If I asked folks which is harder to treat of the two patients below (puffy nipples and “man boobs” due to genetics) most would say the smaller, more muscular patient. Certainly there is a lot more present on the other guy and this will take more time and effort.
But that’s not the case. The smaller, muscular patient was a secondary gynecomastia (this means he already had previous treatment elsewhere). He also doesn’t have a lot of body fat that I can work with.
You see, the goal is to remove all the glandular tissue (he took hormones) and then to contour the final result. You can always leave some of the gland so there won’t be a depression, but this isn’t what makes patients happy. They want to have their cake and eat it too—this means removing all of the gland and doing whatever you need to do so it’s even, smooth and masculine. I get it.
The second, larger case was actually less complex, although it took a bit more. The reason is because this patient had mostly fat and fribrofatty tissue that I was able to contour with mostly liposuction. I didn’t need to be creative or deal with a big empty space as I needed to in the other case.
You can see the difference in directly post surgery in each guy below.
The moral of the story is that you can’t always judge the severity of your case based on size comparison alone. When we provide our patients with pricing, it reflects the difficulty of the case and the effort and expertise that is needed so the result meets Austin Gynecomastia Center (AGC) and Dr. C standards.