Gynecomastia
It is one of the most popular surgeries in the male population. It is characterized as a benign hypertrophy of fat and the mammary gland in men. It affects a significant percentage of the male population and usually involves both breasts, acting negatively on the individual’s psychology, causing reduced self-esteem.
Its etiology may be due to hormonal disorders, genetic predisposition or other diseases or to the use of pharmaceutical substances. The main cause is excess estrogen and reduced circulating androgens (testosterone), or increased sensitivity of the breast to estrogen levels.
A special type of gynecomastia is pseudogynecomastia (lipomastia), which is characterized by excessive fat accumulation in the male breast without hypertrophy of the gland.
In most cases, gynecomastia is considered idiopathic (of unknown cause), without a pathological basis.
(Neonatal gynecomastia) is due to a hormonal disorder of circulating estrogens within the placenta which resolves and does not require any treatment.
Puberty and adult gynecomastia are mainly due to hormonal imbalance, due to the predominance of female hormones (estrogen) over male hormones (testosterone). Depending on its characteristics, it may subside significantly after 3-18 months.
The treatment of gynecomastia is etiological and is treated either pharmacologically when it is due to hormonal and endocrine causes, or surgically.
Neonatal gynecomastia does not require treatment because in most cases it resolves.
In adolescent gynecomastia, we need to wait because in most cases it shows signs of regression. If it remains stable for two years, then it is permanent and requires surgical treatment. Gynecomastia should be treated from the age of 18.
In adults with gynecomastia, surgical treatment is the only effective treatment method.
It is important to investigate the etiology and rule out male breast cancer with hormonal testing and imaging tests, such as mammography and breast ultrasound.
The grading of gynecomastia determines how it is treated, depending on the amount of excess fat and the hypertrophy of the gland.
The goal of surgical treatment is to remove excess fat and the mammary gland and shape the breast according to the male model.
The surgery lasts from 45 minutes to 2 hours depending on the size of the problem and is performed under general anesthesia or a combination of local anesthesia and sedation.
If gynecomastia mainly concerns fat, the VASER ultrasound liposuction technique is ideal, as it allows for its correction without incisions.
If it also involves an oversized mammary gland, then VASER liposuction is used in combination with subcutaneous mastectomy of the gland through a small peri-papillary incision.
In rare cases with significant sagging and drooping of the skin (4th degree gynecomastia), restoration of excess skin with breast lift techniques (mastopexy) is also required.
Gynecomastia does not require hospitalization and the patient leaves the clinic 4-5 hours after surgery, wearing a special elastic vest with graduated pressure for 3-4 weeks, following the postoperative instructions at home.
Swelling and bruising gradually subside after one week. Patients can return to their professional activities 4-7 days after the procedure as long as they do not involve intense physical exertion.
Return to sports activities is recommended after one month.
Although rare, they do exist and the possibility of their occurrence will be discussed during the visit. These include hematoma, wound infection, asymmetry, nipple hypoesthesia, and nipple necrosis.
It is one of the procedures with the highest degree of satisfaction.
The results are permanent and impressive and the patient is freed from the problem of gynecomastia, boosting his self-confidence.
