renuvion j-plasma Archives

Every gynecomastia forum has the same number floating around, usually quoted with more confidence than the person posting it has any right to. A flat price, no exam, no distinction between the patient who needs a few minutes of liposuction and the patient who needs an actual excision. I understand the appeal of a single number. I just can’t defend one in a consult room, and neither should anyone else who’s being honest about this operation.

Our own starting price is real and published: $7,050, all-inclusive of anesthesia, facility, testing, and garments, prescription medications excluded. I’ll defend that number. What I won’t defend is pretending it’s the final number for every chest that walks in.

Three Words That Get Collapsed Into One

Clinically, “gynecomastia” is doing the work of three different diagnoses. True glandular tissue is firm, fibrous, disc-shaped under the nipple. Pseudogynecomastia is fat with no gland involvement at all. Most chests I see are a blend. The word on the intake form is the same regardless. The operation is not, and neither is the price.

The Patient Nobody’s Price List Accounts For

Most of my gynecomastia patients could have had this corrected during puberty. Almost none of them did. What I actually see, over and over, is a patient who waits until he’s financially independent and can take care of it himself, sometimes a decade or more after the fullness first showed up, carrying real self-consciousness about it the entire time.

Anabolic steroids, testosterone replacement therapy, and a handful of medications can also trigger genuine glandular growth. Here’s the myth I correct on repeat, regardless of cause: weight loss shrinks the fatty component of an enlarged chest. It does not shrink the gland. The gland grows on its own signaling, independent of body weight, and assuming diet and exercise will eventually take care of it is simply wrong.

What Actually Moves the Number

The $7,050 starting fee covers gland removal, and it’s actually pretty rare that gland removal alone is the whole job. That’s mostly reserved for athletic patients with well-developed pectoral muscles and no real excess fat, just fullness behind the nipple. Everyone else needs more, and it’s worth naming the additions instead of burying them in a “final price may vary” disclaimer:

Liposuction of the breast with Renuvion J-Plasma, clearing the excess subcutaneous fat (often driven by the gland’s own signaling) and tightening the skin that goes loose afterward, the same way a balloon goes slack when you let the air out.
Liposuction of the lateral chest wall and axilla with Renuvion, because the fullness frequently extends past the central chest and blunts pectoral definition.
A donut lift, a circumareolar incision, for the more severe cases with real breast ptosis or a stretched areola that needs reducing.

Every one of those has a clinical reason to exist, not just a billing reason. An exact number only comes after an exam, and I say that plainly instead of hiding behind it.

The Scarless Claim, Examined Honestly

Patients read “scarless gynecomastia surgery” online and assume it’s marketing. Here’s the actual answer, not the marketing version. We no longer have to put a scar underneath the areola to remove the gland behind the nipple and areola. I use a method where a small incision is made inferior and lateral to the breast or chest. It’s about four millimeters long, and it’s used for the liposuction of the lateral chest and the breast area. Through that same incision, I insert an arthroscopic shaving device and shave down the gland, no large incision needed.

The reason an incision was ever necessary is that the breast gland is rubbery, more indurated than the soft fat around it, so a liposuction cannula cannot suction it out. The arthroscopic shaver is what lets me shave the gland down and remove it instead. With this technique there’s less risk of contour irregularities. After an old-style excisional gland surgery with a scar, a large divot behind the nipple and areolar complex was common. That’s avoided here, and I guard against it further by injecting fat into the area after gland removal. The exception is the patient with true ptosis or a badly stretched areola, who needs a donut lift, a real incision, just a well-hidden one.

Why I Publish a Fee I Know Will Climb

I’d like to think our practice distinguishes itself by providing excellent patient service, pre- and postoperative care, and the latest current techniques and innovations. Because of this, a lot of our fees run on the higher end. We publish them anyway, so patients know before a consultation what it may entail financially, and whether it works for them. That way we avoid surprises after a consultation, and we have better-educated patients. It’s the same philosophy behind everything we do on social media and the website: educate patients as much as possible, so by the time they come in for a consultation, they already know a lot about the procedure itself. The consultation becomes about determining the best technique for that patient specifically, what their expectations are, whether those expectations can be met, and whether there’s the kind of rapport between us that will carry us through the next six months to a year of recovery and results.

What the Waiting Actually Costs

The men who end up in my consult room have usually carried real weight over this, not financial weight, the other kind. Bullying. Years of swimming with a shirt on, or not swimming at all. Locker rooms avoided outright. I tell them plainly that it’s common, and that a lot of people have stood exactly where they’re standing. It’s also true, and worth saying, that longstanding gynecomastia tends to fibrose further with time. The wait doesn’t show up on an invoice, but it isn’t free either.

Why This Sits in a Surgical Practice, Not a Price Comparison Chart

I did my plastic surgery fellowship at Mayo Clinic and I’m a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine, where I teach the anatomy this operation depends on. Castle Connolly has named me a Top Doctor for thirteen straight years. None of that is a gynecomastia-specific credential. It’s the reason I’d rather quote honest additions to a real number, and a real technique, than one flat figure I can’t stand behind.

Ready to Talk?

Skip the forum number. Come in, and I’ll tell you which of the three chests you actually have, and what an honest quote looks like for it.

Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. #StayBeautiful.

@RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.

Cross-links

Patient-facing version on agulloplasticsurgery.com: “What Gynecomastia Surgery Actually Costs in El Paso (And Why the Number Moves)”
Practice version on swplasticsurgery.com: “What Gynecomastia Surgery Costs at Southwest Plastic Surgery”

If you ask a plastic surgeon which part of liposuction is the hard part, and he answers you honestly, he will not tell you it is the fat.

I started using Renuvion J-Plasma in 2019. I was one of the very early adopters, and I saw a missing need after liposuction, which was skin tightening. We were able to perform liposuction effectively, but after deflating the subcutaneous tissue layer, many patients were left with loose skin, which required surgical excision. When we began using Renuvion, we noticed that the tissues would contract, and oftentimes the surgical excision of excess skin was not necessary anymore.

Read that last part again, because it is the whole reason I am writing this. Not that the skin looked somewhat better. The excision was not necessary anymore. A second operation, and a permanent scar, came off the table.

What It Is Doing Under There

This is the explanation I give in clinic, and I have never seen a reason to keep a simpler version for patients and a smarter one for colleagues.

Renuvion J-Plasma activates helium plasma and radiofrequency in the subcutaneous layers, making the connective tissue underneath shrink and contract, resulting in skin tightening and a smoother result. The helium plasma is important because it keeps the temperatures cool, which avoids burning.

That last sentence is where the engineering lives. Radiofrequency by itself will contract tissue. Radiofrequency by itself, at the wrong settings, will also cook it, and our literature has documented what that looks like. The helium is what lets the energy arrive hot and get out fast. The handpiece goes in through the same access sites the liposuction cannula already made, so nothing new is cut and nothing new is closed.

How Much I Use It

We use Renuvion J-Plasma almost every day, performing more than ten to twenty Renuvion cases per week. I am among the ten highest users in the world, according to Apyx, the company that manufactures the device.

I put that near the top rather than the bottom for a reason. When a surgeon speaks well of a device, you are entitled to know how far into it he already is before you weigh anything else he tells you. I am very far into this one.

The Huber Paper

Apyx circulated a study through its clinical newsletter this spring. I read manufacturer mailings the way most of us do, with a raised eyebrow, because the company sending the envelope has an obvious interest in what I conclude. This one held up.

Huber, Bittencourt, Koteski and colleagues published it in Plastic and Reconstructive Surgery Global Open in March 2026. They reviewed 113 consecutive patients from one surgeon’s practice, treated between October 2021 and October 2023. Seventy-three had power-assisted liposuction alone, and forty had power-assisted liposuction followed by Renuvion J-Plasma. Past the twelve-month mark, they went back and asked the patients themselves, using BODY-Q, a validated instrument rather than a satisfaction form somebody drew up in a marketing meeting.

Outcome (greater than 12 months)	Liposuction alone	Liposuction plus Renuvion J-Plasma
BODY-Q appraisal of excess skin	73.8	87.8
Same score, liposuction-only subgroup	64.0	92.8
BODY-Q abdominal appearance, no abdominoplasty	45.0	68.8
Surgical revision rate	37.5 percent	12 percent
Abdominoplasty rate	67.1 percent	30 percent
Complication rate	2.7 percent	2.5 percent

The revision row is the one that stopped me. Thirty-seven and a half percent down to twelve. Any surgeon who has had to bring a patient back for a skin excision that neither of them wanted knows that the distance between those two numbers is not measured in questionnaire points.

The complication row matters too, more quietly. Adding energy under the skin did not add risk here, 2.5 percent against 2.7 percent, and no complication was attributed to the device.

The caveat, which the newsletter was not built to emphasize, so I will. Retrospective, not randomized, one surgeon. The authors say so themselves. It is a strong signal that happens to match what I watch happen in my operating room every week, and a strong signal is not proof. I would rather hand you that limitation myself than have you find it in the discussion section and wonder why I skipped it.

Where I Use It, and Where I Stop

I prefer to use Renuvion J-Plasma in the abdomen, the flanks, the upper back, the lateral chest, and around the knees. We also use it on the arms and thighs. I prefer not to use it in overly thin skin. If I encounter overly thin skin, I transition to BodyTite.

There is a sweet spot in using J-Plasma, where more passes and more energy are not going to give you any further results. So being accurate in the number of passes and the energy for each area is extremely important to get the most benefit with the least risk.

That is the sentence I would put on the wall of every practice that just bought one of these. The dose does not scale in a straight line. Past a point you are collecting risk and buying nothing with it, and the device will happily let you keep going, because it has no way of telling you that what you have already done is enough. That judgment belongs to the surgeon.

The Unpopular Part

The most important thing is really knowing the limitations, and knowing that J-Plasma will not tighten extremely loose skin after pregnancy or massive weight loss. It is very powerful in contracting the skin, and it often keeps patients away from needing a brachioplasty or excision of back rolls.

Both halves of that are true at once, and the industry has a habit of quoting whichever half suits it that quarter. It really is strong enough to spare somebody an arm lift or an excision of the back rolls, and those are not small scars to spare a person. It is also nowhere near strong enough to replace a tummy tuck in a patient who needs one. Stretch marks it does nothing for at all, because a stretch mark is a tear in the dermis, and contracting the tissue under a tear does not repair the tear.

So here is the candidate, exactly as I describe him or her in the room.

In the right patient, one who does not have a lot of skin laxity or stretch marks and no rectus diastasis, the Renuvion J-Plasma can help keep patients away from an abdominoplasty and let them have just liposuction.

Three conditions, and all three are required. If the rectus muscles have separated, the abdomen is pushing forward because the wall came apart, and energy delivered into the fat layer above that wall does nothing about it.

Recovery Does Not Change

I lead with this now, because patients assume the opposite.

It is important to know that Renuvion J-Plasma is not going to increase recovery times. The recovery itself and the protocol are the same with or without Renuvion J-Plasma when you have liposuction. We still use the garments, and we still use lymphatic massages.

You are not buying downtime here. You are buying a better envelope at the end of the downtime you had already agreed to. The skin also keeps contracting for months after you go home, which is why judging an abdomen at six weeks is a mistake, and why I spend part of nearly every week talking somebody down off that ledge.

Why I Am the One Saying This

I am double board-certified by the American Board of Plastic Surgery and the American Board of Surgery, I completed my plastic surgery fellowship at Mayo Clinic, and I have taught as a Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center Paul L. Foster School of Medicine since 2011. Castle Connolly has named me a Top Doctor for thirteen consecutive years.

None of that is why I trust this device. Seven years of using it almost daily is why. The credentials are why I am comfortable telling you where it fails.

#StayBeautiful

Ready To Talk?

If someone has told you that you will need a tummy tuck no matter what, it is worth a second opinion before you accept a scar you cannot undo. Call the office at (915) 590-7900, text 1-866-814-0038, or book a consultation at agulloplasticsurgery.com/appointments. You can also read more about liposuction at Southwest Plastic Surgery.

Follow along at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.

Tag: renuvion j-plasma

The Gynecomastia Quote Nobody Explains: Why $7,050 Is Just the Starting Line