just so there isn't any confusion, Dr. Bermant was NOT my surgeon. But I hear he is one of the best.
Different surgeons do the gyno surgeon differently. Bermant take out the gland and closes the fat flaps (see his website). This approach is very minimally invasive, yet will get out the vast majority of the gland.
My surgeon lipos out all the fat (which has a greater inherent risk for nerve damgage etc.) and then excises the gland. I probably won't have to worry about fat accumulation in my chest from now on. But I also hope I will be able to feel my chest soon (I still have numbness from all that lipo).
Which approach is best? It is up to you to decide based on your own preferences and your particular gyno, especially in regard to how much fat is in them.
P.S. Also of note, no surgeon will remove the entire gland!! Trust me, I looked.