Answer:
The introduction of suction lipectomy has changed the treatment of gynecomastia. It has improved our ability to taper the edges and avoid the “dishing” effect. Some conditions, such as grade II gynecomastia, can be corrected with a suction lipectomy technique alone. However, most patients with gritty, hard, fibrous gynecomastia require an open surgical procedure. If the tissue is too glandular, liposuction may fail to produce sufficient reduction and an open procedure will be required.