Gynaecomastia, spurred upon by hormonal imbalance, is a rise in breast gland tissue in males. In this condition, single or both breasts may be affected.
Pseudogynaecomastia describes a rise in fat in male breasts without an expansion in glandular tissue. Gynaecomastia can emerge from typical hormonal changes in infants, boys undergoing puberty, and older men, even though there are other reasons.
A sedentary lifestyle, unhealthy eating habits, and family heredity can cause hormonal imbalance, leading to such diseases. Gynaecomastia can cause men and boys to experience discomfort in their breasts and feelings of embarrassment. Surgery or medicines are best for gynecomastia treatment.
The goals of surgical treatment are to repair deformities of the breast, areola, or nipple and to regain the original male breast shape.
For a person experiencing gynecomastia, surgical treatment procedures include liposuction-assisted mastectomy, mastectomy, or a combination of the two procedures. The majority of patients recover the fastest from an integrated treatment strategy.
It must be emphasised that the breast gland tissue is dense and frequently almost impossible to eliminate without direct excision.
Subcutaneous Mastectomy or Surgical Resection
The risk of skin overlap following surgery determines the choice of surgical procedure. Younger people typically experience more skin shrinking than older people do.
For the removal of male breasts, countless distinctive incisions have already been documented. The most commonly used method is the intra-areolar incision, also known as the Webster incision.
The author’s favored technique is the Webster incision, which wraps around the areola’s pigmentation region. The incision’s length can vary depending on the patient’s unique physiology. Adipose tissue is less dense than breast gland tissue. Liposuction isn’t an option for glandular tissue.
A 2-stage gynaecomastia treatment method could be used to treat moderate-severe gynecomastia. Liposuction is the initial step in creating a beautiful shape, which is then proceeded by a Webster-style periareolar incision and the excision of glands, fat, and fibrous connective tissue.
Once the blood flow from underneath has stabilised and permits a periareolar doughnut mastopexy, which takes 4-6 months, the second phase is carried out.
This method’s benefit is the small incision made around the nipple-areola complex. It must be emphasised that enough skin contraction usually happens to avoid the necessity for skin excision.
There have been suggested surgical methods for gynecomastia that require little to no incision. The so-called “pull-through method,” which Morelli first proposed in 1996, has been improved upon by Hammond et al., Bracaglia et al., Lista and Ahmad, and other researchers.
The pull-through procedure involves making a very small (5 mm) incision somewhere at the areolar edge, preceded by liposuction that involves loosening the breast gland tissue from the apex of the areola and dragging it down the incision.
Even though the often-used periareolar incision is very hard to discern, the smaller incision is the main benefit. Only carefully chosen patients are treated with this procedure, which has little effect on the outcome.
The surgeon must assess the depth and thickness of the fat & breast tissue to be excised during the preoperative phase.
After the tumescent solution has been injected, the surgeon performs liposuction. Currently, the authors combine classical liposuction with power-assisted liposuction (PAL), ultrasonic-assisted liposuction (UAL), and other techniques.
Following the liposuction, the pectoralis major fascia is also dissected during the surgical dissecting, which takes place after the liposuction. The pectoralis fascia is wholly removed from the fat and breast tissue. An electrocautery device made by Bovie is used to achieve hemostasis.
The application of a tumescent solution having epinephrine significantly reduces the likelihood that a catheter will have to be placed to avoid postoperative hematoma.
Liposuction combined with surgical resection was initially presented in the 1980s by Teimourian and Pearlman. The outcomes of gynaecomastia treatment have lately improved since the introduction of ultrasonic liposuction.
There is minimal risk of areola slough, nipple distortion, and saucer deformity with liposuction-assisted mastectomy. Additionally, this approach has fewer postoperative consequences than open surgical resection, such as bleeding, inflammation, hemorrhage, seroma, and necrosis.
Nevertheless, glandular gynaecomastia cannot be treated with a liposuction-assisted mastectomy. Before any surgical procedure, the fat and gland parts of the breast should be evaluated. Only a small number of individuals can be treated effectively with liposuction.
It’s best to consult the doctor if you have gynaecomastia. The specialists at Max Healthcare hospital can help you throughout the diagnosis and treatment procedure.
Booking a consultation with them will help you know what surgical procedure best suits your condition. They can assist you with the treatment process without any hassle and at the most reasonable cost.