As the chest muscles become very large, breast gland and fat are pushed toward the surface becoming more obvious. Surgical sculpture can remove excess gland and contour surrounding fat. I prefer a combined approach when there is gland. Excision of the glandular mass through a small incision hidden at the junction of the areola and the chest. I then liposuction the surrounding fat restoring about the same thickness of the uninvolved chest.
Liposuction uses high suction and a narrow long tube to remove fat cells.
In cases where the problem is only localized fat, liposuction alone is effective. The thick glandular tissue is not well managed by liposuction. Sometimes additional suture sculpture of the remaining fat can optimize the final shape. This operation can easily be performed under local anesthesia with sedation. Drugs given through an IV make the patient drowsy and then numbing medicine puts the chest tissues to sleep.