Gynecomastia Surgery Instruments: My Own Design
For many years, virtually all gynecomastia surgeons made a half circle incisions around the patient’s areolas, the dark areas surrounding the nipples.
The next step was removing the dense, fibrous male gynecomastia breast tissue with a pair of forceps and then, for removal, making an incision at the bottom of the breast tissue that sits atop the chest muscle.
That works but it also involves a scar, a longer breast surgery and a longer healing time – two to four months for most patients — as well as swelling and bruising.
Drains are usually involved, too, even though they are placed under the compression vest the patient must wear for up to four weeks.
I almost always perform liposuction during the same procedure and soon wondered if it was possible to combine the liposuction with surgical excision of the breast tissue.
The method offers several benefits. Because a liposuction instrument, or cannula, is thin – less than the width of a #2 pencil – a smaller entry hole through the skin, a “stab” wound, is used.
That helps reduce swelling, bruising and healing time which leads to a happier patient who can return sooner to his normal activities. In many cases, it can eliminate the need for any other incision on the chest.
The basic liposuction cannula tip is blunt and rounded. My version has a sharp tip, and is known as a “cobra” tip; it’s pointed and thin but not sharp, something like the prow of a ship that cuts its way through water. It can penetrate some breast tissue.
But thick, dense tough breast tissue cannot be liposuctioned — it must be excised with a scalpel.
About five years ago, I figured that by cutting a sharpened aperture into the tube of the cannula, I can remove a thin slice from the gland, let it be sucked into the cannula and out of the body.
The cannula I now use in most cases works very much like a cheese knife peeling off a thin slice of cheese. I push the cannula through the breast gland and then pull it back — so its sharp aperture removes a slice of breast gland.
Result? Multiple to and from movements into and through the gland, removing it all – without that longer incision in the areola. It’s like “whittling” it down from the inside.
But, alas, in a few cases, the breast gland is as hard as a golf ball and my cheese-cutting instrument just, well, does not cut it!
So I use a scalpel and surgically excise that breast tissue.