Gynaecomastia Surgery

Gynecomastia appears as a rubbery or firm mass that starts from underneath the nipple and then spreads outwards over the breast area. It is not cancerous. The tissue is enlargement of glandular tissue, not fat tissue. Enlargement is found in both breasts in about half of cases, while in the other cases it only affects one breast.

Gynecomastia can happen in males of any age or weight. Obese men can look like they have man boobs as they have fat tissue all over the body including the breasts; however, this is not true gynecomastia. The growth of breast tissue can be painful or tender. This should always be checked by a doctor. gynecomastia can appear as a small lump that becomes tender as the mass becomes larger.

It is common in adolescent boys as breast development is affected by hormonal changes at puberty. This can cause psychological stress.

What causes Gynecomastia?

gynecomastia is commonly seen during infancy, puberty and older age. All males have the male sex hormone testosterone as well as low levels of the female hormone oestrogen, which controls breast tissue growth. When the ratio of testosterone to oestrogen changes (that is, there is an imbalance in the levels of these two hormones with relatively higher amounts of oestrogen), breast tissue can grow. Some men with gynecomastia have higher than normal oestrogen levels.

Many newborn male babies have enlarged breast tissue because of the transfer of oestrogen from the mother during pregnancy. The oestrogen goes down after birth so this type of gynecomastia is temporary. During mid to late puberty more oestrogen than testosterone is made by the maturing testis until the time when the testes start to make testosterone at adult levels. gynecomastia starting during puberty often goes away, but in less than one in 20 adolescent boys it continues into adulthood. As men get older there is often a gradual decrease in testosterone levels (and therefore the ratio of oestrogen relative to testosterone goes up) and this can lead to gynecomastia.

gynecomastia can also be caused by genetic problems, chronic diseases (especially kidney and liver disease) or some medicines. Men who take anabolic steroids for sporting performance or body building often develop gynecomastia.

How common is Gynecomastia

Gynecomastia is very common in boys going through puberty, happening in more than half of all normal adolescent males, and usually goes away over time. In older men, enlargement of the breast tissue happens in about one-third of men, who often have excess surrounding fatty tissue as well.

Treatment options for Gynecomastia

There is no effective medical management for gynecomastia.

The surgical treatment options are aimed at the removal of excess fat and glandular tissue from the male chest giving it an appearance like the female breasts.

Many techniques have been used in the surgical removal of male breast tissue including the open excision (removal with knife) of the male breast tissue and fat , liposuction for fat removal and removal of glandular tissue through an incision (surgically created wound ) around the areola. As it being a cosmetically embarrassing condition for mostly of the affected males, surgery is best done through access sites that leave minimal or inconspicuous scars of the surgery. And the newer surgical access sites are from the axilla (arm pit) for liposuction and through a very small stab wound on the nipple which do not leave any noticeable scar of the surgery alleviating the fear that the surgical scars can be cosmetically more embarrassing than the original condition with tell tale signs of the surgery

Surgery for gynecomastia

Surgical correction of Gynecomastia/ male breast is often called Gynecomastia Reduction Surgery (GRS). There are many methods for effective correction of this problem-

1.Chest liposuction +Minimal access gland excision for complete chest contouring (keyhole male breast reduction)

2.Direct excision using an incision around the areola

3.Liposuction and direct excision combined.

4.Liposuction combined with a breast lift procedure (for skin removal) in cases of large sagging male breasts..

Keyhole surgery for gynecomastia

Gynecomastia can be reduced by minimal access surgery in most cases using special instruments and modified technique of Liposuction. Excess fat on chest is removed by liposuction. Remaining tough gland tissue is then removed through tiny incision under areola. This results in adequate correction of chest shape. The scars are tiny and not easily visible in most cases. This method is better for Indian skin which is prone to have prominent scars. Hospital stay is not neccessary. Drains are not required when minimal access method is used. A custom made compression vest is put on immediately after surgery to reduce swelling and fluid collection.

In some cases of large male breasts with sagging of skin, two stage procedure may be required first removal of the gland and fat by keyhole surgery and few months later a skin tightening surgery. Sagging skin tightens up to a great extent in most people if elastic vest is worn for longer period. 99% of man boobs/ puffy nipples can be treated well by Minimal access surgery in Thrissur, Kerala..

Recovery after gynecomastia surgery

The surgery is performed as a day care procedure and you will be able to go back on the same day. A custom made corset will be put on immediately after surgery and should be continued for 6-12 weeks. Minor discomfort and soreness can be expected in the initial few days. Swelling in the operated area will be greatest in 48-72 hours and then will keep on reducing till 3-4 weeks after the surgery.

Numbness/ altered sensation on the chest can occur during the healing phase. You may resume light physical activities within 24 hours. Gym and other heavy workout should be withheld for at least a month after surgery. There is no effective medical management for gynecomastia.

Side effects of gynecomastia surgery

Usually a safer surgery, when done from a good centre.

Minor discomfort and soreness can be expected in the initial few days.

Swelling in the operated area will be greatest in 48-72 hours and then will keep on reducing till 3-4 weeks after the surgery.

Numbness/ altered sensation on the chest can occur during the healing phase.

Gynecomastia surgery Scars

Usually dont leave any visible scar. will be hidden in nonvisible regions like axilla

Does gynecomastia re occur?

The glandular tissue of male breasts does not form again and thus the surgery provides permanent removal of the breast tissue. However, if you put on a lot of weight, fat cells on the chest can enlarge and can cause fullness of the chest again (pseudo Gynecomastia)

Gynecomastia surgery cost in Kerala

The cost of gynecomastia surgery in Kerala can vary depending on the grade of gynecomastia. Total cost of treatment by Dr Prince at elite hospital can vary from INR 60,000- 140,000 as a day care procedure (USD 900-2500).