GYNECOMASTIA (ENLARGED MALE BREASTS)

Gynecomastia is enlargement of male breasts. Men can get affected by this condition at any age. It results in excess breast tissue in response to hormones.

In most of the cases, no definite cause is seen. Gynecomastia can occur secondary to:
1. Medicines like steroids, antidepressants, agents used in the treatment of cancer etc.
2. Diseases elsewhere like cirrhosis of the liver and certain type of tumors.
3. Secondary to use of alcohol, amphetamines, marijuana etc.

Gynecomastia can result in embarrassment and social inhibitions. It can prevent affected individuals to refrain from participating in sports and other situations where the altered appearance is easily made out.

Male breast enlargement is characterized by:
1. Excess of glandular tissue
2. Excess of fat ( adipose tissue)
3. Excess of skin in long-standing and severe cases
4. Unilateral or bilateral

Individuals with gynecomastia are evaluated to rule out secondary causes of gynecomastia. Male breast enlargement can be a temporary phenomenon in adolescents.

Candidates for plastic surgery include:
1. Patients were not responding to medical management
2. Non-smokers
3. Good general health
4. Those with realistic expectations

Plastic surgery treatment options:
These include:
1. Liposuction: This is performed in individuals with a predominantly fatty component. The fat is sucked out with the help of small tubes with a vacuum. The access sites are loosely sutured. The tissues settle into new appearance once the swelling subsides. Use of pressure garments is advised for 6 months.
2. Excision of glandular tissue: The complete removal of glandular tissue is difficult with liposuction alone. The glandular tissue is removed with the help of a small incision at the junction of the areola ( pigmented skin) and chest skin.
3. Excision of skin: Excess skin is sometimes seen in long standing severe cases of gynecomastia. When it is associated with reduced skin tone, the skin may be excised in the shape of a donut. The wound is closed as a purse string. An advantage of this technique is that it also addresses excess skin. When it is carried out as a part of surgery following massive weight loss the incisions may be extended in the shape of a 'J' to better contour the chest skin.

Postoperative care: Patients can usually go home after a short stay. Small tubes (drains) may be used to drain out the excess of fluid collection from the operated site. These are removed within the first week. The patients are advised to use compression vest for one month to help adapt the operated site to the new contour. Patients can return to work in a week.

How does plastic surgery of gynecomastia help?
An improvement of appearance leads to markedly enhanced self-confidence and better body image.

Related topics.

To visit our web page on gynecomastia in Malayalam, please visit: https://www.plasticsurgerymalayalam.com/gynecomastia

Well settled areolar scar three months following surgery

Patient journey: The following images describe a patient journey during gynecomastia correction. Patient underwent liposuction and gland removal with an areolar incision under general anesthesia in a hospital setting. Recovery was uneventful.

1. Preoperative appearance of gynecomastia.

2. Preoperative markings to highlight the muscle, fat and gland

3. Liposuction

4. After gland removal with an areolar incision

5. Dressing after the surgery

6. Appearance as well as dressing after 3 days

7. Pressure garment

8. Appearance two weeks following procedure. Residual swelling gradually resolves over the next few months.

Gynecomastia with excess glandular and fatty tissues with lax skin

Gynecomastia treated with liposuction, direct excision of gland and dough-nut excision of skin

Gynecomastia treated in a muscular individual with direct excision of the gland through an areolar incision. Liposuction was not performed.

enlarged male breasts before plastic surgery

Gynecomastia with excess fatty and glandular tissues.

Gynecomastia treated with liposuction and direct excision through intra-areolar incision under general anesthesia.

Before: Fatty and glandular excess with good recoil of skin

After: Liposuction and glandular excision done with an intra-areolar incision

Before: Gynecomastia in an individual with asymmetry of the underlying muscles (left pec major is bulkier compared to the right).

After: 6 weeks post-operative image following liposuction and gland removal using areolar incision.

Before: Marked asymmetry with gynecomastia on right greater than left

Intra-operative: With the excised gland near kept near the wounds

After: Improvement in the symmetry with gland removal

Before: Gynecomastia in a muscular individual without lipodystrophy

Preoperative markings

After: 10 weeks postoperative appearance

Before: Gynecomastia in a middle aged male with pendulous abdomen

Before: Lateral view

After: 2 weeks postoperative appearance. No abdominal procedures were performed

After: 2 weeks postoperative appearance

Before: Gynecomastia with mild lipodystrophy

Preoperative markings

After: Early postoperative appearance at 11 days with swelling (temporary) and sutures in situ

Before: Gynecomastia in an individual with massive weight loss and excess skin

Before: Lateral view

After: 5 months postoperative appearance. Skin excision (removal) was not performed

After: Lateral view. Skin recoil continues to more than a year

Before: Glandular asymmetry of the breasts

Preoperative markings

After: Early postoperative appearance at 3 weeks. Swelling is visible over the lateral aspect of the chest

Before: Gynecomastia in an individual with mild lipodystrophy

Preoperative markings

After: 1 month postoperative appearance

Before: Gynecomastia in an individual with a low IMF (inframammary fold)

Preoperative markings

After: 3 month postoperative appearance

Before: Gynecomastia with moderate lipodystrophy

Before: Lateral view

Before: 1 month postoperative view. Swelling of the treated regions is visible

After: Lateral view

Before: Gynecomastia with preoperative asymmetry, ptosis, and a keloidal scarring tendency

Preoperative marking

After: 5 month postoperative appearance