Gynecomastia

A gynecomastia is defined by an increase in the volume of the mammary gland in men.
It corresponds to uni- or bilateral hyperplasia. Generally it is idiopathic, i. e. there is no cause for its occurrence; however, in some cases it may be related to abnormal hormone production, or related to the use of certain drugs. A check-up is necessary to eliminate a possible cause. The purpose of this assessment will be to measure the various known hormones, to look for a testicular or pituitary tumour. A mammogram or ultrasound may be requested to analyze the density of the gland, or to rule out breast cancer in older men, especially in cases of unilateral form. If a cause is found, it will have to be specifically treated. Indeed, when an etiology is found, its treatment can allow a more or less complete regression of the gynecomastia.
Breast augmentation in men, especially during adolescence, is often poorly experienced and can cause many psychological problems. This physical attack on the adolescent, at the very moment when he is building his male image, can lead to a withdrawal into himself or even a real complex. In addition, this gynecomastia can be painful.
From an anatomical and physiopathological point of view, the mammary gland exists in normal men, but it is of the infantile type, reduced to a simple breast bud. In some cases, this mammary gland may develop if the hormonal environment is favourable.
When no cause has been found and the patient is embarrassed, surgery may be proposed, provided the patient is in good physical and mental condition. This type of intervention is called a "gynecomastia cure".

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The assessment in search of a cause for gynecomastia has been mentioned above.
In obese or overweight men, a diet combined with physical exercise is introduced because weight loss can reduce or even eliminate gynecomastia (adipomastia). Depending on the anatomical context, the surgeon's preferences and habits, and the wishes expressed by the patient, an operating strategy will have been decided. This will determine the surgical technique used and the location of the scars.
A regular preoperative check-up is carried out in accordance with the instructions. The anaesthetist will be seen in consultation, at the latest 48 hours before the operation. Your surgeon and anesthesiologist should be kept informed of all medications you are taking. Indeed, some of them may interfere with the anesthesia or promote bleeding.
Except in special cases, no medication containing aspirin or anti-inflammatory drugs should be taken within ten days of the operation.
In order to promote recovery, it is advisable to stop smoking and reduce alcohol consumption.
Type of anesthesia: This is usually a classic general anesthesia, during which you sleep completely.
In some cases, however, a "vigilant" anaesthesia (deep local anaesthesia with intravenous tranquilizers) or even a simple local anaesthesia may be used.
Hospitalization conditions: The operation is most often performed on an outpatient basis, i.e. with a discharge on the same day after a few hours of supervision. However, a 24-hour or even 48-hour hospital stay is sometimes desirable. The length of hospitalization actually depends on the surgical technique used. Indeed, a simple liposuction will require a shorter hospital stay than a subcutaneous mastectomy.

Each surgeon adopts a technique that is unique to him/her and that he/she adapts to each case to obtain the best results. However, common basic principles can be retained.
In the typical procedure, an incision is made at the lower edge of the areola. From this incision, the surgeon can remove the excess breast gland and fat. Often in addition to this procedure, the surgeon can perform liposuction at the periphery of the excess glandular tissue in order to harmonize the whole and promote skin retraction.
In the case of gynecomastia with a predominant fat content, excision can sometimes be performed by liposuction alone. The scars are then very short and can be located at a distance from the gynecomastia, such as in the sub-mammary or axillary regions.
When gynecomastia and excess skin are very important, the surgeon may have to make longer and therefore more visible scars. These scars can then be around the areola, horizontal and extend on either side of the areola. In extreme cases, the surgeon may have to graft the areola and nipple. Other types of scars are possible (vertical, racket tail…), they depend on each particular case.
During the procedure, a drain can be set up depending on the technique used and the surgeon's habits. This drain is used to remove blood and lymphatic residues that may accumulate at the surgical site.
At the end of the operation, a "shaping" bandage is applied, often with an elastic bandage.
The duration of the operation varies according to the surgeon and the technique used, ranging from a few minutes in the case of isolated liposuction to two hours for complex forms requiring a major reduction.

The after-effects of surgery can sometimes be painful in the first few days. An analgesic treatment, adapted to the intensity of the pain, will be prescribed for a few days. In the case of isolated liposuction, the patient may experience local pain of the type of "severe aches and pains".
Edema (swelling), bruising and discomfort when lifting the arms are common in the early stages.
The first bandage is removed after a few days. It is then replaced by a lighter bandage. Often, the initial bandage is compressive, then quickly a lighter one is associated with a "bolero" or a compression vest to wear day and night for a period of time. This restraint helps skin retraction and promotes uniform healing.
The total duration of work interruption varies from five to twenty-one days. It is advisable to wait one to two months before resuming a sporting activity.

About Gynecomastia

The improvement is often clear and immediate. However, a period of two to three months is necessary to assess the final result. This is the time required for the post-operative edema to disappear and the excess skin to retract. After this period, the tissues will gradually become more supple.
The reduction in breast volume provides physical comfort, especially for clothing. Finally, the result is often very beneficial from a psychological point of view because a gynecomastia is often considered as a shadow of virility.
By choosing a MEDICAIM qualified Plastic Surgeon trained in this type of operation, you limit these risks as much as possible, but do not completely eliminate them.
MEDICAIM is looking for the best specialists for you and we will offer you several renowned doctors.
MEDICAIM organizes your entire stay for you: post-operative nursing care, biological follow-up, therapeutic, nutritional and psychological support.