Gynecomastia is characterized by hypertrophy which means increment of glandular and/or adipose tissue, on one or both sides. Aesthetic correction of gynecomastia is one of most wanted procedures both with younger and older men.

With this surgery, swollen glandular tissue, adipose tissue or even both, are removed (depending on the type of gynecomastia).

We differentiate three types of gynecomastia:

1. False type, which is actually pure adipose tissue, but is aligned into the group of gynecomastia problems
2. Real tip, or glandular tissue hypertrophy which manifests through appearance of so called “glandular tiles” in the chest area
3. Mixed type, where there exists hypertrophy of glandular and adipose tissue

Hypertrophy of male breast can already appear in new-born age, later during puberty or during adulthood. There is a variety of different causes which can be divided into:

• Idiopathic (the reason is unknown)
• Endocrine (disfunction of hormones)
• Tumor (tumors which produce hormones)
• System disorders (e.g. liver cirrhosis)
• Gynecomastia caused by medicines
• Gynecomastia due to weight gain

CANDIDAES FOR THE PROCEDURE

With all the types od gynecomastia there is a need for plastic surgery of reducing male breasts and it can be divided into the following groups:

1. With pure, adipose hypertrophy of a mild extent (false type)- it is being corrected through an aspiration of adipose tissue
2. Pure hypertrophy of glandular tissue (real type) – it is corrected through a surgical procedure of glandular tissue removal
3. With hypertrophy of both glandular and adipose tissue (mixed type)- it is corrected through an aspiration of adipose tissue and resection of glandular tissue
4. With hypertrophy that has come to a higher extent, together with drooping male breast that are lowered for more than 2 cm- it is corrected through an aspiration of adipose tissue and skin surplus reduction

Before the procedure itself, it is necessary to identify the causes of gynecomastia, which sometimes includes analysis from more medical fields. All the necessary information you are going to get after the consultation with our surgeon.

PREPARATION FOR THE PROCEDURE

It is possible to notice the difference between hypertrophy of glandular tissue and adipose tissue accumulation already during clinical examinations. Those examinations should be complemented with the with an ultrasound of a chest area. Tissue with glandular hypertrophy is firm, irregular and sometimes even painful when you touch it. With adipose tissue hypertrophy, the tissue is soft and it is usually painless. After confirmed diagnosis and decision regarding the procedure, we are going to choose the most suitable surgical approach to treat your gynecomastia.

With previously described examinations that are sometimes necessary, for the gynecomastia corrective procedure, standard blood tests are required: complete blood count, erythrocyte sedimentation rate, coagulogram, blood glucose levels, urea and creatinine concentration, urine tests and to record electrocardiogram (ECG). All these examinations can be done in our polyclinic.

ADMISSION TO POLYCLINIC

Previously appointed admission to polyclinic is possible during the morning hours on the day of surgery, or the evening before the procedure if it suits you better. After situating you into your room, taking anamnestic data, consultations with a surgeon and a detailed agreement regarding surgical technique are to follow. After that comes planning and marking the places for surgical section.

ANAESTHESIA

This surgery is most frequently performed under the general anaesthesia, but in some exceptional cases it can be performed under a regional anaesthesia too.

PROCEDURE

With adipose tissue hypertrophy, 0,5 cm long incisions are made for placing aspiration cannula from both internal and external side and under the breast. Through those incisions with help of specialised probes, a complete lipo-aspiration of chest regions is performed on both sides. Since there are small incisions, they become completely invisible after the healing process.

In case of pure hypertrophy of glandular tissue, conventional surgical procedure is necessary. Hypertrophy glandular tissue is removed through an incision around areole. The treatment of closing the skin is performed by continuous subcutaneous stitches and the surgery finishes with placing pipe drains and an elastic compressive jersey. Extracted materials are sent to histopathological analysis as a whole unit.

Wit mixed hypertrophy, a combined procedure is necessary. After adipose tissue aspiration, subtotal excision of glandular tissue is performed.

When it comes to expressed gynecomastia, skin surplus reduction is necessary and it is removed by a special technique with remodelling of nipples.

Each of these methods radically solves a problem of gynecomastia, or to be more precise- hypertrophy of breast is completely eliminated.

IMMEDIATE POSOPERATIVE PERIOD

If a plastic surgery of gynecomastia is performed under a regional anaesthesia, the patient leaves our polyclinic on the very same day. The patient gets written instructions for the health care during the postoperative period. If the surgery is performed under general anaesthesia, stay in our polyclinic can be prolonged up to 24 hours. Before the departures, pipe drains are taken out and compressive jersey is placed once again and it should be worn continuously for 3 weeks, and for additional 3 weeks, it should be worn only during the day.

FINAL RESULT

Results after correction of gynecomastia are excellent, whether it comes to hypertrophy of adipose or glandular tissue. Lipoaspiration and/or conventional surgical procedure performed by an experienced plastic surgeon, give excellent results and the problem of enlarged breast is completely solved with this surgery.