though this small areola incision.

The amount of breast tissue remaining after treating gynecomastia with liposuction alone can be remarkable. Look how much gland Dr. Bermant removed during this secondary case.


	Notice the glandular tissue removed from each side.

Revision of problem after surgery by another doctor - photographs during operation

There can be quite a cavity left after the dense gland is removed. This cavity left untreated can leave a depression under the nipple and areola. Dr. Bermant uses liposuction and tissue contouring to sculpt surrounding regions.

Tumescent liposuction contours the surrounding fat. The tumescent technique means the fat removed has very little blood. This translates into less bleeding, bruising, and discoloration after surgery.


Surrounding fat is sculptured with a thin liposuction cannula.	The fat in the tube is yellow with very little blood with the tumescent technique.

After contouring the surrounding fat with liposuction, the fat layer is repositioned under the nipple and areola. This patient had the excess fat to model. In cases where other doctors have removed too much tissue, this technique may not be a reasonable solution.


There may still be a defect in the fat layer after removal of the gland.	Suture sculpture of the fat layer restores continuity under the nipple and areola regions.

Pictures of operation for male breast deformity.

The skin closure suture finely approximates the outer tissues. This suture may be dissolvable or need to be removed 6-10 days after surgery.

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Revision Gynecomastia Surgery - Dynamic Chest Sculpture

and Gynecomastia
Male Breast Reduction

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