Gynecomastia is a condition of enlarged breasts in men. It may be because of the hormonal changes or weight gain. It can occur on any age. At times it is caused by certain medicine.
Apart from physical deformity, it can cause psychological problems and low self esteem to the affected patient. You may feel shy in going for activities like swimming.
Gynecomastia consists of:
- Excess fat OR
- Excess Breast glands or both
- If the size is too big, there may be extra skin also
It can be one sided (unilateral) or both sided (bilateral)
When is the Surgery done? :
It can be done at any age. The man with good elasticity of the skin and one who is otherwise in good health is a good candidate. When the primary cause of the condition is known, attempts are directed to remove that first, like, stopping the drug responsible for it. If the enlargement of the breast does not decrease even after that, the surgery may be considered.
What type of anesthesia ? :
It may be done under general anesthesia or local anesthesia combined with sedation, depending upon level of cooperation and medical condition of the patient.
What does the doctor do in operation?
If the Gynecomastia is primarily due to excess fat, the surgeon selects liposuction for its removal. Here a small incision is given around the areola and a small tube connected to a vacuum pump is passed under the skin. With in and out movement of the tube, fat is sucked out.
If the condition is because of excess glandular tissue, the surgeon removes it by giving a cut around the areola and removing glandular tissue. Sometimes the enlargement is due both to fat and gland. Under these circumstances, the doctor does liposuction followed by excision of the gland tissue.
Very rarely the enlargement is such that it requires removal of skin also.
The operation lasts for about 2 hours(both sides). A confirming dressing is generally given.
What is the course after operation?
Most of the patients can walk around few hours after surgery. Most of them are allowed to go home same day. There will be mild pain and discomfort t in the treated area. These can be controlled with medication. The person can go to school or work in about 3 to 5 days time. The dressing will be removed after a week. Stitches are of self dissolving type.
For first few days, there is significant swelling in the area and the result of the surgery might not be appreciated. This however, decreases with time. The scar is visible initially but fades gradually.
The patient is advised to avoid for 3 to 4 weeks, heavy exercises and contact sports likely to injure area of surgery.
What are the complications ?
Collection of Blood under the skin : This usually dissolves on its own or it may have to be removed by puncturing it with a needle.
Infection: Infection is treated either with antibiotics or it may require an incision for removal of collection. In case of infection there may be an excess scar formation.
It is to be noted that all these complications are uncommon and not all the complication would occur in a given patient.