What is gynecomastia/ male reduction mammaplasty ?
Gynecomastia surgery is a surgical operation that is made to reduce the breast tissue of a man with female form of breast because of the abnormal growth and give a compatible appearance with the body by reshaping to achieve a male form of breast. Gynecomastia can occur due to hormonal, tumoral reasons or usage of different drugs. Gynecomastia caused by hormonal reasons is most common on newborns and teenagers and mostly temporary. But the excessive growth of
breasts that is seen in teenagers doesn't reduce at 30 percent of teenagers and becomes permanent. This effects these younger peoples lives negatively. They try to hide with loose outfits and by stooping; entering the sea or a pool becomes a nightmare for them. The hormonal drugs that some body builders use uncontrolled, are one of the reasons of abnormal breast growth on men. Hormones that are used to enhance muscle growth can cause permanent growth on mammarial glands and even cause lactating. The patients who present with complains of uni or bilateral abnormal breast growth, the type and severity of gynecomastia is assessed with imaging techniques and detailed examinations. Hormonal analyses also can be necessary. Gynecomastia if caused by abnormal glandular or fat tissue growth is determined by examinations. Staging is based on breast size and level of sagging concomitant to abnormal growth.
How is gynecomastia surgery done?
Gynecomastia surgery is done at operating conditions on hospitals under sedation or general anesthesia depending on stage of gynecomastia. If the gynecomastia caused by local fat build up, liposuction technique is used. If there is abnormal growth of breast tissue that can be palpated under nipples caused by different reasons exists, liposuction will not be enough on its own. After subcutaneous thickness of breast is reduced with liposuction and the desired contour of breast is achieved, a semilunar incision that will stay at the juncture of skin and areola is made. The excessive breast tissue is excised through this incision. Insicion line is sutured with self absorbable suture material. The excised breast tissue is sent for pathological examination. In patients with advanced stages of gynecomastia, sagging below the lower breast curve presents. And nipples can be bigger than normal. Especially with advances and widespread usage of bariatric surgery the number of people who lose high volumes of weight (over 20 kilograms) is increasing. During and after the process of these people losing high amounts of weight, sagging of the skin becomes inevitable. Severe breast sagging is seen in men. In correction of excessive skin on these types of gynecomastia patients, more detailed techniques are preferred. For correction of excessive skin and nipple; a circular incision is made that will stand at the juncture of skin and nipple and reaches from midpoint of nipple until lower breast curve. With this operation breasts are reshaped by removal of sagging breast tissue and elevation of nipples. Permanency of scars depends on the person’s genetic composition; for scars and breast to take their final shape takes about a year.
Patient is dressed with a corset and a bandage that covers thorax region after the surgery. If exicions are made from breast tissue, vacuumed pipe system called drainage tube is used to prevent the leakage build up in operation zone. Drainage is removed in three days depending on the outcoming leakage. Patient is discharged the same day or the next day with a prescription of antibiotic and a analgesic.
How is the postoperative phase of a gynecomastia surgery?
The patient is asked to wear the corset that has been dressed to him regularly for 4 weeks. It can be removed at nights if it discomforts too much. The swelling on the chest doesn't disappear and thorax doesn't take its shape before 6 months. Intense sportive activities, especially those based on heavy lifting by chest are not recommended before 8 weeks. Walking and swimming are permitted after 2 weeks.
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