What does gynecomastia consist of?
Gynecomastia is a process by which the male breast is enlarged. This increase in size generally occurs at the expense of the mammary gland, although sometimes it can also occur due to an increase in fatty tissue.
Why does this enlargement occur?
The increase in the size of the breasts in the male can be produced by multiple causes although most often it is idiopathic in nature, i.e., of unknown cause. In most males there is an increase in glandular size during adolescence, which eventually disappears a few months later, but in up to 10% of males the mammary gland may remain without involution.
In other cases we can also find that this increase in breast size occurs at the expense of fatty tissue. This may be more frequent in patients who have had a significant weight loss and whose fat has remained residual in the breast without disappearing concomitantly with that weight loss.
It is also common in our environment to observe an increase in the size of the breasts in those males who have consumed steroids or anabolic agents for muscle development, which can secondarily lead to the growth of the mammary gland. It has also been seen that this growth is related to the consumption of certain drugs.
What does a gynecomastia operation consist of?
The intervention of gynecomastia will basically depend on which tissue has predominantly increased in size in the male breast. In cases where patients have an enlarged gland, a small incision is usually made at the lower edge of the areola through which we perform the removal of the excess gland. In those patients where the predominance of tissue augmentation is fatty we will perform liposuction. However, most patients have a mixed component in gynecomastia, both glandular and fatty, so the most commonly used technique is the combined technique of mastectomy and liposuction.
When we perform only liposuction, the procedure can be performed on an outpatient basis under local anesthesia and sedation. However, when we perform a glandulectomy, or subcutaneous mastectomy -associated or not to liposuction- it is recommended that the intervention is performed under general anesthesia and at least one night of admission. In these cases a small drain is usually placed in the residual cavity after the glandulectomy, which is generally removed after 24 to 48 hours. And subsequently in any of the procedures, either mastectomy or liposuction, the patient must wear a pressotherapy garment to promote the reabsorption of edema, inflammation and a better result thanks to the retraction of the skin for about a month.
Which patient is suitable for this procedure?
In general, the patient who will benefit most from this type of intervention is usually a young patient whose skin retraction capacity is preserved and who will be able to obtain better results with both subcutaneous mastectomy and liposuction. In patients who have suffered a significant weight loss, they will experience a significant improvement in the appearance of their breasts but in many cases auxiliary procedures are necessary to obtain a good result because this skin has lost retraction capacity and sometimes it is necessary to carry out other techniques involving the reshaping of the breast.