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Surgery

The severity of gynecomastia varies from a slight prominence in the breasts to a feminine appearance. This variability causes differences in surgical approach.

Gynecomastia can be divided into 3 types clinically:

Type  1: Minimal enlargement,  no excess skin.

Type  2: Moderate enlargement, with or without excess skin.

Type  3: Marked enlargement, excess skin.

TYPE 1

TYPE 2

TYPE 3

In Type 1 and Type 2 cases candidates for liposuction. The tissues are removed from 2-3 mm entry holes, by using thin cannulas. In cases where sufficient amount of tissue cannot be removed - especially those with excess fibro/glandular tissue endoscopy asissted techniques may be helpful. 

With the advent of modern Liposuction techniques, endoscopic techniques are rarely required today.

Drains are not used, recovery is fast without any scars.

Type 3 cases need skin and tissue removal. Scars are usually limited to the colored tissue (areola) of the breast. Scars overflowing on the chest may be necessary in sever Type 3 patients with feminine enlargement. Surgical approach is not different from breast reduction surgery in female patients. Drains may be required in Type 3 cases.

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Small blue marks are used for liposuction incisions. Red marks indicate areolar  cut incision for skin/gland removal.

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Inverted-T or Lollipop incisions may also be required in severe cases.

Depending on the technique used and the stage of gynecomastia, the duration of operation is 1 to 3 hours.

 

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