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Aesthetic Procedures: Breast

Aesthetic Procedures: Breast

Aesthetic Procedures: Breast

Gynecomastia Surgery

Gynecomastia is a condition characterized by enlargement of the male breast that affects up to 60% of the male population. The most common reason for gynecomastia is idiopathic (unknown), but it can also be related to certain drugs or secondary to conditions such as liver cirrhosis, hormonal imbalances, or testicular cancer.

There are usually 3 age groups in idiopathic gynecomastia which correspond to times of physiologic hormonal change. These are the neonatal, pubertal, and older (> 50years old) age groups.

Work-up of gynecomastia first involves a thorough history and examination to uncover any sinister underlying causes. These may be followed by ultrasound scans of the breasts or testes as well as blood tests. Once any treatable medical conditions have been excluded, gynecomastia surgery can be considered.
 
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How is gynecomastia surgery performed?

Gynecomastia surgery can be performed under general anaesthesia, or local anaesthesia with sedation.

There are many different grading systems for gynecomastia, most involving the assessment of skin versus excess breast tissue. Treatment modalities are then aimed at removing these two aspects.

Excess breast tissue can be removed through a combination of liposuction and excision of the fibrous breast disc behind the nipple by using a small incision around the areola. If there is excess skin, there may be a need to remove skin in a mastopexy-style approach using a periareolar or vertical scar, depending on the amount. More recently, ultrasound-assisted liposuction (VASERTM) has been used to good effect in both removing breast tissue, and thermal tightening of skin without having to make large incisions. This is suitable for patients with mild to moderate excess skin and smaller fibrous breast discs.

The aim of gynecomastia surgery should be to give the patient a shapely, athletic male chest suitable for their body type. It goes beyond just pure removal of tissue. At Polaris Plastic & Reconstructive Surgery, Dr Adrian utilizes both VASERTM and other techniques to give you an outcome tailor-made to your goals and desires.
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What can I expect after gynecomastia surgery?

After your procedure, you may have drains placed to remove excess fluid and blood, which are usually removed the day after surgery. You will have a pressure dressing over the chest, and a suitable pressure garment will be obtained for you. This pressure garment should be worn as often as possible for the first 6 weeks, to enable the skin to retract over the chest muscles.

There are usually no stitches to be removed. Pain is usually well controlled with oral painkillers, and you can perform most daily activities on your own the day after surgery. You should avoid exercise for 3 to 4 weeks after surgery to aid with healing. The final result after skin retraction and reduction in swelling is seen at 2 to 3 months after surgery.

What are the potential complications of gynecomastia surgery?

Complications of gynecomastia surgery, though uncommon, include hematoma, seroma infection, asymmetry, and contour deformities. These can usually be managed conservatively. Occasionally, secondary procedures are required.

FAQs

Is gynecomastia surgery covered by my insurance?

As gynecomastia is an abnormal accumulation of breast tissue in a male, your breast tissue from the procedure will routinely be sent for testing to determine whether there are any sinister abnormalities. However, insurance coverage for gynecomastia surgery is variable according to the insurance company. Our doctor will work with you on communication with your insurance company to see if this is possible, though insurance coverage cannot be guaranteed.


References
1. Rohrich RJ, Ha RY, Kenkel JM, Adams WP. Classification and Management of Gynecomastia: Defining the Role of Ultrasound-Assisted Liposuction. Plast Reconstr Surg. 2003;111(2):909–23.

2. Holzmer SW, Lewis PG, Landau MJ, Hill ME. Surgical Management of Gynecomastia: A Comprehensive Review of the Literature. Plastic Reconstr Surg Global Open. 2020;8(10):e3161.

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