Many healthy and active men struggle with excess breast tissue. If you are one of them, you might be interested in achieving a flatter and firmer chest through gynecomastia surgery. This procedure can help you feel confident enough to go shirtless — especially if you visit a surgeon who uses advanced techniques to create the least possible amount of noticeable scarring.
The Traditional Approach to Gynecomastia Surgery
Most surgeons take the standard approach to treating enlarged male breasts. They will typically use liposuction to remove excess fatty tissue before using excision to address glandular tissue or excess skin. To do this, they often create an incision at the lower border of each areola.
There is nothing inherently wrong with this technique, but it can create noticeable scarring. Men who seek out gynecomastia surgery to gain more confidence in shirtless situations, such as working out, swimming, or being intimate, may feel a bit dissatisfied with their cosmetic results.
The Lateral Pull-Through Technique
Board-certified plastic surgeon Dr. Ronald Schuster understands that gynecomastia patients want to achieve a flatter chest but don’t want to deal with conspicuous surgical scars. That is why he uses a special technique called the Pull-Through or Lateral Pull-Through technique.
The “Pull-Through” technique was first reported in 1996 by Morselli and Morellini. Later, in 2003 by Hammond described the additional use of ultrasonic assisted liposuction to improve the results. With the Pull-Through technique, Dr. Schuster can eliminate excess fat and looser breast tissue with Ultrasonic-Assisted Liposuction (UAL) followed by traditional liposuction. In spite of this, there is usually a thicker, more dense portion of glandular tissue attached directly beneath the nipple. This tissue must be removed to reduce puffy nipples and flatten the central breast area. Once the UAL and lipo are completed, the smaller gland can be pulled out through the small incision (½”) on the side of the chest and excised under direct vision. This approach effectively eliminates areola scars. In addition, Dr. Schuster believes that by avoiding the lower areolar open approach, the Lateral Pull-Through technique decreases the chances of getting irregularities, irregularities, depressions, and retractions. It cannot be used all the time, however. Glandular tissue that is rock hard requires the standard open approach. This mostly occurs with gyno caused by steroid and pro-hormonal supplements, as well as gyno caused by Prolactinomas and sometimes when there is elevated estrogen/progesterone. Dr. Schuster recognizes that there is certainly a learning curve to be able to perform the Lateral Pull-Through technique well. He has been using it for over 20 years and has figured out how to make it successful for most guys. Recovery is fairly quick. Cardio can be resumed after a two-week “quiet” period, and weights can be resumed soon thereafter. A compression vest is worn for a total of three weeks. While there is an obvious improvement immediately, final results are usually seen after 3-4 months.
The scars from the small incisions on the side of the chest tend to heal very well. They typically fade a significant amount after surgery. Most importantly, they are located “off” the breast.
As with the open approach, the lateral Pull-Through technique requires the skin to shrink down for the best results. Sometimes, it is necessary to remove excess skin, such as in the case of too much skin or poor skin elasticity. Excess skin can be eliminated with an incision around the areola or along the bottom of the breast. Dr. Schuster will perform a physical evaluation to determine if you might benefit from this step. It is still possible to minimize and conceal these types of surgical scars.
Book a Consultation in Baltimore
Dr. Schuster has spent over 20 years refining his scar-reducing gynecomastia surgery techniques. He is committed to offering great results with the least amount of visible scarring. Call 410-902-9800 today to schedule your consultation. We serve Baltimore, Lutherville-Timonium, and the surrounding areas of Maryland.
