Gynecomastia |Asymmetry and its management.

Gynecomastia is an enlargement of the male breast tissue. This enlargement can be of one or both sides.  In cases of bilateral involvement, one side can be affected more than the other, leading to an asymmetrical appearance.

Mild cases of asymmetry are common. But in certain cases, the difference between the two sides can be readily noticeable. The asymmetry can be as a result of two causes, namely, a difference in the amount of breast tissue or changes as a result of the underlying chest wall and muscles. The treatment strategies for managing the asymmetry depends on the underlying cause. Usually, the reason is apparent during a clinical examination.

In the case of asymmetry arising due to the difference in the size of the breast tissue, the treatment involves liposuction and direct glandular excision. We take care to leave behind equal amounts of subcutaneous tissue at the end of the procedure. A more enlarged gland will require a longer time for adequate skin recoil. Such a gland may also have a longer duration of postoperative firmness. In most cases, adequate symmetry is achieved with the passage of time.

In cases of asymmetry due to underlying chest muscles, unfortunately, nothing much can be done to correct the difference at the time of surgery. We bring this to the notice of the patient during the consultation. Usually, such differences in chest muscles arise from altered posture and position during strength training exercises. It is recommended that individuals seek help and guidance from an expert physical trainer for the correction of the posture and technique.

Gynecomastia surgery is essentially a cosmetic procedure and the goal of undertaking a correction is to minimize the effect of the deformity. Wide variations occur in the presentation of this condition. Asymmetry is a commonly seen variant, even though severe asymmetry is uncommon. In cases of asymmetry, it is important that individuals understand the reason and the role of different treatment strategies to tackle the same.

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An individual with asymmetry due to difference in the size of the gland. The right side is bigger compared to the left.

Asymmetry due to the difference in the breast tissue.

Post-op view of the same patient treated with liposuction and gland excision.

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Asymmetry due to the difference in the size of the underlying muscles. The left pectoralis major is more developed when compared to the right.

Left pectoralis major (muscle) is more hypertrophied compared to the right.

Patient was treated with liposuction and gland excision. He was advised about the need to make get help for correction of the muscle asymmetry.