Gynecomastia removal continues to be a very popular procedure among men. Except for the patient whose chest enlargement is entirely due to excess fat, most men require removal of breast tissue as well. Because this tissue is so very firm, it cannot be removed with liposuction only. The traditional way of removing it has been by making an incision at the bottom of the areola, the colored skin that surrounds the nipple. Although this incision tends to heal well with what is usually minimal scarring, the scar is sometimes visible and the procedure usually requires that a drain tube be left in place overnight.
What are the options if a patients wishes to avoid this additional scar and the drain tube? One of these that I have found quite helpful and use frequently involves an electric shaving device that is inserted through one of the liposuction incisions beneath the breast. This avoids the need for the additional nipple incision by using one of the incisions already present. The shaver allows me to trim away the gynecomastia tissue from the undersurface of the nipple just as if I had used the incision beneath the areola. The results are just as good with this approach.
Based on my excellent experience with this technique in a number of patients, my approach is to offer patients this alternative. If it becomes apparent in surgery that we cannot achieve the desired result with the shaver, we can always make the incision beneath the areola and take things out that way.
Using the liposuction incision, no drains, minimizing the chance of decreased nipple sensation – all advantages with the shaver technique.
What do you think? Feel free to leave a comment.
George Sanders, M.D.
