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Only one areolar incision for lean patients

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Only one areolar incision for lean patients
« on: May 09, 2019, 05:53:50 AM »
Hello,

I attended a consultation with a gyne surgeon along with my friend. He is super lean at 8% body fat with a few lumps nothing major. I am 12% body fat with a mild case of squidgy gyno that has not gone away after dieting down from 25% bf . The surgeon said that since we are lean, by friend particularly so, only one incision at the areolar would be necessary and any fat removal could be done through vaser lipo via this incision. Do surgeons on this site have a view on this? It does sound kind of logical, and hopefully entails quicker recovery time?

Thanks

Linkback: https://www.gynecomastia.org/smf/index.php?topic=35326.0

Re: Only one areolar incision for lean patients
« Reply #1 on: May 15, 2019, 08:29:24 PM »
I use VASER on nearly every case. I perfer to use a small incision laterally. I suspect it can be done from the areola.
Dr. Schuster
Chief, Division of Plastic Surgery Northwest Hospital
Private practice in Baltimore, Maryland
10807 Falls Road
Lutherville, Maryland 21093
410-902-9800
email: info@drschuster.com
website: www.CosmeticSurgeryBaltimore.com

Re: Only one areolar incision for lean patients
« Reply #2 on: May 24, 2019, 09:53:25 AM »
The tiny incision on the side of the chest (less than 1/4 inch) heals so very well that for most guys, it produces a faint scar that is difficult to find (after 6-12 months).

I tend to do my gynecomastia surgery in stages.  First, the lateral nick in the skin and aggressive liposuction.  In about 20% of my cases, I can get everything out and there is no cut on the areola at all. I can do this using a variety of specially designed, sharp and semi-sharp cannulas.  

For the other 80%, I do a peri-areolar incision in order to facilitate direct excision of sub-areolar breast tissue under direct vision -- this gives me perfect control.  If there is any hint at a crater deformity, I see it at this time and immediately correct it.  The peri-areolar incision tends to heal incredibly well.

Every surgeon has his own favorite technique -- what counts, though, is the final result -- and it really doesn't matter which route was taken to achieve that result.

Dr Jacobs
Dr. Jacobs 
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
815 Park Avenue
New York, New York 10021
Telephone:  (212) 570-6080
Email:  dr.j@elliotjacobsmd.com
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.com/revi

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Offline Litlriki

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Re: Only one areolar incision for lean patients
« Reply #3 on: June 07, 2019, 07:05:06 AM »
I use a tiny stab wound incision near the armpit, which I put in a skin fold or stretch mark, and this is my approach for the liposuction initially. Like Dr. Jacobs, if I can get a complete result with just liposuction, I might not need to make the peri-areolar incision, though I almost always use the peri-areolar incision as well. I've only had an issue with the small scar one time on one side, and that was corrected under local in the office in about 5 minutes. I like to come at the liposuction from a spot remote to the areola, since that gives me better control. 
Dr. Silverman, M.D.
Cosmetic and Reconstructive Plastic Surgery
29 Crafts Street
Suite 370
Newton, MA 02458
617-965-9500
800-785-7860
www.ricksilverman.com
www.gynecomastia-boston.com
rick@ricksilverman.com

Certified by the American Board of Plastic Surgery

Re: Only one areolar incision for lean patients
« Reply #4 on: June 17, 2019, 10:50:54 AM »
Thanks guys. I’m confused. In my simple mind the most direct access, and therefore giving most control, to breast tissue would be via incision at 6 o clock to nipple. Why would you need anything on the side of the chest or armpit for a very lean individual?

Re: Only one areolar incision for lean patients
« Reply #5 on: June 19, 2019, 05:13:18 PM »
I typically use a small incision on the pec tendon for the UAL. As far as the "control" issue the probe is fairly long around 12 inches I am estimating and the business end is the tip .It is technically easier to use and position the probe from an incision 6 inches away from the area of treatment as opposed to millimeters away. The probe oscillates around 40K per second so if it touches the incision (areola) it can result in adverse scaring. So in non surgical slang its just a lot easier and safer to not use the areolar incision. The healing of the areolar scar is very important.
Jay M. Pensler,M.D.
680 North Lake Shore Drive
suite 1125
Chicago,Illinois 60611
(312) 642-7777
http://www.gynecomastiachicago.com

Re: Only one areolar incision for lean patients
« Reply #6 on: July 15, 2019, 09:17:18 PM »
Liposuction cannulas come in certain lengths and I think it is easier to control the removal with the cannula using a small incision from the side. I think helps to reduce over resction, retraction and nipple deformities by using this approach.


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