surgicalaestheticsmagazine.com | MAY/JUNE 2016 61
PHOTOS
COURTESY
OF
BABAK
DADVAND,
MD
Young people are good candidates for gynecomastia surgery; careful placement of incisions below the areola allows them to move forward with no telltale scarring.
BEFORE
BEFORE
AFTER
AFTER
literature, the recurrence rate for patients who have only
liposuction is 35%. If you remove the gland—or breast
tissue—it doesn't come back." He typically removes about
95% of the breast tissue, "and my recurrence rate is less
than 1%," says Dr. Blau.
"If it's true gynecomastia, I'm always cutting out tissue,"
says Dr. Dadvand. "But I'm not removing all of it—this is
not cancer surgery or mastectomy—you have to leave a
certain amount of tissue behind. Otherwise the nipple is
going to sink down or crater in, so knowing how much to
leave behind is the fi nesse of the surgery."
To minimize visible scarring, both Dr. Blau and Dr.
Dadvand remove the tissue through a small incision on
the lower part of the areola. "I tend to put it between 4
o'clock and 7 o'clock, right at the junction of the areola
and the normal skin around it," says Dr. Dadvand. "No
matter the race or ethnicity of the patient, the areola is
going to be a different color than the skin around it, so
when you place the scar right in that confl uence, it heals
exceptionally well."
In addition to looking at the amount of breast tissue and
fat to be removed, surgeons must also consider skin laxity
and nipple position. Dr. Blau will not perform skin excision
on gynecomastia patients because the scarring is so severe.
"When we do skin excision for women, the scarring is hor-
rible, but women typically wear a bra or a bathing suit top.