What is Gynecomastia Surgery?

Gynecomastia surgery, also known as male breast reduction, is the procedure to correct the overdeveloped or enlarged breasts in men. The surgery reduces the breast size, thereby, restoring the chest appearance. The chest is flattened, and the contours are enhanced by removing the excess glandular tissues and fat.

What happens in gynecomastia surgery?

Diagnosis

Before surgery, the doctor will perform a physical examination to accurately diagnose whether you have gynecomastia or chest fat, also known as pseudogynecomastia.

The physical examination is done while the patient is lying on his back. It includes:

• Examination of the breasts in which the doctor will examine the breast’s shape, size, and firmness.

• The doctor will pinch the side of the breasts around the nipple or areola.

• If a disk-shaped mound of tissues is felt around the nipples, it indicates true gynecomastia.

• The doctor will also check the armpits or breasts to see if there are any enlarged lymph nodes present.

Besides the physical examination, the doctor will also recommend a few tests, such as X-rays, MRIs, ultrasound, etc., that will allow the doctor to gather more information about your overall health and narrow down the most appropriate treatment option.

Procedure

Once you are taken to the operation theater (OT), the anesthetist will inject the solution into the breast region. Usually, the surgery is performed under local anesthesia, but general anesthesia may be used if the patient has an allergic reaction to some component of the anesthesia. Once the doctor ensures that the patient won’t have any sensation in the chest region, then they proceed with the following steps:

• The liposuction technique is used at first to break down the fat deposits and extract them using a suction device.

• A small incision is made around the areola (the darker region around the nipple) to insert the liposuction cannula and extract the melted or broken fat tissues.

• The same incision is used for gland excision. A scalpel is used to cut the glandular tissues and remove them without harming the surrounding tissues and muscles underneath.

• Then the incision is closed with the help of stitches or left open to heal on its own with time. But the wound is properly covered.The patient is kept under observation for the next few hours until the anesthesia wears off and then transferred to the ward.

What are the Causes of Gynecomastia?

• Hormonal Changes

• Overuse of Antibiotics

• Anxiety Medications

• Excess of Alcohol & Drug Abuse

• Renal/Kidney Failure

What are the Symptoms of Gynecomastia?

• Lump of fatty tissue

• Uneven swelling of breasts

• Pain or tenderness in breasts

• Nipple discharge

• Increase in diameter of the areola

Types of Gynecomastia & Their Treatment

Gynecomastia is of two types- true gynecomastia and pseudogynecomastia. In true gynecomastia, only breast glandular tissues are present. Unlike this, in pseudogynecomastia, mainly fat tissues give the appearance of breasts.

To treat true gynecomastia, the surgeon uses the gland excision technique to remove the glandular tissues permanently. And for the treatment of pseudogynecomastia, the surgeon uses liposuction as most of the fat tissues can be successfully removed through this technique.

In younger teens and children, the breasts will disappear as soon as the hormones stabilize. But in adults, the condition doesn’t go away without proper treatment. And the best treatment method for gynecomastia treatment is surgery. The surgical procedure is known as male breast reduction surgery.

Before the technology was advanced, breast tissues were excised through open surgery, which was invasive in nature. But thanks to modern technology, now male breast reduction surgery is performed using one of the two techniques or a combination of both:

• Liposuction : It is a technique that is used when there are excess fat tissues present in the breasts. There are various techniques available to remove the fat tissues, such as laser, ultrasound-assisted, etc. A liposuction cannula is inserted into the targeted area through a tiny incision, and the fat is removed through suction.

• Gland Excision : This technique is used for the removal of glandular tissues as they can’t be broken down like fat tissues. The glands need to be excised carefully. A scalpel is used to excise the tissues through a small incision around the areola. Once the tissues are removed, the incisions are closed and left to heal.

Generally, in gynecomastia, both fat tissues and glandular tissues are present. Due to this, these two techniques are combined together to treat gynecomastia permanently.

Risks & Complications During the Surgery

Gynaecomastia surgery is usually a safe procedure with minimal risks. While the surgery is being carried out, the doctor will ensure that the patient’s health is not at risk at all. Still, there are some risks that a patient should be aware of before having the surgery. These includes:

• Bleeding

• Damage to the deeper structures like nerves, blood vessels, muscles, etc.

• Tissue death

These complications rarely arise if you have an experienced and well-trained surgeon beside you. Moreover, the doctor will ask you to sign a consent form after discussing all the possible risks and complications prior to the surgery.

How to prepare for the surgery?

To prepare for the male breast reduction surgery, the doctor will first ask you to:

• Get diagnosed properly to see if you have any underlying medical conditions or not

• Take certain medications and adjust other medicines to prepare your body for the upcoming surgery

• Avoid smoking completely at least 4 weeks before the surgery

• Avoid taking aspirin, anti-inflammatory drugs, herbal supplements, or blood thinners, as they can increase the risk of bleeding during surgery.