Gynecomasty

Gynecomastia, characterized by excessive development of breasts in men, unilateral or bilateral, may cause severe psychological impact as well as other sexual problems.

Gynecomastia is usually asymmetric with excessive abnormal proliferation of mammary gland and breast fat.

In the case of isolated fat proliferation, it is called gynecomastia or false adipomastie. In most cases, gynecomastia is called essential or physiological, that is to say, no cause is found.

However, complete right endocrine with hormonal dosages must be carried out before surgery, and testicular ultrasound and bilateral mammography. This systematic review can, in some cases, find a medical or drug toxicity cause.

When a medical cause is found, it is of course given priority.

In some cases, hormonal therapy of two to three months may be prescribed by the endocrinologist to reduce gynecomastia. This hormone therapy preoperatively is, in general, of little effectiveness. Surgery alone, reliable and definitive can effectively treat gynecomastia.

This surgery can be supported by social security in the case of severe gynecomastia that may lead to sexual imbalance and under certain conditions (asymmetric gynecomastia, painful distension of areolar).

The surgery is performed under general anesthesia.
In case of gynecomastia or merely fat or adipomastie, liposuction can be performed exclusively. In this case, a small incision of a few millimeters is made in the inframammary crease to draw out breast fat.
The postoperative result will be more satisfactory if skin is elastic and of good tone.
In the case of actual gynecomastia, where the mammary gland is dense and fibrous, it cannot be drawn out and must be removed surgically.
The scar is ideally positioned around the areola (hemi-areola) or a complete periareolar scar (around the areola) when deciding to remove the excess skin around the areola.
In case of significant excess skin especially if the skin is of average quality, the full periareolar scar must be combined with a horizontal scar whose length is variable depending on the excess skin to be removed.
The procedure usually takes less than two hours.
A drain is always placed during surgery to prevent hematoma formation.

Hospitalization generally lasts from 24 to 48 hours.
The drain is removed during the first dressing the day after surgery before discharge from the clinic.
Bruising and swelling are sometimes found during the first dressing and disappear within two to three weeks.
Despite the drainage during the operation, hematoma is possible the day after surgery or later.
This is the reason why a compression vest is ideally required for a month which reduces the risk of hematoma by promoting re-adjoinment of the skin.
Mastery of surgical technique must avoid insufficient correction of gynecomastia resulting in excess residual subcutaneous fat and skin, or in some cases, excessive correction with the appearance of a hollow area at the areola providing an unattractive and permanent depression.
A stoppage of work is advised for a period of 15 days.
The resumption of sporting activity is possible after a month.
Surgical treatments for gynecomastia are currently well codified.
Support for regular breast surgery in women, restorative as well as for aesthetic purposes, allows you to choose the best surgical procedure to treat gynecomastia.