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Company logo: Elliot W. Jacobs, MD, FACS - Diplomate, American Board Of Plastic Surgery

815 Park Avenue New York, NY 10021
212-570-6080

Man Boob Surgery: It Takes Two

both liposuction and gland removal for man boob surgery

We couldn’t help but chuckle when we read a recent opinion posted by a member of gynecomastia.org. This patient had visited four prospective doctors, two who recommended liposuction only, one who said gland excision only would do it, and one who advised that both would be needed.

What I learned in my experience of shopping around for a doctor is that the majority of average plastic surgeons simply do not know how to do this procedure.

We won’t comment on whether it’s true that “the majority” of surgeons don’t know how to perform successful male breast reduction. But we were pleased to read that the patient chose the doctor who advocated both liposuction and gland excision because we feel very strongly that this is the right approach. It has been the correct strategy for nearly 100% of our New York man boob patients for about three decades.

Obviously, this is a complex topic. But briefly, here’s a look at why “it takes two.”

Why Not Liposuction Only?

Liposuction only is recommended often for overweight man boob patients. Sometimes plastic surgeons will use the term “pseudogynecomastia” to characterize the condition these men have. We generally don’t believe pseudogynecomastia is an accurate term for men with moobs, even when fat is the main type of tissue under the skin. One reason is that fat tissue creates its own little environment, one that includes extra hormones. These hormones most often trigger the growth of breast gland that then becomes entwined in the fat tissue. Thus, both liposuction and gland excision need to be performed.

When a guy hears “lipo only” as the recommendation, there are a couple of things he should keep in mind. One is that it’s virtually impossible to tell what kind of cells are where, exactly, under the skin until the plastic surgeon gets inside. Another is that “lipo only” can be a hint that the plastic surgeon is inexperienced in treating man boobs, truly believing that good results can be had with just liposuction or feeling hesitant about removing gland tissue.

Why Not Gland Excision Only?

Gland excision only is sometimes advised when a patient is not overweight and the tissue under the skin seems like lumpy, bumpy breast gland. A clear example of a case like this would be a bodybuilder with extra tissue under the nipples but very little body fat. But even in these cases, we would stand by with our unique liposuction cannula at the ready.

To be fair, we might elect not to turn on the suction for some patients. But we use the special cannula of our own design to gently loosen the skin and help it re-distribute itself smoothly over the area where gland is removed.

Quite often, dense breast gland will extend downward and leave an indentation when it’s removed in a slender patient. In these cases, we use the cannula to loosen fat flaps from nearby, either suturing them end-to-end or overlapping to build up the right amount of tissue. Then we re-drape the skin so it lies flat and looks natural.

In nearly every single patient we’ve treated in New York for man boobs, we have worked with both gland and fat tissue in some way to assure smooth, masculine contours are the result.

We’re also in synch with the observations the gynecomastia.org poster shared after his man boob surgery. He said he was so glad he did not choose one of the one-technique doctors, as he probably would not have achieved the outcome he was hoping for. He added, “That’s why experienced gyne surgeons do so many revisions.”

We would love to welcome you to our practice in New York for a man boob surgery consultation. There, we can explain our approach in detail, show you the instrument we developed, and share hundreds of before and after gynecomastia photos of very different patients. But if you don’t live nearby and traveling is not an option, we urge you to seek the services of a board certified plastic surgeon who has treated hundreds of guys and who is ready to sculpt both gland and fat to give you the most natural looking results.
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