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 for breast reduction can be considered.
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.
