A male breast reduction surgery aims to correct gynecomastia in which the excess skin and tissue leads to woman-like breasts. Doctors use incisions that are usually placed within the areola’s border and the inframammary fold in an attempt to hide the scars.
Meanwhile, male breast reduction through liposuction can only address “fake” or pseudo-gynecomastia in which the underlying mass is not breast tissue but fat.
Surgeons are able to distinguish real from pseudo gynecomastia by making their patients lie flat on their back and then feeling if there is a firm mound of tissue around the areola complex with the use of their thumb and index finger.
If there is no palpable “disk” of tissue around the areola complex, it is a case of pseudo gynecomastia which responds well to liposuction-only procedure.
Male breast reduction via liposuction requires the insertion of a cannula, a thin stainless hollowed tube, through 2-4 small incisions that fade into imperceptible scars within a year, assuming the patients have no predisposition to aggressive scarring (e.g., keloids) and have avoided skin irritants and sun exposure for at least six months.
The cannula is moved back and forth to loosen the excess breast fat, which is then removed from the body by a vacuum pump.
The risk of visible scars is markedly low with a liposuction-alone procedure because the incisions are typically less than ¾ cm, and are placed within the breast crease, in or very near the armpit, and around the margin of areolar complex where it meets the “normal” skin.
Contrary to popular belief, liposuction of male breasts is not about removing the fats altogether. In fact, over-correction can lead to crater deformity in which the nipple “sinks” due to the absence of fat wall that is supposed to “support” the areola complex.
Due to the nature of fatty tissue found in the male breast—i.e., extremely fibrous and hard to work with—leading Beverly Hills plastic surgeon Dr. Tarick Smaili recommends tumescent liposuction in which large volumes of local anesthesia, epinephrine (to control bleeding), and saline are injected into the treated area to make it swollen and firm.
The tumescent fluids, he adds, paves way for more accuracy that the risk of over-correction is greatly minimized.
Meanwhile, postop swelling could hide the results for three weeks, although after this most patients will see some improvements. Final results, nonetheless, can take up to six months since it takes a while for the skin to redrape to the new contour.