Gynecomastia correction is a commonly done cosmetic procedure. Surgery is indicated in case the affected individuals are bothered about the deformity. An effective correction is associated with improvement in self-confidence.
Most cases are done under general anesthesia in a hospital setting. We reserve local anesthesia for the mild variants with only gland enlargement.
Gynecomastia is usually associated with an increase in fatty and glandular tissues. The incisions and the resulting scars depend on the tissues being tackled during gynecomastia correction. Less commonly, there can be a significant excess of skin.
1. Fat is removed with the help of liposuction. During liposuction small tubes are used to suck out fat. An advantage of liposuction includes the ability to treat large areas with the help of very small wounds. These incisions are usually not sutured and heal very rapidly. Liposuction also contributes to postoperative comfort during recovery. This is due to the infiltration of the anesthetic solution during the procedure.
2. The gland is removed with the help of an incision placed inside the areola. The areola is pigmented skin immediately surrounding the nipple. The wound is closed with sutures. These sutures are removed around 7 days following surgery. The areolar scar usually settle very well. The exceptions would be seen in certain patients prone to prominent scars.
3. Skin is usually not removed during correction of gynecomastia. Skin excess can be seen in long-standing severe gynecomastia and those with massive weight loss. These individuals present with droopy or hanging breasts. Removal of the underlying gland and fatty tissues helps the skin to recoil. This can take as long as one year. For this reason, we usually wait for a year before planning any skin tightening or removal procedure. Depending on the severity of excess skin, incisions may be confined to the junction between the areola and skin or may extend downwards and laterally towards the sides of the chest.
In most cases presenting for gynecomastia, we do a combination of liposuction and gland removal with an areolar incision. These scars are associated with high patient satisfaction rates. Skin removal surgery is very uncommonly done in our practice.
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I like to keep it simple.