Gynecomastia is a common male breast deformity, and in some cases surgical correction is required. Basically, it is a benign increase in the size of the breast in the male, of multifactorial origin. In most cases it is idiopathic in origin (the specific cause is not known), and in many cases it appears that an imbalance between estradiol and testosterone is an underlying causal factor.
A proper diagnosis of gynecomastia must be made, and it must be determined whether the excessive development of the male breast has been caused by a physiological imbalance, or whether there is a pathology behind it that requires treatment (a tumor, pathological hormonal imbalances, use of drugs, etc.).
The prevalence of gynecomastia in adolescent males is quite high, there are studies that place it at 38-64% of adolescent males, although in most of these cases, gynecomastia eventually disappears with development.
Gynecomastia can have as its origin an excess of adipose tissue, or focus on an exaggerated development of the mammary gland exclusively; in other cases it is a mixed excess of both tissues.
Sometimes we speak of pseudogynecomastia or false gynecomastia, since breast development is exclusively at the expense of adipose or fatty tissue, and is closely related to excess weight.
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How do we correct gynecomastia?
Regarding the surgical correction of gynecomastia, there are basically 3 procedures that are combined according to the individual requirements and characteristics of each patient:
- Breast tissue excision.
- Liposuction of mammary adipose tissue.
- Skin resection. It can be pure circumareolar (around the areola), circumareolar with transverse extensions, or spindle-shaped at the level of the sulcus.
- Combination of the above.
- Sometimes it is necessary to graft the areola, if the excess tissue is severe and it is very ptosic or sagging.
What is gynecomastia? Excess breast in the male body.
Recalcitrant gynecomastia, which does not resolve spontaneously with development, growth, or medical treatment, is often a great complex for the male who presents it. Thus, gynecomastia constitutes a real deformity that affects the patient psychologically, and as a consequence leads to social and self-image dysfunction.
The most important factors to consider when treating gynecomastia are:
- Breast size
- Excess skin
- Breast ptosis (the degree to which the breast is sagging and/or drooping).
- Composition (gland and/or adipose tissue)
- Deformity: the most typical is tuberosity.
- Nipple malposition
- Chest shape
Gynecomastia: before and after images
Gynecomastia in bodybuilders
In this type of patient the psychological impact is even greater since they are subjected to great demands, imposed both by themselves and by the competitions in which they participate.
In this population group, gynecomastia or mammary gland enlargement is almost exclusively due to an increase in glandular development (since they present almost inexistent percentages of body fat).
In these patients the appearance of gynecomastia is generally due to the use of anabolic steroids or ingestion of hormonal compounds sold in sports nutrition stores. Despite stopping the use of these drugs, gynecomastia usually remains.
Surgical correction in these cases is more demanding than in other patients. This is due to the following reasons:
- Gynecomastia is usually purely glandular, without excess adipose tissue, thus requiring a very precise excision.
- Tissues are usually highly vascularized due to overtraining and hormonal influence.
- The entire gland must be resected to prevent recurrence (if remnants are left, gynecomastia often reappears).
- These patients are demanding and perfectionists, and will not settle for a mediocre or poor result.
What should be taken into account when performing this surgery?
- Smoking is a relative contraindication. Tobacco has negative effects on healing.
- It must be performed in an operating room with the necessary safety conditions.
- The type of anesthesia will vary depending on the procedure: from deep sedation if only liposuction is required, to general anesthesia if the procedure requires more procedures such as excision of the mammary gland.
- The duration of the procedure is 60-120 minutes.
- Admission is usually 12 to 24 hours.
- Drains are generally not used, except in cases in which the cutaneous or glandular resection is too extensive.
- After the operation, compression garments should be worn for 4-6 weeks.
- The recovery period is 1-2 weeks to recover normal life activities, and 4-6 weeks to resume sports practice.
- Complications are rare, although sometimes there could be hematoma, seroma, infection, skin or areola necrosis, poor healing, contour alterations, redundant skin, asymmetries, etc. This is why it is so important to choose a good surgeon with experience in this pathology.
If you are considering undergoing this procedure, you can request a visit to our office to learn about your specific case, analyze your individual characteristics and give you personalized advice.
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