I have been reading about 2 doctors who say they have made their own liposuction tools that remove gland of gynecomastia? Their cutting cannula can avoid the cut by the nipple and remove gland from my armpits. Does this work?
The earliest liposuction started out with sharp cutting cannula before this tool was turned to deal with gynecomastia. Unfortunately, I have yet to see proof this technique works. It would be simple enough, gland is dense tissue and will drop to the bottom of a liposuction container. Fat floats, the liquid would be in between. Take this deeper tissue, put it on a table and the white of the gland contrasts nicely with the fat. I have used aggressive cannula for years and have never seen any such tissue. The cannula I use have the same configuration of what some doctor advocate. With my tiny incision at the edge of the areola, I can see more. The cannula does indeed target the fat leaving the gland behind.
Also missing from those advocating the technique is a critical documentation that it works. Gland compresses different than fat. Suck out the fat, leave the gland, and as the muscle expands the remaining gland sticks out. This is demonstrated on flexing muscle views of my Standard Revision Gynecomastia Pictures
and even more so with my Standard Gynecomastia Video
I have had so many requests for help after liposuction based techniques for gynecomastia, I decided to review them over the past several years and found over 500! Here are some of the Unhappy After Liposuction for Gynecomastia from Texas
and here are some from Fixing Failures After Liposuction for Gynecomastia from New York
were 2 of the collection I just published.
I explained the most common complications I saw during revision surgery for such patients and described the problem as the Puffy Nipple Complication
as the fat is removed leaving gland to support the areola that then looks bad as the muscle contracts or areola muscle relaxes. In forums it seems the doctors pushing this method answer that the "swelling" will just go down if the individual waits long enough or has enough steroid injected. Yet to date, I have never seen an example posted of such a patient resolving over time with a critical picture / video analysis. It would be nice to see the surgeon documentation of how such methods evolve from the operating room to the final result such that if the swelling is expected but does resolve, then the patients could have less stress and anxiety understanding what to expect over time.
I have also noticed that over time some surgeons advocating that that technique works open the nipple to remove the gland. Searching older posts the percentage of patients they added the the additional incisions (4 compared to my 2) has increased over the years. Either they are coming around to my way of thinking or their "sharp cutting" cannula are getting duller.
So in my experience, no it does not work unless there is so much fat contributing to the contour that the gland is trivial and does not contribute to the contour. There are just too many unhappy patients asking for help and the revisions I have done have been a residual gland component. My findings are compromised since those happy would not be coming to me for help. But then I should be able to find documentation that the results look good on those doctors' web sites. Instead they tend to show limited photos and seem to avoid videos and flexing views. Here is a great demonstration of how limited pictures hide deformity. Check this Extended Crater Deformity After Failed Revision Gynecomastia Surgery
. This is another complication of aggressive excessive liposuction, too much damage to the tissues resulting in adhesion: skin stuck to the muscles. The results almost look good on the front view with muscles relaxed (the views these doctors seem to use to show how good their results are.) Look at the flexing still pictures, and the results no longer look good. Watch the video and the real ugly head of this bad surgery really come through.
Hope this helps,
Michael Bermant, MDLearn More About Gynecomastia and Male Breast Reduction