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FAQ’s Regarding Gynecomastia

Gynecomastia is simply defined as female like breast. Any just allotment which makes the person uncomfortable in his clothes or with himself can be defined as this.  in more than 95% of patients not fat and gland and it makes no difference whether there is only gland or fat or both as all of them require surgery.  in fact in the majority we need to remove both fat and gland

No it is not ok to remove only the gland and not sad because if you remove only the girl and the centre part of the nipple will be depressed and rest of the chest will be raised up and this will give a doughnut appearance which no patients like and they always come and blame the doctor for bad surgery later

No and this is only possible in extreme exercising and extreme weight loss that you can remove from chest and  fat from the body and in other situations it is best to do surgery for both fat and gland

Yes this surgery is the safest and most common plastic surgery in men. The complication rates are extremely rare and less than 1 % of patients

  • It is not recommended to do 2 large gynecomastia cases under local anesthesia because – there will be excess of local anesthesia overdose in order to give local anesthesia over the entire chest 
  • Secondly it is extremely painful because multiple injections have to be given and many times patients don’t feel comfortable during the surgery because some places might not have the entire effect of the local anesthesia
  • It takes very long to do last uses and it is very uncomfortable for the operating surgeon also
  • Monitoring the patient and a local anesthesia becomes the task of the operating social and in a hospital setting it is then it is to look after the well-being of the patient so that the surgeon can concentrate on his surgical aspect

The typical symptoms of Puffy nipple and is due to the increased gland below the areola area and the treatment is basically to remove the gland, the condition will become normal . 

  • Each category of gynecomastia the costs are different because the extent of the surgery is different in each case
  • The initial grade surgery can be done under local anesthesia and there we save on Hospital costs  like anesthesia,  medicines,  room rent,  nursing charges etc
  • Enlarge it is a hospital admission becomes mandatory and the costs of hospital admission and operation theatre charges are added
  • Patient needing  skin lift – require more than 30 minutes extra and added operation theatre time increases the cost of the procedure
  • In grade 4,  the surgery can take almost two hours and therefore the hospital charges become double and that is why the costs are more
  • In vaser –  there are machine charges which lead to the increase in total cost

  • Ths technology works specifically on fat to break the fat , without touching the blood vessels and nerves. So better healing
  • It also causes better skin contraction since it causes heat production due to sound energy
  • 6 pack and chest pack surgery are impossible without VASER
  • Testosterone blood level test is not needed before surgery except in patients who have testosterone deficiency like undescended testis or any other problem related to the development of testis
  •  these patients have feminization symptoms like soft voice or no beard growth on face for short height

There is no medical treatment for gynecomastia and please do not do any medicines like tamoxifen or homeopathy medicine,  they have not been proven to conclusively treat gynecomastia  and may have significant side effects

  • There is no need to do an ultrasound scan  or CT scan for the diagnosis of gynecomastia.  this is a clinically diagnosed problem and in most cases and ultrasound will not be able to pick up the  gland or  fat.  if a patient is suffering from gynecomastia, then it is better to show to  a plastic surgeon and get the treatment done surgically. 
  • The only  to diagnose if patient insist is to do a Mammogram which clearly picks up the gland and the fa
  • There is no need to do an ultrasound scan  or CT scan for the diagnosis of gynecomastia.  this is a clinically diagnosed problem and in most cases and ultrasound will not be able to pick up the  gland or  fat.  if a patient is suffering from gynecomastia, then it is better to show to  a plastic surgeon and get the treatment done surgically. 
  • The only  to diagnose if patient insist is to do a Mammogram which clearly picks up the gland and the fa

You have a Gynecomastia in teenager problem and yes only option is to do a surgical treatment.  Results of the surgery are very good and create a completely different confidence in young patients

The option is to make them speak with doctor so that he can discuss  the problem.  The most ideal thing is for the patient to openly discuss their problem with their parents and in most situations the parents will agree for the treatment.

Only treatment is surgery and it involves removal of fat by liposuction and gland by direct excision. in some patients additional nipple reduction  is also needed

In all probability it is just a seroma which is nothing but a reaction of the body  after surgery and it happens in all the patients.  in more than 90% of patients this just resolves on its own while doing massage over a period of 3 months.  in some patients steroid injections are needed while in only one percent of a small touch up procedure may be required to remove the serom

There may be bleeding which causes  clot formation or a seroma. The treatment involves regular massage with warm compression.  if asymmetry is still persistent after 3 months,  I need to assess if there is any bone deformity on both the sides or any muscle deformity.  it is assessed that there is some remaining fat or fibrous tissue then a small touch up  procedure will be needed.

  • This is not a problem in the initial few days after surgery,  just put to sit in ointment morning evening for a few days and it will be fine
  • If it happens Some weeks after the surgery then it might be due to infection or poor wound healing. It  is better to review with your doctor for the treatment
  • To reduce risk of seroma because a garment compresses skin against muscle leaving no dead space
  •  Better skin shape
  • Reduces swelling

They help by mobilizing swelling and allowing it to resolve faster

Check with doctor to rule out any – infection, allergy to particular stich material, or any other reason. They will resolve it.

After 2 Day you can start doing your office work

  • After skin lift – 3 weeks
  • Without skin lift – 1 week

The surgery results can take about three months to show completely after all the swelling is gone

  • Many patients do abdomen  liposuction together since it gives overall better shape. After gynecomastia surgery, many patients feel tummy is showing, so they want to remove it. 
  • Chest pack and 6 pack can be done together for body contouring
  • You can do surgery anytime,, it is not a problem. Even if you do hormone replacement, you will need gynecomastia treatment
  • This is done to allow better results with liposuction. A small incision near the axilla give a good angle to pass the liposuction cannula comfortably in all directions. The same procedure from the nipple becomes very difficult as the angles to move the canula are limited. The distance to move the cannula is very less from the nipple
  •  we give the nipple incision to directly remove the gland and achieve perfect symmetry while also taking care of any bleeding. 
  •  these incisions heal with Virtually no  scar in more than 90% of patients
  • In patient who have saggy skin it is believed that the contraction will not be optimal and skin lift will be able to achieve better chest shape
  • Sometimes the gland is very large and after gland removal the skin may sag down and therefore we do a skin lift to prevent that
  • Yes this procedure will leave scars on the upper part of the areola.  however over a period of three months the scar becomes ery v Fine and it can even be improved later by a small procedure under local anesthesia
  • There is nothing called scarless surgery,  however in gynecomastia in the stars are hidden so beautifully in crease lines that in more than 90% of patients it is invisible.
  • After doing this surgery you can go to office within 2 days 
  • Pain is there only for at the maximum 3- 4 days, easily managed with pain killers
  • Painless
  • Patient have no memory of the surgery
  • Very comfortable
  •  5 – 6 hours. If done on local anesthesia , only 2 – 3 hours
  • Very rare, only if high dose steroids are taken for any reason for a long time, 
  • Any new medical problem 
  • Lot of  increase in weight
  • If heavy use of Steroids is done then definitely the gland will increase later but it does not increase as much as before,  also trainers do cutting cycle to remove 
  • Steroid from the body and that prevents large accumulation of steroid in the body.  We leave a little bit of gland tissue, approximately 5% of the gland to prevent nipple deformity. Even this does not increase much on steroid use 
  • Body builders can easily do surgery
  • Bleeding
  • Asymmetry
  • Scar 
  • Infection
  • Pain
  • No one can give any medical guarantee for any because all surgeries and treatment  depend on an individual’s response to that treatment and in many situations we cannot predict how the patient will respond to the treatment procedure
  • It is difficult to get an ideal shape in very large gynecomastia and in grade four or if there is skin lift involved ,  in other situations very very good chest shape can be expected
  • There is no muscle injury after the surgery, however that can be some muscle bruising ,  which resolves itself over a bit of 3 to 4 days
  • It is extremely rare to find fat embolism after surgery for gynecomastia
  • Yes nipple reduction  is done in many situations specially in Puffy nipples where the nipple may itself be much larger.  up to 50% of the nipple can be reduced in size without causing any damage at all.
  • Yes , easily done in local anesthesia
  • It is difficult to prove this scientifically but many patients tell us that their chest size was much smaller a few years back if you have gynecomastia then it is better to get surgery done as soon as possible to prevent any increase in size later on
  • There is no direct correlation between gynecomastia and cancer formation and it is extremely rare find male breast cancer
GradeBDescriptionInfiltiltrationTreatment plan
1aPuffy nippleNo obvious problem visible except stretched areola. Button type feel below50 ml each side along the glandExcision in LA from infraareolar incision
1bMinor chest enlargement (< 100 gm fat, gland +)Chest is visibly bigger, but limited fat, usually higher amount of fibroglandular tissue200 ml each sideSuction and gland excision in LA from infraareolar incision and stab incision in inframammary area
2aModerate chest enlargementChest is moderately enlarged. Fat component is between 250-500 gm. No skin looseness expected500 ml each sideSuction - stab incision in axillary area, and gland excision In GA from infraareolar incision
2bModerate chest enlargement with skin loosenessChest is moderately enlarged. Fat component is between 250-500 gm.. large gland component in the form of a conical chest. Excision likely to leave loose skin. U lift needed500 ml each sideSuction from stab incision in axillary area, and gland excision + U skin lift from supra areolar approach In GA
3aBig chest with side rolls without skin loosenessChest is severely enlarged. Fat component is between 500+ gm.Fat in breast rolls+. No skin looseness expected750 ml each side and axillaSuction - stab incision in axillary area,axilla from infra areolar, and gland excision In GA from infraareolar incision
3bBig chest with side rolls with skin looseness expectedChest is severely enlarged, fat component + , axilla rolls +, skin looseness expected750 ml each side and axillaSuction from stab incision in axillary area, and gland excision + U skin lift from supra areolar approach In GA
4aBig chest with very large skin laxityChest is severely enlarged, fat component + , axilla rolls + large skin looseness expected. 750 gm fat +750 ml + each sideStage procedure. 1st stage sams as 3b. 2nd stage, o- lift procedure
4bSevere weight loss conditionChest is hanging, not much fat excess expected, gland +, skin excess ++200-250 each sideMastopexy, chest lift type of procedure

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