Male chest reduction surgery is not just about removing the excess tissue and fat that are causing the appearance of “man boobs.” Other equally important goals include creating high level of symmetry between the two sides, ensuring smooth and natural contour, and avoiding surgical stigmata such as surface irregularities and visible scars.
Prominent Los Angeles plastic surgeon Dr. Tarick Smiley has recently posted male chest reduction before and after photos on Snapchat to demonstrate what the surgery can [realistically] accomplish.
Dr. Smiley combined liposuction and direct excision technique to achieve a more masculine physique. This “combo” surgery has allowed him to extract up to 2 liters of fat and copious amounts of glandular [breast] tissue.
He first performed liposuction to remove the excess fat through a small cannula (hollowed tube) that could fit into a puncture hole placed right at the lower border of the areola for optimal scar concealment.
When doing liposuction, Dr. Smiley said he preferred the tumescent technique in which large volume of fluids that contain saline, lidocaine (local anesthesia), and epinephrine (to constrict the blood vessels and thus limit the amount of bleeding) are injected into the treatment site.
With liposuction, he was able to remove around 1 liter of unwanted fat on each side.
Next, Dr. Smiley created an incision still right at the lower border of the areola so the scar would remain hidden. The idea, he said, was to remove the excess glandular tissue.
“The white glandular tissue is extremely fibrous and so it will not come out with liposuction alone. Most patients really need an excision-based technique to achieve a nicer and flatter chest,” Dr. Smiley said on Snapchat.
Before closing the incisions, the surgeon examined both sides to ensure that high level of symmetry has been achieved and possibly to address any contour irregularities while the patient was still on the operating table.
He then closed the incisions with multiple rows of tiny sutures without picking up the skin whose edges were instead held together by surgical tape. With this suturing technique, the skin received no or very little tension, which is the key to favorable scar.