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Surgeries

Gynecomastia

Many men suffer from the condition known as gynecomastia. This is a benign one or two-sided enlargement of male breast tissue and/or the mammary gland. It is not always clear what causes it. However, certain medications or the excessive use of anabolic steroids, cannabis and alcohol can be responsible for their emergence. Gynecomastia is not considered to be an illness in itself, but as a symptom that can indicate a hormonal disturbance. In contrast, pseudogynecomastia has no additional clinical significance.

Experts estimate that half of all men develop gynecomastia. For many, male breast development has a negative effect on their self-confidence, particularly if the disorder cannot be successfully managed with targeted nutrition or exercise. In such cases, breast reduction and/or gynecomastia treatment can help.

Indications

In the case of gynecomastia, special treatment can be used to reduce the breast and improve its appearance. This results in a smaller and manlier breast, which most treated men are very happy with and is usually enduring. In very rare cases the mammary glands may become enlarged again.

Gynecomastia treatment methods

There are currently two fundamental therapy methods for gynecomastia, one of which is liposuction. This method usually achieves very good results on very fatty breast tissue, leaving barely visible suture marks on the skin around the nipples and armpits. The doctor extracts the excess fat and gland tissue from the breast area using a narrow tube. Liposuction can be carried out under local anaesthetic on an outpatient basis. If the patient only has a local anaesthetic, he is given an additional sedative either in the form of a tablet or as an intravenous injection to induce a kind of twilight sleep. So although the patient is awake, he is not sensitive to pain.

For men with a significantly enlarged breast, the excess gland tissue is usually removed directly. It may sometimes be necessary to remove excess skin. In these cases a small incision is made at the edge of the nipple.

For liposuction, it is occasionally necessary to remove excess tissue. However, this is only required if the skin does not contract to the expected extent.

Before the treatment

Particularly for problems occurring only on one side, a urological examination of the testes and breast should be carried out before treatment. The lungs are also x-rayed, and the breast and upper body are examined using ultrasound. However, breast cancer screening is rare. As a routine, a blood sample is taken in order to ascertain hormone levels and provide a liver count.

Gynecomastia surgery

If the gynecomastia is caused by severely increased mammary gland tissue, this is usually removed directly through an entry in or on the edge of the nipple. Excess fat and, if necessary, excess skin are also removed in connection with this procedure. Liposuction can then also be performed in order to contour the breast. The liposuction tubes are usually inserted through the incisions that have already been made, or into the area to the side of the lower breast crease, and/or in the armpit.

If the disorder consists primarily of excess fatty tissue, this is normally remedied exclusively using liposuction. The liposuction tubes are positioned in the areas of the body mentioned above. In a few cases, tightening of the breast skin is required after the breast reduction in order to achieve an adequate result.

After the treatment

An elastic compression dressing is usually applied during the procedure. This should then be worn constantly for two weeks after the treatment. This is the only way in which to provide optimum support for reduction of the swelling, wound healing and skin contraction.

Light physical activity can usually be resumed after just a few days. Experience has shown that the breast area feels somewhat unusual during this time. Patients whose work primarily involves being seated can usually return to work after three to seven days. Physically strenuous activities should be avoided for two to three weeks. In order to prevent pigment disorders, the patient should avoid exposing the breast area to direct sunlight during the first six months. Sporting activities (in particular lifting, pulling and pushing) should be avoided for two weeks.

Risks & side effects

Overall, breast reduction has few complications and can be performed with a high degree of efficiency and safety. In spite of the great care taken, in isolated cases the procedure can lead to scar formation, discolouration of the skin in the breast area, raised areas on the breast or asymmetry of the nipples. However, these undesirable changes can usually be evened out by special follow-up treatment

Residual swelling in the breast area is relatively frequent but normally subsides again after approximately three to six mont