What is gynecomastia?
Gynecomastia is the benign enlargement of male breast tissue caused by an imbalance between estrogen and testosterone levels or increased sensitivity of breast tissue to estrogen. This condition affects approximately 30% of males at some point in their lives and can occur at any age.

Important points for trainers
What Gynecomastia Is NOT

1. Not simply excess fat tissue (that's pseudogynecomastia)
2. Not a result of poor training or diet alone
3. Not something that can be "exercised away" completely
4. Not always related to being overweight

Common CausesHormonal Changes

1. Puberty
2. Aging
3. Certain medications
4. Anabolic steroid use
5. Some medical conditions

Lifestyle Factors

1.    Some medications
2.    Certain supplements
3.    Marijuana use
4.    Heavy alcohol consumption

When to Refer to Healthcare Providers

Trainers should recommend medical consultation when:

1. The client experiences pain or tenderness
2. There's rapid growth or changes in breast tissue
3. It's affecting their mental health and self-esteem
4. They're using supplements that might contribute to the condition
5. The condition persists despite lifestyle changes

What Trainers Can Do
Exercise Recommendations

1.   Focus on overall fitness and health
2.   Include chest exercises but manage expectations
3.    Explain that spot reduction isn't possible
4.    Design balanced programs that don't overemphasize chest training

Lifestyle Guidance

1.    Maintain a healthy body weight
2.    Follow a balanced diet
3.    Avoid supplements that might worsen the condition
4.    Encourage regular medical check-ups

Communication Guidelines
Be sensitive and professional

1.    Use medical terminology
2.    Maintain confidentiality
3.    Show empathy and understanding
4.    Avoid making assumptions or promises

Set Realistic Expectations

1.    Exercise alone cannot cure true gynecomastia
2.    Surgery may be the only permanent solution
3.    Weight loss may help with pseudogynecomastia

Important Disclaimers | As a fitness trainer

1. Do not attempt to diagnose the condition
2. Do not recommend specific medical treatments
3. Do not suggest supplements or hormonal interventions
4. Always refer clients to healthcare providers for medical advice

Red Flags Requiring Immediate Medical Attention

1. Sudden onset
2. Pain or tenderness
3. Nipple discharge
4. Hard lumps
5. One-sided growth
6. Rapid changes in size

Resources for Clients
The most appropriate specialist for gynecomastia treatment is a plastic surgeon. They can:

1. Properly diagnose true gynecomastia vs pseudogynecomastia
2. Evaluate the severity and best treatment approach
3. Perform surgical correction if needed
4. Provide comprehensive pre- and post-operative care
5. Address both functional and aesthetic concerns

After liposuction, your surgeon will recommend wearing a pressure garment – but what exactly is it, and why is it so important? Let's dive into everything you need to know about this crucial recovery tool.

What Is a Pressure Garment?

A pressure garment is a specially designed, compression garment made from stretchable fabric that fits snugly against your skin. Think of it as a high-tech shapewear that provides uniform compression to surgical areas. While it might feel slightly uncomfortable at first, the benefits far outweigh any temporary discomfort.

6 Key Benefits of Wearing Your Pressure Garment

1. Reduces Post-Surgical Swelling
During liposuction, a thin tube called a cannula makes multiple passes through the treatment area to remove fat deposits. This process creates tiny wounds that can lead to fluid accumulation and swelling. Your pressure garment works actively to:
- Minimize fluid buildup
- Control post-operative swelling
- Support faster healing

2. Creates Smoother Contours
Without proper compression, prolonged swelling can lead to:
- Areas of hardening (induration)
- Tissue fibrosis
- Irregular contours
Your pressure garment helps ensure the skin adheres properly to underlying tissues, promoting smoother, more aesthetically pleasing results.

3. Prevents Seroma Formation
Seromas – pockets of clear fluid that can collect under the skin after surgery – are a common concern after liposuction. Pressure garments significantly reduce this risk by:
- Promoting tissue adherence
- Eliminating spaces where fluid can accumulate
- Supporting proper healing of skin flaps

4. Minimizes Scarring
Consistent pressure on surgical incision sites has been shown to improve scar appearance. This benefit is particularly important if you're prone to:
- Hypertrophic scars (raised but contained within the original scar line)
- Keloids (scars that grow beyond the original incision)

5. Enhances Comfort
While it might seem counter-intuitive, wearing your pressure garment actually increases comfort by:
- Providing support to treated areas
- Reducing movement-related discomfort
- Contributing to an improved sense of well-being during recovery

6. Accelerates Recovery
By addressing multiple aspects of healing simultaneously, pressure garments help you get back to your normal routine faster through:
- Reduced swelling
- Better tissue support
- Enhanced comfort during movement

How to Use Your Pressure Garment?

Choosing the Right Garment
- Your surgeon will help select the appropriate type based on your treatment areas
- Sizing is crucial – similar to buying regular clothing, proper measurements ensure the right fit
- You may need different sizes as swelling decreases

Wearing Schedule
Initial Recovery Period (First Few Weeks):
- Wear the garment constantly
- Remove only for:
  - Showering
  - Dressing changes
  - Brief cleaning of the garment

Later Recovery Period:
- Gradually reduce wearing time according to your surgeon's instructions
- Continue wearing until cleared by your medical team

Care Instructions
- Follow manufacturer's cleaning guidelines
- Have a backup garment if possible
- Replace if the garment loses elasticity or compression

The Bottom Line
Whether you're having standalone liposuction or it's part of another procedure, your pressure garment plays a vital role in achieving optimal results. While wearing it requires commitment, the benefits of improved surgical outcomes, enhanced comfort, and faster recovery make it an invaluable part of your healing journey.

Remember: Always follow your surgeon's specific instructions regarding pressure garment use, as recommendations may vary based on your individual case and the extent of your procedure

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Introduction
Male nipple reduction is a cosmetic surgical procedure designed to decrease the size and alter the shape of a man's nipples and areolas. This guide aims to provide clear information about the procedure, its purposes, and what patients can expect.

Causes of Enlarged Male Nipples
Several factors can contribute to the enlargement of male nipples:

1. Genetic predisposition
2. Hormonal fluctuations
3. Significant weight changes
4. Gynecomastia (enlarged male breast tissue)
5. Natural aging process

Candidates for Male Nipple Reduction
Men considering this procedure often:
- Experience self-consciousness about their nipple size
- Seek to enhance their overall chest aesthetics
- Believe the change will positively impact their self-esteem

The Surgical Procedure

Pre-operative Consultation
Before the surgery, patients will meet with a qualified plastic surgeon to:
- Discuss medical history and any underlying conditions
- Evaluate current nipple size and shape
- Outline desired outcomes
- Address questions about the procedure, recovery, potential risks, and associated costs

Surgical Process
1. Administration of local anesthesia
2. Creation of incisions around the areola or on the nipple
3. Removal of excess skin and glandular tissue
4. Closure of incisions with sutures
5. Application of protective dressings

Recovery Process
- Initial days: Patients may experience mild discomfort, swelling, and bruising
- Activity limitations: Strenuous activities should be avoided for approximately two weeks
- Follow-up care: Regular appointments with the surgeon to monitor healing progress

Potential Risks and Complications
While generally safe, the procedure carries some risks:
- Infection at the incision site
- Visible scarring
- Changes in nipple sensitivity
- Potential asymmetry between nipples

Important Considerations
1. Realistic Expectations: Patients should have a clear understanding of achievable results
2. Surgeon Selection: Choosing an experienced plastic surgeon specializing in male cosmetic procedures is crucial for optimal outcomes

Conclusion
Male nipple reduction can be an effective solution for men seeking to improve their chest aesthetics. While many patients report high satisfaction post-surgery, it's important to approach the decision with thorough information and realistic expectations.

To learn more about gynecomastia, click here.

Gynecomastia, or enlarged male breasts, is a common condition that we treat in our medical practice. Many patients express concerns about potential complications from gynecomastia surgery. However, it's important to note that gynecomastia surgery is generally a safe procedure, and complications are uncommon.

The risk of complications can be further lowered by addressing modifiable risk factors. This video discusses the various aspects that can help patients avoid complications from gynecomastia surgery.

Some key points covered in the video include:
- Proper patient selection and evaluation
- Surgical techniques to minimize tissue trauma
- Strategies to manage postoperative swelling and bleeding
- Importance of following postoperative care instructions

By understanding these factors, patients can feel more confident about the safety and outcomes of gynecomastia surgery. The video provides a comprehensive overview to help address common concerns and ensure the best possible results for our patients.

1. Why do gynecomastia surgery? 
Gynecomastia correction is done to improve the appearance. This helps in reducing the sense of shame and discomfort with the appearance. 

2. What are the steps for undergoing gynecomastia correction? 

1. Consultation: We examine you. We assess the deformity and suggest corrections based on the findings. 
2. Investigations: There are usually 2 sets of investigations. One is assessment of hormones and the other is for the assessment of fitness to undergo surgery. These can be done at a lab near your home. 
3. Procedure: This is usually done as a short-stay procedure. You would have to stay in the hospital overnight and be discharged the next day. In patients who have to travel far (another district), we encourage them to stay an additional day. 
4. Follow-up visits: We check on you the day following surgery when the drains would be removed and dressings applied. After you reach home the first follow-up is at 2 weeks. Later visits are at 1 month, 3 months, and 6 months. 

3. What is the cost of the procedure? Would there be additional costs? 
The cost of the procedure depends on the anesthesia (local vs general), and the deformity (extent of liposuction and need for skin resection). In most patients, the surgical cost of liposuction and gland excision comes to approximately 70,000 rupees. The additional costs include stay and investigations. These may cost you an additional 5000 rupees. 


4. Are there any EMI schemes? 
We do not offer any loan or EMI scheme. We do not encourage individuals to take loans for procedures. In case of any financial difficulties, you could talk to one of us. 

5. Which anesthesia is used for correction? 
Most of our procedures are done under local anesthesia. General anesthesia is usually done for anxious individuals or those who require skin resection (removal). Modern anesthesia protocols are safe. 

6. Which surgical procedure is carried out for gynecomastia correction? 
The steps depend on the deformity. In most of our patients we do the following: 

1. Liposuction. This is done to aspirate the fat. It helps get a better contour and makes the procedure safer. 
2. Gland excision. This is done with the help of a small incision in the areola (pigmented skin around the nipple) 

In most of our patients, we do not perform skin removal. 

7. What is the recovery following gynecomastia correction? 
Most patients have an uneventful recovery. We recommend the following: 

1. Lots of rest for the first 3 days. 
2. Return to a desk job in 7 days. 
3. Recreational walking, starting at 2 weeks. 
4. Gym and heavy exercise, starting at 4 weeks. 

8. I stay far away. Can I come directly for surgery? 
We do not encourage combining consultation and procedure at one visit. We believe an individual needs additional time to understand the procedure, possible outcomes, and complications. We also require investigation reports to rule out any other issues. Hence we advise a separate visit for the consultation before the procedure. 

9.Can I come to the surgery alone? 
No. We want you to be accompanied by a close relative or a dependable friend. This is for the following reasons, 

1. Some individuals may require additional help in the immediate postoperative period. 
2. We would want one individual to be aware of the procedure and any potential changes in the treatment plan. 
3. Having someone to be with you helps in emotional well being. 

10. I'm staying abroad. I want to get it done during my vacation. Are there any additional steps that I should take? 
We advise the following to such individuals: 

1. It is recommended to schedule the surgery towards the beginning of the vacation. This will give you sufficient time to recover before going back. 
2. Get yourself examined by a physician near you. This will help rule out any potential comorbidities like diabetes, hypertension and altered liver enzymes. 
3. Stop smoking (in case you do). Smoking increases complications. 
4. We suggest you stop herbal or vitamin supplements about one month before the procedure. Unless it was prescribed for correction of a known deficiency. 
5. You can contact us over WhatsApp or email. 

11. Are there any risks to life? 
Modern anaesthesia protocols are very safe. So any serious complications are very unlikely. 

12. Will I get a recurrence? 
Most patients do not get a recurrence. Individuals who are prone to recurrence are those below 18 years of age and secondary gynecomastia. 

For more information please click here. 


1.എന്തുകൊണ്ടാണ് ഗൈനക്കോമാസ്റ്റിയ ശസ്ത്രക്രിയ നടത്തുന്നത്?
കാഴ്ച മെച്ചപ്പെടുത്താൻ ഗൈനക്കോമാസ്റ്റിയ ശസ്ത്രക്രിയ നടത്തുന്നു. ഇത് കാഴ്ചയിൽ നാണക്കേടും അസ്വസ്ഥതയും കുറയ്ക്കാൻ സഹായിക്കുന്നു.

2. ഗൈനക്കോമാസ്റ്റിയ ശസ്ത്രക്രിയയ്ക്ക് വിധേയമാക്കുന്നതിനുള്ള ഘട്ടങ്ങൾ എന്തൊക്കെയാണ്?
 1. കൺസൾട്ടേഷൻ: ഞങ്ങൾ നിങ്ങളെ പരിശോധിക്കുന്നു. ക്ലിനിക്കൽ കണ്ടെത്തലുകളെ അടിസ്ഥാനമാക്കി ഒരു ചികിത്സാ പദ്ധതി ഞങ്ങൾ നിർദ്ദേശിക്കുന്നു.
 2. ലാബ് പരിശോധനകൾ. അവയിൽ ഹോർമോണുകളുടെ അളവ് സംബന്ധിച്ച പരിശോധനകൾ ഉൾപ്പെടുന്നു.ശസ്ത്രക്രിയയ്ക്കുള്ള ഫിറ്റ്നസ് വിലയിരുത്തുന്നതിന് മറ്റ് പരിശോധനകൾ നടത്തുന്നു. നിങ്ങളുടെ വീടിനടുത്തുള്ള ലാബിൽ ഇവ ചെയ്യാവുന്നതാണ്.
 3. നടപടിക്രമം: ശസ്ത്രക്രിയയെത്തുടർന്ന് ആശുപത്രിയിൽ രാത്രി താമസമുണ്ട്. മറ്റൊരു ജില്ലയിലേക്ക് യാത്ര ചെയ്യേണ്ടി വരുന്ന രോഗികൾ ഒരു ദിവസം കൂടി താമസിക്കണം.
 4. തുടർ സന്ദർശനങ്ങൾ: ശസ്ത്രക്രിയയുടെ അടുത്ത ദിവസം ഡ്രെയിനുകൾ നീക്കം ചെയ്യുകയും ഡ്രെസ്സിംഗുകൾ മാറ്റുകയും ചെയ്യും. നിങ്ങൾ വീട്ടിലെത്തിക്കഴിഞ്ഞാൽ ആദ്യത്തെ ഫോളോ അപ്പ് 2 ആഴ്ചയ്ക്ക് ശേഷമാണ്. പിന്നീടുള്ള സന്ദർശനങ്ങൾ 1 മാസം, 3 മാസം, 6 മാസങ്ങളിലാണ്.

3. ശസ്ത്രക്രിയയുടെ ചെലവ് എത്രയാണ്? അധിക ചിലവുകൾ ഉണ്ടാകുമോ?
ശസ്ത്രക്രിയയുടെ ചെലവ് അനസ്തേഷ്യ (ലോക്കൽ vs ജനറൽ), വൈകല്യം (ലിപ്പോസക്ഷൻ്റെ വ്യാപ്തിയും ത്വക്ക് വിഭജനത്തിൻ്റെ ആവശ്യകതയും) എന്നിവയെ ആശ്രയിച്ചിരിക്കുന്നു. മിക്ക രോഗികളിലും ലിപ്പോസക്ഷൻ്റെയും ഗ്ലാൻ എക്‌സിഷൻ്റെയും ശസ്ത്രക്രിയാ ചെലവ് ഏകദേശം 70,000 രൂപ വരും. അധിക ചെലവുകളിൽ താമസവും ലാബ് അന്വേഷണവും ഉൾപ്പെടുന്നു. ഇവയ്ക്ക് നിങ്ങൾക്ക് 5000 രൂപ അധികമായി ചിലവായേക്കാം. 

4. എന്തെങ്കിലും EMI സ്കീമുകൾ ഉണ്ടോ?
ഞങ്ങൾ ഒരു ലോണും EMI സ്കീമും വാഗ്ദാനം ചെയ്യുന്നില്ല. നടപടിക്രമങ്ങൾക്കായി വായ്പ എടുക്കുന്നതിൽ നിന്ന് ഞങ്ങൾ വ്യക്തികളെ പ്രോത്സാഹിപ്പിക്കുന്നില്ല. എന്തെങ്കിലും സാമ്പത്തിക ബുദ്ധിമുട്ടുകൾ ഉണ്ടെങ്കിൽ ഞങ്ങളിൽ ഒരാളോട് സംസാരിക്കാം.

5. ശസ്ത്രക്രിയയ്ക്ക് ഏത് അനസ്തേഷ്യയാണ് ഉപയോഗിക്കുന്നത്?
ഞങ്ങളുടെ മിക്ക നടപടിക്രമങ്ങളും ലോക്കൽ അനസ്തേഷ്യയിലാണ് ചെയ്യുന്നത്. ഉത്കണ്ഠയുള്ള വ്യക്തികൾക്കോ ​​ചർമ്മം നീക്കം ചെയ്യേണ്ടവർക്കോ സാധാരണയായി ജനറൽ അനസ്തേഷ്യ ചെയ്യാറുണ്ട്. ആധുനിക അനസ്തേഷ്യ പ്രോട്ടോക്കോളുകൾ സുരക്ഷിതമാണ്.

6. ഗൈനക്കോമാസ്റ്റിയയ്ക്ക് ഏത് തരത്തിലുള്ള ശസ്ത്രക്രിയയാണ് നടത്തുന്നത്?
ഞങ്ങളുടെ മിക്ക രോഗികളിലും ഞങ്ങൾ ഇനിപ്പറയുന്നവ ചെയ്യുന്നു:
1.ലിപ്പോസക്ഷൻ. കൊഴുപ്പ് നീക്കം ചെയ്യുന്നതിനാണ് ഇത് ചെയ്യുന്നത്. ഇത് മികച്ച രൂപം ലഭിക്കാനും നടപടിക്രമം സുരക്ഷിതമാക്കാനും സഹായിക്കുന്നു.
2.ഗ്രന്ഥി നീക്കം ചെയ്യൽ. ഏരിയോളയിൽ (മുലക്കണ്ണിന് ചുറ്റുമുള്ള ചർമ്മം) ഒരു ചെറിയ മുറിവിൻ്റെ സഹായത്തോടെയാണ് ഇത് ചെയ്യുന്നത്.
ഞങ്ങളുടെ മിക്ക രോഗികളിലും ഞങ്ങൾ ചർമ്മം നീക്കം ചെയ്യുന്നില്ല.

7. ഗൈനക്കോമാസ്റ്റിയ ശസ്ത്രക്രിയയ്ക്ക് ശേഷം എനിക്ക് എപ്പോഴാണ് ജോലിയിലേക്ക് മടങ്ങാൻ കഴിയുക?
 ഇനിപ്പറയുന്നവ ഞങ്ങൾ ശുപാർശ ചെയ്യുന്നു:

• ആദ്യത്തെ 3 ദിവസം ധാരാളം വിശ്രമം.
• 7 ദിവസത്തിനുള്ളിൽ ഡെസ്ക് ജോലിയിലേക്ക് മടങ്ങുക.
• 2 ആഴ്ച മുതൽ നടത്തം പോലെയുള്ള ലഘുവായ വ്യായാമം.
• ജിമ്മും കനത്ത വ്യായാമവും, 4 ആഴ്ച മുതൽ ആരംഭിക്കുന്നു.

8. ഞാൻ ദൂരെയാണ് താമസിക്കുന്നത്. എനിക്ക് ശസ്ത്രക്രിയയ്ക്ക് നേരിട്ട് വരാമോ?
ഒരു സന്ദർശനത്തിൽ കൺസൾട്ടേഷനും ശസ്ത്രക്രിയയും സംയോജിപ്പിക്കുന്നത് ഞങ്ങൾ പ്രോത്സാഹിപ്പിക്കുന്നില്ല. ശസ്ത്രക്രിയ, ഫലങ്ങൾ, സങ്കീർണതകൾ എന്നിവ മനസ്സിലാക്കാൻ ഒരു വ്യക്തിക്ക് കൂടുതൽ സമയം ആവശ്യമാണെന്ന് ഞങ്ങൾ വിശ്വസിക്കുന്നു. മറ്റേതെങ്കിലും പ്രശ്‌നങ്ങൾ ഒഴിവാക്കുന്നതിന് ഞങ്ങൾക്ക് ലബോറട്ടറി അന്വേഷണ റിപ്പോർട്ടുകളും ആവശ്യമാണ്. അതിനാൽ, നടപടിക്രമത്തിന് മുമ്പ് കൂടിയാലോചനയ്ക്കായി ഒരു പ്രത്യേക സന്ദർശനം ഞങ്ങൾ നിർദ്ദേശിക്കുന്നു.

9. എനിക്ക് ഒറ്റയ്ക്ക് സർജറിക്ക് വരാമോ?
ഇല്ല. നിങ്ങളോടൊപ്പം ഒരു അടുത്ത ബന്ധുവോ സുഹൃത്തോ ഉണ്ടായിരിക്കണമെന്ന് ഞങ്ങൾ ആവശ്യപ്പെടുന്നു. ഇത് ഇനിപ്പറയുന്ന കാരണങ്ങളാലാണ്,
ചില വ്യക്തികൾക്ക് ശസ്ത്രക്രിയാനന്തര കാലഘട്ടത്തിൽ സഹായം ആവശ്യമായി വന്നേക്കാം.
നടപടിക്രമത്തെക്കുറിച്ചും ചികിത്സാ പദ്ധതിയിലെ എന്തെങ്കിലും മാറ്റങ്ങളെക്കുറിച്ചും ഒരു വ്യക്തി ബോധവാനായിരിക്കണമെന്ന് ഞങ്ങൾ ആവശ്യപ്പെടുന്നു.
ഒരാൾ കൂടെയുണ്ടെങ്കിൽ അത് മാനസികാരോഗ്യത്തിന് സഹായിക്കുന്നു.
10. ഞാൻ വിദേശത്താണ് താമസം. എൻ്റെ അവധിക്കാലത്ത് അത് പൂർത്തിയാക്കാൻ ഞാൻ ആഗ്രഹിക്കുന്നു. ഞാൻ എന്തെങ്കിലും അധിക നടപടികൾ സ്വീകരിക്കേണ്ടതുണ്ടോ?
അത്തരം വ്യക്തികൾക്ക് ഞങ്ങൾ ഇനിപ്പറയുന്നവ ഉപദേശിക്കുന്നു:

• അവധിക്കാലത്തിൻ്റെ തുടക്കത്തിൽ ശസ്ത്രക്രിയ ഷെഡ്യൂൾ ചെയ്യുന്നതാണ് നല്ലത്. തിരികെ പോകുന്നതിന് മുമ്പ് ഇത് നിങ്ങൾക്ക് മതിയായ സമയം നൽകും.
• നിങ്ങളുടെ അടുത്തുള്ള ഒരു ഡോക്ടറെക്കൊണ്ട് സ്വയം പരിശോധിക്കുക. പ്രമേഹം, ഹൈപ്പർടെൻഷൻ, മാറ്റം വരുത്തിയ കരൾ എൻസൈമുകൾ തുടങ്ങിയ സാധ്യമായ ഏതെങ്കിലും രോഗാവസ്ഥകളെ ഇത് ഒഴിവാക്കാൻ സഹായിക്കും. ഉണ്ടെങ്കിൽ അവർക്ക് മുൻകൂട്ടി ചികിത്സിക്കാം.
• പുകവലി ഉപേക്ഷിക്കു. പുകവലി സങ്കീർണതകൾ വർദ്ധിപ്പിക്കുന്നു.
• നടപടിക്രമത്തിന് ഒരു മാസം മുമ്പ് ഹെർബൽ അല്ലെങ്കിൽ വിറ്റാമിൻ സപ്ലിമെൻ്റുകൾ നിർത്താൻ ഞങ്ങൾ നിർദ്ദേശിക്കുന്നു.
• നിങ്ങൾക്ക് ഞങ്ങളെ WhatsApp വഴിയോ ഇമെയിൽ വഴിയോ ബന്ധപ്പെടാം.

 
11. ജീവന് എന്തെങ്കിലും അപകടങ്ങൾ ഉണ്ടോ?
ആധുനിക അനസ്തേഷ്യ പ്രോട്ടോക്കോളുകൾ വളരെ സുരക്ഷിതമാണ്. അതിനാൽ, ഗുരുതരമായ സങ്കീർണതകൾ ഉണ്ടാകാനുള്ള സാധ്യത വളരെ കുറവാണ്.

12. എനിക്ക് ഗൈനക്കോമാസ്റ്റിയ വീണ്ടും വരുമോ?
മിക്ക രോഗികൾക്കും ഗൈനക്കോമാസ്റ്റിയയുടെ ആവർത്തനം ലഭിക്കുന്നില്ല. 18 വയസ്സിന് താഴെയുള്ളവരും ദ്വിതീയ ഗൈനക്കോമാസ്റ്റിയയുമാണ് ആവർത്തനത്തിന് സാധ്യതയുള്ള വ്യക്തികൾ.
കൂടുതൽ വിവരങ്ങൾക്ക് ദയവായി ഇവിടെ സന്ദർശിക്കുക

Liposuction is a part of the treatment of gynecomastia correction in most of our patients. It is relatively uncommon to do a gynecomastia correction without accompanying liposuction. Why so? 

Liposuction has many advantages. They include the following: 

1. Help avoid step deformity. Liposuction helps extract the fatty tissue as small parcels from a relatively large area. Since the parcels are removed in small increments and over multiple passes there is a gradual transition between the treated and untreated areas. This is smooth transition is difficult to accomplish when the breast tissue is removed without liposuction. Thus liposuction is not associated with an abrupt transition between the treated and untreated areas. This leads to better aesthetic outcomes. 
2. Better pain relief in the postoperative period. Liposuction starts with the infiltration of a solution. This infiltrate contains a mixture of various drugs including a local anesthetic agent. Because of this agent, it is also possible to perform liposuction under local anesthesia. The pain relief obtained with the infiltration continues into the postoperative period. Patients usually report less discomfort when the procedure involves liposuction. 
3. Makes gland removal easier and faster. The surgery involves liposuction followed by gland excision. The liposuction removes the fat parcels in the form of small tunnels. The gland is left behind because the gland is firmer when compared to fat. The subsequent dissection to excise the gland is facilitated by liposuction. Liposuction opens up multiple surgical planes that help make the surgery faster and more efficient. 
4. Less blood loss. The infiltration used before liposuction also contains an agent to temporarily shrink the blood vessels. This leads to very less blood loss during the removal of fat and gland. Less blood loss makes the procedure safer. 
5. Ability to contour lateral chest wall. Some individuals may present with excess fat deposits lateral (to the side) of the chest wall. This is not composed of breast tissue. Liposuction helps reduce or debulk this area effectively. This is difficult to achieve without liposuction. 
6. Ability to combine with fat grafting in secondary corrections. Some individuals may present for correction of contour abnormalities following a previous gynecomastia correction. These are often corrected in a secondary procedure with liposuction combined with fat grafting. The fat aspirated during liposuction can be injected (grafted) into areas of deficiency. 

There are instances when we may not do liposuction during gynecomastia surgery. But these are relatively uncommon. Liposuction is sometimes not done in thin individuals with less breast fat. Such individuals usually present with a gland enlargement confined to the area under the areola. They also have a very thin skin pinch. In such situations, we proceed with a gland excision through an areolar incision after local anesthetic infiltration. 


Liposuction has many benefits when done in gynecomastia treatment. It is usually done in almost all cases of gynecomastia surgery in our practice. 
To learn more about gynecomastia, please click here. 

Gynecomastia is excess breast tissue in men. In a subset of individuals with gynecomastia, there can be redundant or excess skin. The excess skin affects the outcomes following a gynecomastia corrective surgery. It can mean a longer duration to achieve an acceptable outcome. In some cases, we may do additional surgery to take care of excess skin. 


How does skin redundancy present in gynecomastia? 
Redundant skin is usually apparent with a clinical examination. The breast tissue tends to sag in such individuals. The breasts appear deflated. There can be visible folds on the lower part, and lateral areas of the chest. The presence of ptosis or sagging gives an aged appearance to the chest. 


Who are the individuals prone to get skin redundancy associated with gynecomastia? 
The risk factors associated with excess skin in gynecomastia include:

1. Following massive weight loss: Individuals with loss of weight over 25 kg can present with skin redundancy. The weight loss can result in a relative excess of the skin when compared to the breast volume. 
2. Long duration: Gynecomastia in older individuals is associated with a deflated appearance. The ability of the skin to recoil after breast reduction is reduced as we grow older. 
3. Large breasts: These are often associated with obesity. The presence of excess skin is usually apparent after the breasts are reduced following gynecomastia surgery.
4. Smoking: Smokers tend to have reduced ability for skin recoil. The skin recoil tends to be suboptimal when compared to individuals who do not smoke. 

What are the treatment strategies that can be adopted in case of skin excess? 
hereAmong individuals with excess body weight, it is always recommended to lose weight before undergoing a surgical correction. Optimizing the body weight before surgery has certain advantages. It is easier to assess the extent of excess skin before surgery. This makes the surgical outcome more predictable. In some cases, we may opt to undertake skin reduction during the time of gynecomastia correction. With weight loss, patients can benefit from the skin recoil beforehand. 
In an individual, with excess skin, gynecomastia correction can be done in two different ways. It can be done either with skin excision or without skin excess. Both strategies lead to different outcomes. 
When the correction is carried out without a skin excision there may be a postoperative course with an increase in the deflated appearance. This usually improves with time due to the skin recoil. It may take many months before the full extent of skin recoil is appreciated. We usually advise our patients to wait as much as 8 months before deciding on an additional surgery to remove the skin excess. Many patients are usually satisfied with the skin recoil and choose not to have any skin excision procedures. This has the advantage of an initial simpler procedure with shorter scars. Skin excisional procedures are associated with longer and more visible scars. 
The second strategy would include gynecomastia correction carried out with simultaneous skin excision. The pattern of the excision can vary depending on the extent of skin excess. Patients with more excess tend to have a greater amount of skin removed. With this technique, the excess skin is addressed in a single procedure. However, it carries the disadvantage of longer scars. In our practice, this approach is less commonly used. We tend to choose individuals with severe excess for this approach. 


What are the steps that can be taken by an individual to address excess skin? 
The excess skin is usually seen to accompany increased body weight. Individuals should try to maintain their weight close to ideal. This is usually achieved with the help of dietary modifications such as diet and exercise. Weight training helps recruit the excess skin and contributes to reduced sagging over the lower part of the chest. Weight training and accompanying muscle hypertrophy also bring along aesthetic benefits. 


Excess skin is seen in some individuals presenting with gynecomastia. This is more commonly seen in those with excess body weight. The skin excess can be tackled with surgery in a staged or simultaneous way. Both strategies have their advantages and disadvantages. A treatment plan is chosen based on individual preferences and extent of excess skin. Individuals with skin excess can help improve this condition with appropriate dietary modifications and exercise. 

Learn more about gynecomastia here. 

Secondary corrections refer to operations undertaken to improve the outcome after primary surgery. Secondary corrections for gynecomastia are done to improve the appearance of the operated site.

Some of the deformities that may be corrected with secondary surgery include the following: 

1. Asymmetry: Minor degrees of asymmetry can be seen in most cases of gynecomastia. They may arise as a result of the differences in the breast or the underlying muscles and skeleton. Surgery is useful in the former type. 
2. Residual gland: During gynecomastia correction, a disc of the gland is left underneath the areola. Complete removal of the gland can lead to other deformities. However, in a small number of some individuals, this may be associated with a recurrence of gland enlargement. Recurrence is more common among younger individuals. This can be corrected by secondary gland excision.   
3. Irregularities of the treated area. Some irregularities of the treated areas are common in the initial months following surgery. This is a result of scarring of the tissues following surgery. Such irregularities usually improve with time. Irregularities persisting beyond a year can be treated with the help of liposuction and fat grafting. 
4. Excess skin. Excess or redundant skin of the breasts is usually seen in two types of patients. One, in those, underwent massive weight loss. These patients may have lost more than 20 kg in a short period and have redundant ptosis or sagging of the breast during the presentation for primary correction. Two, in individuals with large breasts. This can cause a deflated appearance after liposuction and gland excision. After a gynecomastia correction, the skin recoils and adjusts to the new contours. However, this may be inadequate in some. Such patients can be treated with skin removal surgery. These corrections would involve long scars.  
5. Scar revision. The scars of a primary gynecomastia surgery usually settle without much deformity. However, the scars involving skin outside the areola may have pigmentation and texture abnormalities. In case of minor deformities, they are managed with medicines and topical applications. Some of the scars can be improved with surgical scar revisions. 

Timing of secondary corrections of gynecomastia. 
We usually wait for a year before undertaking secondary corrections. This has some advantages. They include the following,

1. Remodeling of the scar. In addition to the visible scar over the skin, gynecomastia surgery leads to scarring in the deeper tissue planes. These scars change with time. This phenomenon is known as remodeling. The operated areas can feel firm and nodular in the first few months following surgery. They soften with time and do need any particular treatment in most cases. 
2. Skin recoil. Skin recoil takes time. We tend to stage skin removal in those presenting with skin excess for two reasons. One, they may not be warranted since the skin recoil may be adequate at the end of a year. Two, removal of skin leads to lengthy scars. These may be easily noticeable. 

 Various procedures are undertaken during secondary gynecomastia corrections. These may be carried out in isolation or as a combination. They include, 

1. Liposuction. This can help treat any step deformity and persistent irregularities of the chest. 
2. Fat grafting. Fat grafting is useful to treat contour defects. The fat may be harvested from the adjacent regions or distant parts of the body. Fat grafting is usually not combined with open gland excisions. 
3. Gland excision. This is sometimes carried out when there is a residual gland or during a recurrence. The gland is usually removed by an areolar incision. 
4. Skin removal surgery. This is carried out when there is the persistence of skin excess beyond a year. The pattern of skin removal is determined by the severity of excess skin. The different patterns of the skin include those of a doughnut shape and ellipse. The resulting scar may be at the junction of the areola and surrounding skin or may extend downwards. 

A surgical plan is based on the appearance of the deformity and concerns of the patient. In other words, such plans are customized. Two patients with a similar-looking deformity may undergo different types of surgical correction. A realistic expectation is important since it is usually only possible to make some improvements in the appearance. Also, secondary corrections are usually taken after a year following the primary surgery. During this period patients can help optimize their appearance by the following activities. 

1. Healthy diet. Having a stable weight close to the ideal body weight helps in skin recoil. 
2. Avoid smoking. Smoking impairs skin recoil. 
3. Exercise. Weight training improves muscle volume and this additional volume can recruit excess skin. This lessens the sagging of the chest skin. 

Secondary corrections of gynecomastia can help improve the appearance of selected individuals. 

For more information about gynecomastia please visit: https://www.amicusclinic.in/gynecomastia

I could also have gone for a title called ‘why am I fond of syringe liposuction?’. Liposuction is a technique in cosmetic surgery for removing fat cells from certain parts of the body. The fat cells amenable to liposuction are between the skin and muscles. We do not perform liposuction on fat deeper than the muscles. Liposuction may be part of another procedure like abdominoplasty or gynecomastia correction. 


Liposuction involves the creation of a vacuum. This vacuum helps remove fat cells with small cannulas. Such cannulas are called liposuction cannulas. Cannulas vary depending on their diameter, length, and shape of openings near the end. We use different types of cannulas based on the area treated.  


During liposuction, a vacuum is obtained by a machine or a syringe. Syringe liposuction employs a syringe for generating liposuction. A cannula is attached to one end of the syringe. After insertion of the cannula inside the body, the surgeon pulls back the piston and locks it in place. The vacuum created inside the syringe helps move the fat cells into the syringe during to and fro movement. Once the syringe gets filled, the cannula is disconnected and the fat is emptied. The same process gets repeated till the desired endpoint is reached. This constitutes syringe liposuction. 


Syringe liposuction is a simple technique with a lot of benefits. This makes it popular among many practitioners. Some of the benefits include the following, 

1. Precision. Syringe liposuction enables the exact measurement of the aspirated fat. This helps correlate fat aspirated from both sides of the body. In the case of pre-existing asymmetry, the aspirate can be adjusted to improve the symmetry. This is more difficult to achieve with conventional liposuction in which the fat is collected in a large canister. 
2. Combination with fat grafting. Fat grafting is done to correct deformities of liposuction or pre-existing asymmetries. Since the aspirated fat is collected in syringes, it does not require any complex processing for it to be injected back into the body.  
3. Lower cost. The disposables used in syringe liposuction are not expensive. It does not involve any costly equipment. This helps reduce the cost of the procedure. 
4. No sound or smoke. The absence of any electrical moving parts makes this a very quiet and smoke-free procedure.

Syringe liposuction was introduced by Toledo in 1989. The advantages of this technique make it very endearing to some practitioners of liposuction. One of them includes me.  

For more information about liposuction, please click here.

For more information about gynecomastia, please click here.