Gynecomastia (male breast reduction) is the development of abnormally large mammary glands at males. The growth in volume of the mammary gland during puberty is temporary and disappears in a few months. Sometimes the problem persists and if it does not disappear after a long period we can talk about gynecomastia. The causes of gynecomastia are several. Starting with the overuse of steroids, alcohol, tobacco and continuing with genetic flaws they all can determine gynecomastia. It is estimated that about 40 to 60% of males suffer from this malfunction that fortunately in most cases represents a cosmetic flaw.
There are 3 phases of gynecomastia:
Phase 1 – moderate excess of fat or mammary tissue without tegumentary excess
Phase 2 – great excess of fat and mammary tissue with or without tegumentary excess
Phase 3 – exaggerated fat excess or mammary tissue with great tegumentary excess.
Patients who need surgical intervention are the ones situated in the last two levels.
Considering that gynecomastia is generally accompanied by other affections, being sometimes one of their results, before starting the cosmetic treatment the following investigations must be performed:
- Blood test including hepatic tests and hormonal dosage;
- Urinary tests;
- Endocrinological consultation;
WHAT ARE THE GYNECOMASTIA SURGICAL PROCEDURES?
There are two surgical treatment methods of gynecomastia that are chosen considering the severity of the mammary gland’s affection.
1. Liposuction- performed in patients situated in Phase 1 and 2. The method is based on the aspiration of the fat tissue with a special cannula through several small incisions of 2-3 mm. The main condition to succeed this procedure is a tonic tegument that can withdraw after removing the excess of glands and fat. The procedure is similar to liposuction in every other part of the body (see liposuction).
2. Mammary reduction – a surgical procedure to remove the glandular and tegumentary tissue and to remodel the breast. According to the glandular and fat amount and the tegumentary excess one of the methods will be chosen. In the moderate cases mammary reduction of type ” round block” will be performed. Through a periareolar incision the excess of gland and fat is removed and the tegumentary excess is circularly removed around the areola. The scar that results as a follow up of this intervention will be only around the areola. In the case of great excess another mammary reduction will be performed which involves a vertical scar beginning at the periareolar scar. Sometimes both procedures are performed simultaneously.
GYNECOMASTIA SURGICAL INTERVENTION RISKS
As any other surgical intervention gynecomastia implies certain risks. Over passing general risks common to any surgical intervention, there are also particular characteristics. Liposuction’s risks are identical with complications existing in liposuctions in other body parts (see liposuction).
As far as mammary reduction we may find affections of the tegument including the areola. There might also appear de-pigmentations of the areola’s sides. The areola’s sensitivity may diminish a while. Scars can enlarge or become hypertrophic which is strictly connected to individual tendency and can influence at some point local treatments with silicon-based ointments.
PREOPERATIVE INDICATIONS FOR GYNECOMASTIA
- Do not eat or drink after midnight before the surgical intervention;
- It is forbidden to take any medicines containing aspirin, with 2 weeks before the gynecomastia surgery;
- Usually, for women, the surgical intervention must be performed outside menses;
- The surgeon and the anesthesiologist must be notified if any medical problems exist (blood pressure, vascular problems, heart attack, diabetes, lung problems, bleeding problems, epilepsy, neurological problems, allergies to different drugs);
- The doctor must be notified if you have a set of plates or eye lenses;
- If you smoke, plan to quit 1-2 weeks before the operation and do not start to smoke again for at least 2 weeks after the gynecomastia surgery;
- Avoid sunbathing in excess before surgery, particularly in the abdominal area;
- Do not follow a strict diet before surgery because it might delay the healing process;
- If you catch a cold or have any infection the gynecomastia surgery must be rescheduled.
GYNECOMASTIA POSTOPERATIVE PERIOD
After surgical intervention you will be placed under medical care for 24-48 hours. At home you will have a quiet lifestyle for about 10 days and you will avoid thermal extremes, trauma, physical effort. If you respect these rules professional rehabilitation can be started at a week after surgery. Bandages will be applied at the surgeon’s indications, usually every couple of days, until the surgical wires are removed. The surgical wires are removed in the case of liposuction at 5-7 days after the surgery and as for the mammary reductions at 12-14 days after surgery. During all this time you will have to respect daily hygiene rules avoiding touching and moisten bandages. After the surgery you will have to wear compressive bandages for at least one month.
Non-surgical treatment, sports, diet can be applied only at Phase 1 of gynecomastia. In all the other cases only surgical intervention can remove unpleasant aspects of gynecomastia. Moreover, the affection evolves in time and the treatment will be more difficult in neglected cases. Certainly, taking care of the physical aspect and correcting some flaws is without doubt not only a feminine care. Men have and must have the same tendency towards perfection. Changing positively our social and personal life after this intervention is a good reward for your effort and we are here to provide you all the support you might need.
Gynecomastia , clinical cases in plastic surgery clinics Romania, performed by top plastic surgeons in Romania:
This blog post is an educational resource only and does not replace a medical consultation with a doctor .
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