The goal of gynecomastia treatment is to reduce breast size in men who are embarrassed by overly large breasts. Reduction methods include liposuction, cutting out excess glandular tissue or using a combination of liposuction and excision. If you are treated by a board-certified plastic surgeon, gynecomastia can be effectively and safely improved or corrected completely.
Are you a good candidate for gynecomastia treatment?
Gynecomastia is usually not caused by any serious medical problems; in fact, its cause is rarely identified. However, because there are some medical problems that do cause gynecomastia, your first step is to see your family doctor to rule this out.
A. Diet and exercise-resistant fat in the chest area can cause both physical and social discomfort.
B. Maintaining a stable weight will ensure that your improved body contour will be long lasting.
The following are some common reasons why you may want to consider gynecomastia treatment:
You are unhappy with the size or appearance of your breasts.
You experience physical discomfort because of your breasts.
You have good skin elasticity. Successful gynecomastia surgery involves adequate skin contraction after your excess skin is surgically removed.
Your skin may lack the necessary elasticity for good contraction if you are age fifty or older, have significant sun damage, have breasts with a lot of stretch marks or have undergone gastric bypass surgery.
You have first tried diet and exercise to reduce your breast size.
You are not significantly overweight. Although surgery will help this patient population, the results will not be as good. For this reason, you should try to get within thirty to forty pounds of your ideal body weight before surgery.
You do not use marijuana, steroids or drink alcoholic beverages excessively (it is theorized that these substances may cause gynecomastia).
How is a gynecomastia procedure performed?
The goal of gynecomastia surgery is to restore a normal male breast contour and to correct deformities of the breast, nipple or areola. Surgical options include liposuction, excision (surgical removal of tissue) or a combination of both approaches. Glandular breast tissue is denser than fatty tissue and is not appropriate for liposuction.
The choice of surgical technique depends on the likelihood of skin redundancy after surgery. Skin shrinkage is greater in younger than older patients.
The most common approach is the intra-areolar incision, or Webster incision, which extends along the circumference of the bottom half of the areola in the pigmented portion.
The length of your incision will be based on your anatomy.
In severe gynecomastia, skin resection (surgical removal of part of an organ or structure) and moving the nipple (nipple transposition) may be necessary.
Minimally invasive gynecomastia surgical procedures have gained popularity. In the “pull-through technique,” a very small incision (approximately 5 mm) is made at the areolar edge. Following liposuction, the glandular tissue from the overlying areola is pulled through the incision. The major advantage of this procedure is the smaller incision. This technique is used in well-selected patients.
Ultrasonic liposuction has improved the results of gynecomastia correction. In liposuction-assisted breast reduction, there is less compromise of blood supply, nipple distortion and areola slough. In addition, postoperative complications are fewer with this technique than with open surgical resection; however, liposuction-assisted breast reduction is not effective for correcting glandular gynecomastia.
The fatty and glandular components of your breast must be assessed before surgery. Few patients can be sufficiently treated with liposuction only.
What are my options?
Enlarged breasts may be excess fatty tissue (pseudogynecomastia) rather than breast tissue and, in this case, can often be improved with diet and exercise alone. To treat the puffy nipples associated with gynecomastia, you will probably need liposuction combined with chest reduction using glandular excision. If you’re considering gynecomastia surgery, a board-certified plastic surgeon will determine the best course of treatment based on your physical presentation, i.e., your options will be determined by your condition.
What will my gynecomastia incisions and scars be like?
Scars resulting from gynecomastia surgery vary, depending on the amount of breast tissue you have and the elasticity of your skin. Even those who have larger breasts and tend to get larger scars are usually quite satisfied with the results.
If you have small breasts that are only fat, then your scars will be tiny (just large enough to admit a liposuction cannula).
If you have large female-like breasts, then the scars may extend across each side of your chest, but your surgeon will attempt to hide them in a crease.
With firm breast tissue, there is usually a scar under the areola.
If the areolas are large and need reduction also, then the scar goes all the way around the areola.