Gynecomastia

Gynecomastia is a condition that presents in men with excess tissue growth in one or both breasts, and which is particularly pronounced under their nipple and areola.  The condition can be the result of hormonal changes, extreme weight loss, heredity, aging, obesity, or the use of certain drugs. Men of all ages suffer from gynecomastia, which can lead to the avoidance of certain social and physical activities as well as intimacy. In males who have had significant weight loss, excess droopy breast skin rather excess breast tissue may be present, a condition that resembles gynecomastia but is referred to as pseudogynecomastia.

What is gynecomastia correction?

When gynecomastia is present, male breast reduction — also known as gynecomastia surgery or male reduction mammoplasty — may be the solution. Dr. Motakis performs gynecomastia surgery to reduce breast size in men by flattening the area of fullness and restoring the normal contours of the chest. By removing excess fat, breast tissue and occasionally, excess or sagging skin, he gives his patients a flatter, firmer, more masculine chest shape. Patients who have the procedure feel more comfortable and confident about their body.

The procedure

Gynecomastia correction surgery is usually performed under general anesthetic and usually takes 1-2 hours. Depending on the case Dr. Motakis may use one (or a combination) of three different techniques: the liposuction technique, the gland excision technique or in much fewer cases the skin and gland reduction technique.

If your case of gynecomastia is predominantly the result of excess fatty tissue, Dr. Motakis may recommend the liposuction technique. One to two tiny incisions are made, and vacuum suction is used to remove excess fat via a thin cannula. In cases where excess breast gland is present, liposuction is insufficient, and an incision is required around the areola in order to excise the hard, glandular tissue. The scar in this procedure is within the areola and virtually imperceptible. In cases where there is excess skin, such as in massive loss patients (pseudogynecomastia) liposuction and breast gland excision may be also inadequate. In such cases, the skin is tightened either with the use of a radiofrequency apparatus known as BodyTite© or in more severe cases excised directly usually around the areola or along the natural creases of the male chest. Dr. Motakis may also recommend this technique in cases where the size of the areola needs to be reduced or the nipple is droopy and in a very low position.

Are You an Ideal Candidate for Gynecomastia Correction?

The ideal candidates for male reduction mammoplasty are adult men who have excess breast tissue centralized around their nipple and areola. They also are physically healthy, fall within a relatively normal weight range, and their breast development has stabilized. Like all cosmetic procedures, the patient must have realistic expectations. If you are bothered by the excess fullness around your chest and under the nipple and feel uncomfortable clothed or unclothed, then a male chest reduction surgery may be right for you. Dr. Motakis will assess you to decide if you are a good candidate and discuss your surgical options during your consultation.

What is the recovery period after gynecomastia?

Recovery after surgery takes 1-2 weeks during which a supportive compression vest is worn. Specific dressings will be applied after your surgery and they will stay intact until your follow up visit one week after surgery. You will be able to shower the next day after the procedure as Dr. Motakis does not usually use drains with this procedure. Your chest will be slightly swollen and may feel slightly sore, but when needed, you will feel comfortable with the use of mild analgesics. After one week, you should be able to return to work, but you will need to limit intense physical activity such as going to the gym for 3-4 weeks. At your one week follow up appointment your bandages will be changed, the small incisions inspected, and a special tape applied to expedite healing and reduce scarring. The compressive garment is worn for 6-8 weeks after surgery in order to decrease swelling, improve contour and expedite healing. There are no sutures that need to be removed with gynecomastia surgery, as Dr. Motakis uses only internal dissolving sutures in order to minimize scarring and decrease patient discomfort.

What are the risk factors for gynecomastia?

Complications of gynecomastia surgery include unfavorable healing or scarring, change in skin or nipple sensation, the presence of residual excess skin, infection or asymmetry, among others. However, these seldom occur. Dr. Motakis will discuss all risks in detail during your consultation and pre-operative appointments. Correcting these complications may also require additional surgery.

Are there any alternatives to gynecomastia?

Currently, there are not alternatives to treat gynecomastia.

Can gynecomastia be combined with other procedures?

Gynecomastia correction can be combined with other surgical procedures and is often performed concurrently with liposuction of the body or the area under the chin.

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