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Moderate Amounts of Breast Tissue
% of Cases
This is the next most common type of patient I see, accounting for approximately 20-30% of cases.
The Clinical Problem
In these cases there is also no excess skin. The difference with these cases is the small amount of glandular tissue that remains as a firm ball of tissue under the nipple-areola complex following the liposuctionning.
These cases are best managed with a combination liposuction and minor surgical excision of breast tissue. Again, the areas to be suctioned are marked preoperatively with the patient in the sitting position. The placement of the incisions for the liposuctionning is similar to minor cases, usually well hidden in tissue folds and creases. The incision to remove the breast tissue is made around the lower part of the areola at the junction between the red areola skin and the surrounding white skin.
When slightly larger amounts of breast tissue must be removed, a small extension of the peri-areolar scar can be made laterally or vertically. The decision to use either incision will be made preoperatively and is based primarily on the patient's preferences.
Under a light general anesthesia, the area to be suctioned is first infiltrated with the Tumescent solution to help with the liposuctionning. Very small (2 to 4 mm) incisions are then made, special suction cannulas are introduced and the excess tissue is removed. Generally two access incisions are made on each breast to ensure complete removal of the unwanted tissue. Once the liposuctioning is completed, a firm mass of residual breast tissue remains under the nipple-areola complex. Through the small areolar incision, the tissue is removed and the incision closed with dissolvable buried sutures. Care is taken to suction uniformly to avoid postoperative asymmetry and contour irregularities. Likewise, equal care is taken with the surgical excision to ensure complete removal of the excess breast tissue only and not layers of "normal" fat tissue required for an optimal result. The skin then redrapes over the breast tissue during the healing period.
If you have other questions about moderate gynecosmastia techniques we encourage you to contact our office to set up your consultation.