Gynecomastia Forum, Doctor and Surgery Resources

Supporting Doctors => Ask a Doctor => Topic started by: wantnewlife on September 23, 2013, 02:06:13 PM

Title: Gland removal without separate incision
Post by: wantnewlife on September 23, 2013, 02:06:13 PM
I recently consulted a plastic surgeon for revision surgery and he told me that he could remove the gland without making any incision in the lower border of the arola. he said that he would use the same liposuction incisions to remove the gland. Is it possible to remove the gland using liposuction cannula?
Title: Re: Gland removal without incision
Post by: Litlriki on September 23, 2013, 10:47:28 PM
Some surgeons use a cutting cannula or a device similar to a cartilage shaver to remove gland through the remote incisions.  I don't use this technique.  I find that I have good control and rare problems with the peri-areolar approach. 

Rick Silverman
Title: Re: Gland removal without separate incision
Post by: wantnewlife on September 24, 2013, 11:44:23 PM
Thanks Rick. ok.. so in peri-areolar approach, surgeons would have good control compared to remote incision.
but does any other surgeon (participating in this forum) try or use the other approach (removing gland through remote incision)?
Title: Re: Gland removal without separate incision
Post by: DrPensler on September 25, 2013, 03:13:28 PM
It's not really feasible to remove the gland completely without an incision either around the inferior portion of the areola, under or lateral to the breast.The glandular tissue cannot be removed with a liposuction cannula.
Title: Re: Gland removal without separate incision
Post by: wantnewlife on March 13, 2014, 03:19:08 PM
Hi Dr Jacobs,
I noticed in one of the old threads, you mentioned you would try to remove the glandular tissue using sharp cutting cannulas. DO you continue to use that for removing glandular tissue? have u seen any complications/side effects/limitations with that technique?
Title: Re: Gland removal without separate incision
Post by: Dr. Elliot Jacobs on March 13, 2014, 04:53:38 PM
I use a sharp cannula (actually, several of them) which I designed myself and which bear my name.  They are sharp and capable of removing both fat and gland.  But they do not work all the time. Sometimes the gland tissue is just to darn thick and firm, particularly just under the areola.  But in the circumstances that I can remove the gland, what is left is just the skin of the areola with virtually no gland underneath.

These cannulas form the basis for my staged, progressive operative technique.  I always start with a remote incision.  If I can get everything out through that incision, then that is all that is needed -- and I have saved the patient a scar around the edge of the areola.  This occurs around 20-30% of the time.

If I am unable to remove sufficient tissue through the remote incision, I will then make a peri-areolar incision to complete the removal of the gland tissue.  However, the remote incision will still have enabled me to contour the entire chest and actually to reduce the size of the gland tissue under the areola, thus making it simpler to remove the last remaining amount of tissue.  I never hesitate to make a peri-areolar incision if I feel it is necessary -- I am very concerned about getting it right the first time around.  This decision is always made during the surgery -- not before.

Using the sharp cannula in my hands and with thousands of cases under my belt, I have not seen any additional problems or complications or recurrences.  There are no limitations to this technique -- in my hands, it works.

With reference to fees, I charge one fee for gyne surgery and do not break it down to "lipo alone" as one fee and "
lipo with excision" as another fee.  In other words, one fee will pay for whatever it takes to get the job done.

Dr Jacobs
Title: Re: Gland removal without separate incision
Post by: wantnewlife on March 16, 2014, 01:45:07 PM
Thanks Dr for the detailed clarification