Gynecomastia is the condition of having excessively enlarged or enlarged breasts similar to female breasts, which often occurs during puberty in men, but can occur at any age.
This may be due to hormonal changes, after the use of certain medications, or due to heredity or obesity.
Gynecomastia can cause emotional discomfort and destroy individuals' self-confidence. Some men may avoid wearing revealing clothes, physical activities that reveal their breasts, or even sexual intimacy to hide their situation. Patients may be ashamed to wear a t-shirt and swim in the sea and pool in summer. Some patients walk and sit with their breasts stretched to hide the size of their breasts.
Gynecomastia surgery can be performed with the liposuction method, or in addition to liposuction, devices such as laser or vaser (ultrasonic-based fat breakdown) can be used. Open surgery technique is used in patients who find hard tissues in the breasts that cannot be removed with liposuction. Excess skin should also be removed in patients with excess skin tissue or sagging chest.
A patient with gynecomastia has excess fatty tissue, mammary glands (glands) in the breast area. In some patients, excessive excess and sagging of the chest skin can also be observed. Although it can be seen unilaterally in some patients, it is usually seen in both breasts.
What does gynecomastia surgery provide?
Gynecomastia surgery reduces breast size in men, straightens the chest lines and gives a masculine appearance. In severe cases of gynecomastia, the excess weight of breast tissue can cause the breasts to sag and the nipple to appear enlarged. In these cases, the position and size of the nipple is surgically improved and excess skin is reduced.
Who are good candidates for gynecomastia surgery?
Candidates for gynecomastia surgery include:
- Patients without a hormonal disease
- Healthy individuals who do not have a life-threatening illness or health condition that may impair wound healing
- Non-smokers and drug users
- Men with a positive outlook for improving the physical symptoms of gynecomastia
- Men with real expectations
- Men whose breast development has ceased
- Men who are uncomfortable with the feeling that their breasts are too big
Adolescents may benefit from surgery, but secondary procedures may be needed in the future if breast development continues.
What is the cost of gynecomastia surgery?
The cost of gynecomastia surgery can be very variable. Cost determining factors are:
- Anesthesia fees (general or local)
- Fee of the hospital where the surgery will be performed
- medical tests
- Devices to be used in surgery (vaser or laser)
- Presence of excess skin in the patient – grade of gynecomastia
- Corsets to be used after surgery
- Medications prescribed after surgery
- Geographical location of the surgeon's office
- The fee that the surgeon sets for himself for this surgery
Your health and satisfaction are more important than a fee. When choosing a plastic surgeon for gynecomastia surgery in your area, remember that the surgeon's experience and being able to agree with your surgeon are as important as the final cost.
What should I talk about when I come to be examined for gynecomastia surgery?
When you come to the examination for gynecomastia surgery, you should discuss the following issues with your surgeon,
Your expectations from the surgery
- Your general health, any drug allergies, and any medical treatments you have had
- Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use (including steroids)
- Previous surgeries
- What are the risk factors?
- What are the diagnostic tests to determine the underlying cause of gynecomastia? This may include testing of endocrine function
- Discuss the possible outcomes of gynecomastia correction and any possible risks or complications.
- Ask about your options for surgical technique
In addition, your breasts will be examined during this examination. It can take detailed measurements of its size and shape, skin quality and nipple placement. Your photo will be taken for your medical records.
When you come for the examination, it is time to ask your plastic surgeon questions. To assist you, I have prepared a list of questions you can ask your Aesthetic Surgeon during the examination. You can use this list.
It is very important to understand all aspects of your surgical procedure. It's natural to be worried about your new appearance, or to be stressed and excited before surgery. Do not hesitate to discuss all your concerns with your plastic surgeon
What Are The Risks Of Gynecomastia Surgery?
The decision to undergo a plastic surgery operation is extremely personal? You will need to decide whether the benefits of the surgery will meet your expectations and whether the risks and potential complications of gynecomastia surgery are acceptable.
You will be asked to sign consent forms to make sure you fully understand the procedure, risks and potential complications.
The risks of gynecomastia surgery are:
- Allergic reaction to tape, sutures, creams, or other medications
- Anesthesia risk
- Blood and fluid accumulation in the surgery area (hematoma – seroma)
- Breast asymmetry
- Chest circumference and shape irregularities
- Changes in nipple or breast sensation (may be temporary or permanent)
- Coagulation in the foot veins and its complications
- Excessive loss of adipose tissue in the breast (fat necrosis)
- Poor wound healing
- Possibility of revision surgery
- Negative scar
All these risks are seen with low probability. It is important that you speak directly to us with your questions regarding these.
How Should I Prepare For Gynecomastia Surgery?
You will be asked for gynecomastia surgery,
- Laboratory tests and preoperative evaluation by the anesthesiologist
- If there are any medications you use, they will be adjusted before the surgery.
- Starting 1 week before the surgery and quitting smoking until 1 week after the surgery.
- Avoid using aspirin, some pain relievers and herbal supplements as they can increase bleeding.
How is gynecomastia surgery performed?
The stages of a gynecomastia surgery are;
Anesthesia will be applied so that you do not feel pain during surgical procedures. The most common anesthesia options are intravenous sedation and general anesthesia. In patients with small breasts, surgery can also be performed with local anesthesia (regional numbing).
In most cases, gynecomastia can be corrected with liposuction techniques. During liposuction, a few small incisions are made and a cannula is sent under the skin and the adipose tissue is taken out of the body through this cannula. The cannula is moved back and forth in a controlled manner to remove excess fat, at the same time the adipose tissue is removed from the body with the applied vacuum.
Laser or vaser application
Other techniques such as laser or vaser can be used with liposuction. In these techniques, laser or vaser is applied before liposuction and the fat tissue is melted. Then, liposuction is performed to remove the fragmented adipose tissue. In both laser lipolysis and vaser technique, it is possible to tighten the skin without making an extra incision on the skin. The use of laser or vaser provides more aesthetic results in patients with a small amount of excess or slight sagging on the breast skin.
If there are hard tissues called fibrotic bands in the breast, open technique can be applied. Before the open technique, liposuction is performed again. Fat tissue is removed from the breast. Then, an incision of 1-1.5 cm is made from the nipple to remove other tissues in the breast, and the tissues that are not removed by liposuction are removed from this incision. Since the incision is made between the brown and white skin of the nipple, there is no obvious scar after the operation.
Skin excision techniques are recommended to correct gynecomastia in patients with excess skin. With this surgery, excess skin tissue is removed. The sagging nipple is lifted to its anatomical place. The incision shape varies depending on the patient-specific conditions and the surgeon's preferences. In this surgery, there will be a scar of varying length and shape on the breast, depending on the skin removal technique.
What awaits me during the recovery period after gynecomastia surgery?
Dressing will be applied to the suture areas during the recovery period. An elastic bandage or support garment will be used to minimize swelling (oedema) and support the new chest contour.
A small tube (drain) may be temporarily placed under the skin during surgery to drain any excess blood or fluid that may accumulate.
It is very important to follow your plastic surgeon's instructions and attend checkups as scheduled.
The results of gynecomastia surgery are permanent. However, if the Gynecomastia is due to the use of drugs such as Steroids or weight gain, you need to stop these drugs and stay at a stable weight for the results to be permanent.
Discuss this with your doctor before making changes to your prescription medications.
What should I pay attention to at home after discharge?
It is necessary for the success of your surgery to follow the instructions given by your doctor regarding the dressing, the use of the clothes to be used after the surgery, taking the prescribed medications and coming to the control examinations.
It is important that surgical incision sites are not subjected to excessive force, swelling, abrasion or movement during healing. Your doctor will give you specific instructions on how to care for yourself.
What kind of results should I expect after gynecomastia surgery?
The results of gynecomastia surgery can be seen immediately. Over time, post-operative swelling improves and the incision lines fade. The final results of your gynecomastia surgery show themselves in 3-6 months. The scars on the incision lines will fade over time and become less visible.