This young man has had long standing gynecomastia. He apparently took prohormones when he was in his twenties. On examination, I clearly felt dense breast tissue on both sides. He is seen here after gynecomastia surgery with liposuction (150cc of fat) and glandular tissue removal (26 grams per side).
It’s hard to believe that he had that much glandular tissue present. You can see in the pictures the “filet” of tissue that was removed from each side. The fat removed was designed to offer him a smoother contour after removal of this “rock like” tissue.
His fullness is gone for sure. He is very pleased. He has some minor irregularities side to side. You can clearly see the outline of his pectoral muscle (boomerang shaped).
The art of gynecomastia treatment is to do what is best in the individual patient. In his case, liposuction alone would not have removed the two masses you see. Leaving some of the mass behind will result in something that can cause an irregularity and be palpable to the patient. Because of his thin body habitus, the “room for error” is considerably less in terms of working with existing normal fatty tissue. Leave too much tissue and the patient will be unhappy. Remove too much tissue and the patient could have some irregularities. The “art” of getting it right is in the control of your surgeon and he/she needs to get it right in this challenging patient population.
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