During his normal primary surgery, Dr. Bermant sculpts the fat after the excision and liposuction by moving the surrounding fat back under the areola and nipple. Dr. Bermant avoids the need for secondary gynecomastia surgery with an intense attention to detail for each patient. This patient had prior gynecomastia surgery by another doctor. In this particular case, the patient needed the gland removed, surrounding fat liposuction, and the remaining fat sculpted into the void under the areola and nipple. A thin cannula is used to inject the tumescent anesthesia.
Anesthesia fluid is placed under the skin above the chest muscles.
Tumescent Anesthesia minimizes bruising and bleeding. In secondary gynecomastia reductions, there can be significant scars in this layer when the prior surgeon used liposuction surgery. This can result in more tugging and pulling during the administration of the anesthetic. Dr. Bermant prefers sedation for his patients to increase comfort during this surgery. Excision of the glandular mass starts with a small incision near the areola.