Surgeon quoted me liposuction only and no gland removal, is that going to come back?

Had my consultation yesterday and came away uneasy, which is why I am here. The surgeon was pleasant, examined me for about two minutes, and said I was a good candidate for VASER liposuction, quoted me at the lower end, said it would be day-case and I would be back at my desk in a week or so. All fine. Then I asked, because I had read this site, whether he was taking the gland out as well. He said the liposuction would "address it" and moved on.

Now, I definitely have the firm bit behind both nipples. I can feel it. So when he says liposuction will address it I do not know if that means he is also going to make a small cut and take the gland, or if he means the lipo alone will sort everything. And I did not push because I felt daft. Is "the liposuction will address it" a normal way of saying they remove the gland too, or is that a bit of a red flag? I really do not want to pay, recover, and have it back in a year.

Red flag until proven otherwise honestly. Go back and ask the one question straight: "are you excising the glandular disc as well as liposuctioning the fat, yes or no." If they dodge it again, walk. That firm disc does not suck out through a lipo cannula, it has to be cut. Plenty of good surgeons do lipo plus a small excision as one operation, that is the standard for true gyno. But you need to hear it in words.

I will be the cautionary tale. Mine was lipo only, cheaper quote, surgeon was vague in exactly the way yours was and I did not know to push. Looked brilliant at three months. By about 14 months the firm bits were back behind both nipples, smaller than before but there. Had to pay again for a revision to have the gland properly taken out. So it cost me more in the end AND another recovery. Ask the question Pete.

Pete, I sat where you are sitting. My first quote, years ago now, was liposuction only, and the surgeon used almost the exact phrase yours did, that the lipo would "take care of it." I very nearly booked it. What stopped me was reading, late one night, that the firm gland behind the nipple does not respond to liposuction the way fat does, and that leaving it in is the single commonest reason a chest comes back. I went and got a second opinion from someone who examined me properly, told me plainly it was mostly gland on the right and a mix on the left, and did the combined operation. Ninety minutes, gland out, and years later it has stayed flat.

I am a patient and not a surgeon, so I will not tell you what your chest needs. But I will tell you the thing I learned the expensive-adjacent way: get the answer in plain words before you pay. Our write-up on why the operation is not a fix for everything is honest that surgery flattens a chest and does not build the muscle underneath, and the piece on gland excision explains exactly what the small cut behind the nipple is doing and why lipo alone leaves the disc. Read them, then go back armed. Ryan is right that the cheap quote is not cheap if you buy it twice.

One more thing to check while you are at it, ask where the incision goes. Mine was periareolar, right at the lower edge of the areola, and honestly you cannot find the scar now. If someone is doing a proper gland excision they will be able to tell you exactly where they cut. Vagueness about the incision is the same red flag as vagueness about the gland.

Update because you all took the time. Went back, asked the yes or no question, and to be fair to the surgeon the answer was yes, he does excise the gland through a small periareolar cut in the same session, he just describes the whole thing as "the liposuction" as shorthand. So it was communication not a con. But I would never have known to ask without this thread, and I would have spent the next year braced for it to come back. Booked for May. Thank you.