Surgical treatment options in gynecomastia (enlarged male breasts)

 
Gynecomastia is enlargement of male breasts. It can be a cause of significant anxiety and embarrassment in those affected by this condition. Surgical correction results in a long-term improvement in appearance. The different options available for a surgical cure include:

1. Liposuction: This involves removal of fat cells with thin tubes attached to a suction device. The suction can be produced with a machine or a syringe. The fat cells are permanently removed from the treated site resulting in a flattened contour. Liposuction is especially useful when gynaecomastia is mostly due to fatty tissue. 

2. Gland excision: The glandular tissue also contributes to a varying extent in gynecomastia. This is more amenable to direct excision. The placement of incision can be at, 

a) Intraareolar: The areola is the pigmented skin surrounding the nipple. The incision and the resulting scar lies within the areola. This usually results in a scar which is not easily made out.
 
b) Periareolar: Here the incision lies at the junction of pigmented and non-pigmented skin. It heals with a light-colored scar. 

3. Skin excision: In certain cases of long standing gynecomastia there may be an excess of skin with a reduced ability to recoil. In such situations, a disc of skin is removed for treatment of the excess skin. The removal of skin can also be done at a later stage to allow for the natural recoil of the skin. 

All these modalities can be combined in one procedure depending on the severity of gynecomastia. Postoperatively dressings are removed during the next day. Drainage tubes are sometimes placed to evacuate fluids from the operated site. They are usually removed during the first few days. Sutures are  removed after seven days. Patients can return to work after one week. Workouts and heavy exertion can be resumed after six weeks.