Gynecomastia is an aesthetic and psychological problem especially in adolescents or in men who are unable to sculpt the male breast even after a lot of gymnastics.
It is a condition characterized by the development of breasts in humans. It can be unilateral or bilateral, symmetrical or asymmetrical. Normally, during puberty, there is also a development of the mammary gland in men which, around the age of 17, tends to shrink. When natural atrophy does not intervene, an increase in the volume of the breasts remains which has a high impact on an aesthetic, social and psychological level because it affects the image of man’s masculinity and virility.
Surgical therapy of gynecomastia consists in the removal of the excess mammary gland, excess adipose tissue (or localized fat) and, when necessary, excess skin.
Surgical intervention strategies differ according to the nature of the problem. Gynecomastia surgery can include the simple liposuction of fat through a small incision of a few millimeters, or the removal of the mammary gland through a periareolar incision (in the lower margin of the mammary areola) which will be practically invisible as it is performed exactly between areolar tissue and surrounding skin. Or, when the excess skin is such that it does not guarantee a good aesthetic result, the excess skin is also removed.
Who is the ideal candidate for gynecomastia?
There are no age limits to undergo this type of surgery, but it is preferable to wait until the pubertal phase is definitively concluded, therefore not before the age of 17.
What are the causes of male gynecomastia?
In 25% of cases the cause of gynecomastia is not identifiable. Gynecomastia can be caused by several factors such as: metabolic disorders, genetic pathologies, decreased testosterone, prolonged intake of certain drugs. This is the reason why patients suffering from gynecomastia require a careful physical examination and a scrupulous endocrinological examination.
How many types of gynecomastia are there?
Gynecomastia is defined as true gynecomastia when it is due to an excessive development of glandular tissue (overdeveloped male breasts).
False gynecomastia (also called adipomastia or pseudo-gynecomastia) occurs when the development of the gland concerns only the adipose tissue (gynecomastia due to obesity or to excess fat localized in the male pectoral area).
It is correct to speak of mixed gynecomastia when both the excessive development of glandular tissue and adipose tissue are present. Mixed gynecomastia is the most frequently encountered. Today, gynecomastia is a rather widespread phenomenon, especially as regards false gynecomastia due to dietary causes (incorrect diet) and lifestyle modifications (poor physical activity and too sedentary life) that can lead to obesity or localized fat accumulation in the pectoral area.
The preoperative visit for male breast reduction surgery
The diagnosis of gynecomastia is made with a specialist medical examination supplemented by an ultrasound, so as to evaluate the hypertrophy of the gland (i.e. the abnormal development of the male breast), the excess fat present in the pectoral area or the possible presence of both the conditions.
Anesthesia for gynecomastia
Based on the nature of the problem, it is possible to identify which anesthesia to use. In case of a simple excess of adipose tissue it is generally sufficient to perform a liposuction, which allows to intervene under local anesthesia.
In the case of an excess of glandular tissue, however, surgical removal of the mammary gland will be necessary with a day-hospital operation and under total anesthesia. Through a small incision in the lower part of the areola it will be possible to remove the glandular tissue and after a few days it will again be possible for the patient to resume all daily activities.