Gynaecomastia

Who needs surgery?

Only when there are lot of gland tissue and fat leading to a large breast tissue surgery is advised. There is also a situation where there is lots of fat accumulation happening mainly because of sedentary Lifestyle such as taking lot of junk foods and no exercises. This condition is call as pseudo-gynecomastia.

What is pseudo gynaecomastia( lipomastia)?

A condition where the reason for male  breast enlargement is only fat and not glandular tissue. ‘Pseudo’ meaning false , in actual it is not the regular gynaecomastia .If this is the condition you are suffering with that you don’t have to concerned a lot. As these fat can come down with  your regular exercise and dieting.

How do I know whether I have gynaecomastia or pseudo gynaecomastia?

Simple clinical examination by your surgeon will help in knowing the condition.

There are no requirement for scanning tests and bloods for knowing the pseudogynaecomastia .

What are the causes for gynecomastia?

1. Hormonal changes, estrogen surges that happens during the puberty
2. Obesity
3. Medications
4. Liver or renal diseases, rarely.

What are the grades of gynecomastia?

Grades of gynaecomastia mean the stage of your disease. It simply it reflects the type of surgery plan needed. Grades of gyanecomastia are decided on the size and volume of the glandular and fat component . most important the skin that is hanging and excess .

Classification and grades of severity of gynecomastia,

Grade I: Minimal hypertrophy (<250 g) without ptosis. 

Grade II: Moderate hypertrophy (250-500 g) without ptosis. 

Grade III: Severe hypertrophy (>500 g) with grade I ptosis. 

Grade IV: Severe hypertrophy with grade II or grade III ptosis.

What is the solution for gynaecomastia?

Once gynaecomastia diagnosis is established the only solution to this is surgery.

Nevertheless, there is very little reason to fear as surgery is simple and less complication.

It is done with liposuction , a surgery know as keyhole , where we create small how on the skin and with special instruments we remove the fat,  for the removal of the glandular tissue we might open up in the region of areola, the black colored skin surrounding the nipple.

Will I get  a scar after gynaecomastia surgery ?

No, as we are doing liposuction using only a 5 mm cuts there will not any obvious scars . moreover , as we are making cuts through the areola region even that is inconspicuous.

What are the chances of gynaecomastia coming back after the surgery?

Nil, once the glandular tissues are removed it will not come back. Even as we are removing the fat cells the chances of fat accumulation again are very little.

So you don’t have to worry of it coming back.

How is the surgery done?

It is usually a day care surgery, meaning you can come in the morning and go back in the evening in the same day. The surgery begins with anesthesia , which is usually a sedation anesthesia.

Sedation anesthesia is a simple and effective to make you sleep. You will not sense any pain during the anesthesia , After the procedure, you will not have any troubles of general anesthesia ( which involve putting a tube in your wind pipe) such as throat pain, nausea ,vomiting and dizziness.

We make small cuts on the skin and inject tumescent fluid , which helps in fat break down. After that using liposuction machine we remove the fat cells.

Following which the glands remanants will be removed through a small incision over the areola ( black skin surrounding the nipple) . Suturing will done to close the wounds.

What happens after surgery?

1. Some pain is present for initially 1 to 2 days , easily managed with medicines
2. There will some bruising and swelling in the place of surgery
3. There might be some fluid coming out from the liposuction site and these will normally settle in one day 

Post operative care after gynaecomasia,

1. Wear compression garments , which have to fitting and comfortable. it has to be worn 24x 7 during the initial days for 2 weeks. In most cases we advise you to wear for 4 to 6   weeks.
2. You should me moving around the next day to keep your bloods from leg not getting stagnant
3. Take adequate rest and water
4. You can resume normal diet the same day however, avoid masala and spices as it may cause irritations
5. Take your medication on time.
6. Must follow up the appointments with the doctor in order to avoid possible aberrations.

What is the complication of gynecomastia surgery?

It is considered as one of the safest surgeries how ever there are some unlikely things that could happen.

1. Collection of blood in the operated area ,hematoma.
2. Collection of fluid in the operated area, seroma.
3. Uneven surfaces
4. Asymmetry
5. Feeling of numbness

However, these could be avoided if proper protocols are followed.

When to contact doctor emergency?

1.Increasing pain the region

2.Increasing swelling in the region

3.Excessive bruising

4.Fever and redness in the region.

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