There are two components of gynecomastia tissue, the glandular tissue and fatty tissue. Cosmetic treatment for this varies depending on which tissue type is present. Some fat tissue is necessary over the pectoral muscles or concave areas can form. To reach the desired look, often a combination of liposuction and excision is used. It is not unusual for a combination of glandular and fatty tissues to exist, in which case the surgeon must make sure that the surgeon has discussed the possibility that excision will be needed and the desired look with the patient before the procedure, so the surgeon can make the determination during the procedure as to how to solve the issue using a combination of the two techniques.
Before liposuction was invented, excision was the only option; this is done by using a small excision around the areola, about half of its diameter, and removing the necessary tissue. This works well even today, when there is a well defined mass to remove. The presence of glandular tissue is relatively easy to determine if the patient is thin. When fatty tissue alone is the culprit, then liposuction is a much better option. Liposuction involves making a tiny incision and inserting a cannula, which is a tube used to remove the fat deposits. Fat is removed in pieces, and the surrounding fat tissue fills these areas in as the healing process occurs. Glandular tissue cannot be removed this way, as it is firm, not soft, and the cannula cannot remove it. The Vaser ultrasonic liposuction technology can efficiently remove fatty and glandular tissue.
Your gynecomastia surgery may be performed in an accredited hospital, free-standing ambulatory facility or office-based surgical suite. Most gynecomastia procedures take at least one to two hours to complete but may take longer.