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Gynecomastia Liposuction – General Knowledge and Tips

Updated on July 25, 2010

Gynecomastia is the unusual enlargement of breast among in males. Extra fat stored on the chest not only affects the physical appearance of men, but also to brings stresses, especially to adolescent boys. The best treatment of gynecomastia is liposuction, which is a simple cosmetic surgery that removes excess fat from the chest and reshapes your chest image immediately. The treatment has satisfactory efficacy and few complications, it is gaining popularity in recent years around the world.

Some knowledge on Gynecomastia

Male breast hypertrophy, also known as gynecomastia, is manifested as unilateral or bilateral breast hypertrophy. Men with gynecomastia have unusual enlargements of their breasts, some even have breast shape that is similar to adolescent girls. Usually, there is normal development of nipple and areola in people with gynecomastia, except that when touched, a compact mass can be found under areola skin, with a certain degree of movement and less adhesion when pressed. A small number of patients have pain or mild tenderness, very few may have nipple discharge. On a few occasions, the mass is not located in the center of the breast, but in other places such as upper breast. Gynecomastia is a common type of disease with high incidence rate, studies have shown that it has an incidence rate of up to 68% in adolescent boys and about 58% in men over age 50. Gynecomastia is found in almost any age group, the age of onset can be from 6 to 85 years old, and there is no significant difference in the incidence rates between left and right breast. Unilateral breast enlargement is more common than bilateral case.

Gynecomastia can occur at different times, in different age groups and from different incentives. Adolescent male usually has areolar uplift and a subcutaneous mass that has clear boundary and flexible texture, with light tenderness. Normally the symptoms will subside naturally within a certain period of time. Gynecomastia in old men often occurs of undetermined origin, with unilateral nipple pains, some may have bilateral nipple pains. Under the areola there is a compact mass generally 2 to 4 cm in diameter, accompanied by mild tenderness. A small number of patients have bilateral symmetrical hypertrophy and no significant compact mass under the skin. Some may have fluids secreted from the nipples when pressed and areola pigmentation. Liposuction is the best solution for age groups, it helps to remove excess fat from the chest.

Causes of gynecomastia

Gynecomastia can be divided into two types, that is, primary gynecomastia and secondary gynecomastia. Primary gynecomastia, caused by endocrine disorders, is more common in children and adolescent male. The disease is often due to the physiological endocrine disorder. For example, estradiol level is higher than testosterone in plasma, resulting in disorder of estrogen and androgen ratio, this in turn causes gynecomastia. Or patient’s breast tissue has an increased sensitivity to estrogen. Secondary gynecomastia is usually caused by diseases such as gonadal dysfunction, testicular tumors, hyperthyroidism, or taking certain drugs for a long time. Diseases that cause gynecomastia are listed below:

  • Testicular failure may result gynecomastia, this is often seen in patients in estrogen treatment;
  • Liver dysfunction may also lead to breast enlargement due to decreased function of estrogen inactivation;
  • Adrenal disease, pituitary disease, cancer and emphysema can cause breast development;
  • Long-term application of spironolactone, isoniazid and other drugs, can cause male breast enlargement, however, it is self-healing after drug withdrawal.

Liposuction is also the perfect solution for all types of gynecomastia, usually, extra body fat was removed from the breast using a cannula.

Gynecomastia liposuction

Liposuction is a surgical correction used mainly on those who have apparent breast enlargements to help them reshape their body and regain self-confidences. However, there is no need to rush to the treatment because generally the disease has a self-healing characteristic, especially in adolescent boys.

However, for those who suffer from large breasts with no retractions, liposuction is the best choice. Situations such as apparent pains, failure of medical therapy, or significant fat stored on the breast, can only be improved by surgery. If the mass in the breast is smaller or the patient has large breasts but no skin sagging in the chest, treatment usually focuses on the removal of excess breast tissues through a curved incision around areola. For those with obvious breast hypertrophy and severe breast skin sagging, surgery often focuses on removing the loose skin and its surrounding tissues.

Liposuction is recommended to the following cases: the breast diameter exceeds 4 cm or apparent physical changes of the chest, or failure of drug treatment. The surgery is done under local anesthesia, in the procedure of the operation, doctors will cut a small incision under the breast, then insert a cannula into the incision to suction out breast tissue through negative pressure. Pathological examination reveals that the aspirates contains fat tissue and fibrous tissue, which proves the effectiveness of the surgery.

Examination before liposuction

Patients should be checked before the surgery the texture of their breast, because soft adipose tissue, which usually happens among the elderly or obese patients, is relatively easy to be suctioned. On the other hand, patients whose breasts have compact textures are usually due to breast tissue hyperplasia, which is harder to be suctioned, the liposuction is more demanding on the skills of the doctors, and sometimes it needs tissue excisions.

During the examination, patients are asked to stand straight, doctors will pinch test to check the thickness of breast tissue. Patients are also asked to lift their arms high because this helps to offset the impact of subcutaneous fat stored in the underarm skin, and helps the doctors to accurately calculate the thickness of breast tissue to determine the suction range, then contour line is drawn around the breast to guide the operation and determine the suction volume of different parts. Patient with mild gynecomastia only needs to have liposuction around areola gland and its surrounding tissue, patient with mild moderate should have suction under the breast in a 10 cm range all over the chest, and further expansion is needed for those with severe gynecomastia.

Possible complications of gynecomastia liposuction

  • Surgical complications that may occur include:
  • nipple retraction
  • nipple necrosis
  • dissatisfactory appearance
  • obvious scar
  • remaining excess skin
  • mastectomy is not sufficient
  • breast asymmetry
  • hematoma and fluid accumulation
  • infection

Most of the above complications are very rare, and can be prevented beforehand. Nipple retraction prevention measures include: retention of tissue tick enough on the nipple and areola, if enough skin corium is retained it is almost impossible for nipple necrosis to happen. Breast asymmetry can be prevented by thorough preoperative examinations and accurate contour line drawing. To prevent hematoma and effusion, negative pressure drainage equipment can be placed in the operation. Scars after gynecomastia liposuction will usually diminish after six months or one year, or scaraway products can be used to facilitate the recovery process. Sterile operation condition is the key to prevent infection.

For patients with mild to moderate gynecomastia, liposuction alone can be used to obtain great results, however, patients with severe gynecomastia, semi-circular incision and breast tissue excision will be needed along with liposuction. Adolescent patients with gynecomastia are recommended to be observed for at least 3 years before taking liposuction, because the disease has a self-healing tendency.


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