Author Topic: liposuction cures puffy nipples?  (Read 5527 times)

Offline strato

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I have large breasts and puffy nipples. Soon I will decide and have an operation. I have seen 5 plastic surgeons so far. 2 of them said that I needed both liposuction and excision. But the other 3 surgeons said that liposuction only would fix my condition. 1 of this 3 PS says my gyno is mainly fat and even if I have gland it is so small and can be taken out by liposhaping.

I am really confused now. As far as I know, puffy nipples are caused by gland but not the fat. I mean you MUST have gland if you have puffy nipples.

Having only liposuction sure sounds better since I will not have an incision scar and the operation will be easier. But I do not want to have a second operation just because the first one did not work..

Can you please help me out on this? Any comments and experiences would be highly appreciated.

Linkback: https://www.gynecomastia.org/forum/index.php?topic=15892.0

DrBermant

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I have large breasts and puffy nipples. Soon I will decide and have an operation. I have seen 5 plastic surgeons so far. 2 of them said that I needed both liposuction and excision. But the other 3 surgeons said that liposuction only would fix my condition. 1 of this 3 PS says my gyno is mainly fat and even if I have gland it is so small and can be taken out by liposhaping.

I am really confused now. As far as I know, puffy nipples are caused by gland but not the fat. I mean you MUST have gland if you have puffy nipples.

Having only liposuction sure sounds better since I will not have an incision scar and the operation will be easier. But I do not want to have a second operation just because the first one did not work..

Can you please help me out on this? Any comments and experiences would be highly appreciated.

Puffy Nipple Gynecomastia typically consists of gland and fat.  Check out this Anatomy of the Puffy Nipple in Men

Liposuction Is Great for Sculpting Fat

Various types of ultrasonic and power assisted liposuction (UAL and PAL) have been around for quite sime time.  There have also been many variations on sharp cutting liposuction cannula for many years. Each surgeon uses the tools and techniques he / she prefers.

There are studies claiming that ultrasonic liposuction does not break down gland cells, these were done to justify the safety in female liposuction breast reduction surgery.  Ultrasonic energy cannot be both ways, good for gland breakdown and safe not harming gland unless there is a difference between male and female breast gland tissue which has not been proven to my knowledge.

Tumescent liposuction is a form of anesthesia where fluid is placed in the tissues to be sculpted.  You can see very graphic pictures of the tumecent technique here.

Liposuction such as ultrasonic, VASER, power assisted, and sharp cutting cannula preferentially remove fat over gland.  Gland tends to exist under the nipple areola region.  When fingers of fat extend between fingers of gland, breast reduction can come from removing the fat and leaving gland behind.  On animation such as flexing the pectoral muscles or putting the arms over head, gland does not compress or move like fat.

When gynecomastia is from fat, liposuction works very well for contouring the chest.  I have seen many patients from other doctors who tried to use liposuction alone techniques that left gland behind that the patients just did not like for Revision Gynecomastia Chest Sculpture.

Here is an example of Revision Surgery after Liposuction alone.   Here is another revision after liposuction alone.

The problem is picking the right method for what actually is that patient's problem.  That is why I prefer my Dynamic Technique for Gynecomastia Surgery that permits what I find during surgery to guide my sculpture.

I have also seen patients with channel problems between remote access sites and the areola / nipple.  Scars, adhesions, and depressions can look terrible.  Check out the lateral (side views) and posterior oblique (side from the back views with and without muscle flexing here in this Revision Gynecomastia Pictures to see what I mean.

Ultrasonic liposuction uses energy to help emulsify fat.  Power assisted liposuction uses mechanical vibrating devices to rapidly move the cannula back and forth.  Both PAL and Ultrasonic methods have been around for several years.  Many do not prefer what they do to the tissue.  Others like what they offer.  Both still preferentially remove fat over gland.  Both make the work of the surgeon easier.  Some feel ultrasonic liposuction can cause more swelling, bruising, and the increase the need for drains.

For me however, they also both remove the feel of the tissue sculpture.  I like the much better control I get with my cannula selection and personally I do not like either ultrasonic nor power assisted techniques.  None of the cases on my website used either PAL or Ultrasonic techniques. 

As any artist, I take my cannula selection very seriously and have evolved what permits me to achieve my results.  I have considered and evaluated many, many technologies.  The many different types of cannula I use have their own advantages and qualities.  I pick a subset of these cannula that varies for the many different types of gynecomastia male chest sculpture that I see.

Gland removal by any technique can still leave a depression when  a major part of the problem is from gland.  For gland removal, I prefer the greater precision of removal under direct visualization and feel.  This also give me access to many more elements for my artistic palette of my Dynamic Technique to sculpt the remaining tissues.

This approach permits me to maximize the removal of the firm gland and sculpt the remaining fat.  How tissues move is important.  The human body is beautiful in animation.  That is why I show pictures of the chest with arms up, down, and with muscles tight / relaxed in addition to the results from multiple views.  Such analysis of the results as well as how tissues evolve, the possible need for drains, comfort level after surgery, are important factors in picking your doctor.  It is like an artist selecting a paint brush.  The results are what matters, not with what tool they sculpt.

Hope this helps,

Michael Bermant, MD
Learn More About Gynecomastia and Chest Sculpture

Offline MSJ108

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Lipo only removed my puffy nipples. There are a couple techniques out there that can help remove gland without having to do an incision.

Offline strato

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That is what I am talking about...
Dr Bermant says he needs to see during surgery if there is gland then he does excision..
MSJ108 says he removed his gland and cured puffyness by liposuction..

thank you all for your contribution but obviously the more I try to learn about this the more complex it gets  ???

Offline outertrial

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I wouldnt go near a surgeon who said they were only going to do lipo from the outset.

Offline MSJ108

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I wouldnt go near a surgeon who said they were only going to do lipo from the outset.


My doc said he would start with lipo then make incision if he felt necessary.


 

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