Gynecomastia Surgery: Permanent Reduction, Stitchless, Painless, Scarless

The cause of gynecomastia is multifactorial:

Idiopathic

many cases A DEFINITE cause is elusive. Idiopathic causes are the most common (25%). Most authorities attribute the condition to stimulation of breast tissue by excess circulating estrogens or estrogen-like substances;or a defect in androgen receptors Decreases in the androgen-to-estrogen ratio have also been associated with development of gynecomastia.

Developmental/Physiological Gynecomastia

Neonatal: In newborn baby because of maternal circulating hormone. It is self limiting condition. Go by itself in few months

Pubertal: More than 2/3 of the adolecent boys have small to severe gynaecomastia relative excess of plasma estradiol compared with testosterone is believed as the cause of pubertal gynecomastia

Aging: Increasing the plasma estrogen-to-androgen ratio at old age leads to breast enlargement .plasma testosterone levels decline and peripheral conversion of testosterone to estrogen (peripheral aromatization) occurs,

Hypogonadism (decreased androgen synthesis or increased androgen resistance):

• Primary
• Acquired (trauma, infection, torsion,radiation exposure, mumps, chemo therapy)
• Congenital
• Secondary
• Hypogonadotropic hypogonadism
• Kallmann’s syndrome
• Pituitary failure (infarction, infection, neoplasm)

Tumors (increased estrogen production):

• Steroid-producing (adrenal, testis)
• HCG-producing (testis and others)
• Aromatase-producing (testis)
• Bronchogenic carcinoma

Systemic:

• Thyrotoxicosis (altered testosterone/estrogen binding)
• Renal failure (acquired testicular failure)
• Cirrhosis (increased substrate for peripheral aromatization)
• Adrenal (ACTH deficiency or congenital adrenal hyperplasia)

Congenital Disorders:

• Klinefelter’s syndrome
• Enzyme defects of testosterone synthesis (may be late onset)
• Vanishing testis syndrome (anorchia)
• Androgen resistance syndromes
• True hermaphrodism and related conditions
• Increased peripheral tissue aromatase

Familial:

• HIV
• Chest wall trauma
• Psychological stress
• Spinal cord injury

Malnutrition: When your body is deprived of adequate nutrition, testosterone levels drop, but estrogen levels remain constant, causing a hormonal imbalance.

• Herpes zoster infection
• Cystic fibrosis
• Alcoholism
• Myotonic dystrophy

Medications

These include antidepressants, cancer treatment, antibiotics, AIDS medications; substance abuse like alcohol or drugs and many more. While consulting with the physician, it is important to discuss the usage of the medicine so that the doctor can provide accurate treatment.

Health Conditions

• Hypothyroidism
• Hyper thyroidism/ thyrotoxicosis
• kidney disease
• liver failure and cirrhosis
• Adrenal dysfunction

Note: Medical treatment of associated condition is necessary buy they hardly succeed to reduce developed male breast. Only surgery is the definitive solution for gynaecomastia.

Consistancy Of Gynaecomastia

Gynaecomastia contain glandular tissue and fatty tissue in various proportion. Usually gland is felt as soft rubbery mass beneath areola. When glandular tissue is predominant, it is hard. And when it is mostly made of gland tissue it is called glandular gynaecomastia usually it is mix of both tissue when fat is predominant it is soft when practically no gland and gynaecomastia is composed of fat only it is called pseudogynaecomastia. It reduces with weight loss like the diet and exercise.

Associated risks of male breast cancer

The occurrence of male breast cancer is 1 in 400 to 1 in 1000. One percent of all breast cancer occurs in males. However, patients with klinefelter’s Syndrome have up to a 60 times greater risk of developing breast cancer. Many studies reviewing males with gynecomastia have demonstrated no increased risk of breast cancer compared with The normal male population. Thus in all non-klinefelter’s patients it is reasonable to Treat gynecomastia surgically with both liposuction and excisional techniques.

A. Simon’s Classification

Grade 1 Small enlargement, no skin excess
Grade 2a Moderate enlargement, no skin excess
Grade 2b Moderate enlargement with extra skin
Grade 3 Marked enlargement with extra skin

B. Rohrich Classification

This Classification, it takes into consideration of the amount of extra skin compared to chest

Grade 1: Minimal Hypertrophy, (less than 250g of tissue) without ptosis
1a: Primarily glandular
1b: Primary fibrous
Grade 2: moderate hypertrophy (250-500g of breast tissue) without ptosis
2a: Primarily glandular
2b: Primary fibrous
Grade 3: Severe hypertrophy ((>500g of breast tissue with grade 1 ptosis glandular or fibrous)
Grade 4: Severe hypertrophy with grade 2 or 3 ptosis glandular or fibrous

If gland and tissue are enlarged just below the areola and nipple is protruding. Is called puffy nipple male breast can develop really very large and form sever gynaecomastia.

Checkout some different types of Gynecomastia in Mumbai are:

According to Symmetry:

• Bilateral Gynecomastia
• Asymmetric Gynecomastia
• Unilateral Gynecomastia

According to Size:

• Puffy Nipple Gynecomastia
• Severe Gynecomastia

According to Content:

• Pseudo Gynecomastia
• Pure Glandular Gynecomastia
• Mix Gynecomastia

According to Age:

• Neonatal Gynecomastia
• Adolescent Gynecomastia
• Adult Gynecomastia

Psychological Benefit

Embarrassment often brings physiological psychological disturbance as they become the fodder for taunts as their appearance, do not match with the conventional needs. Male Breast Reduction Surgery helps you out from embarrassment and also improve your appearance, self-confidence that enables you to wear well-fitted clothes and brings you more close to people or make you free to socialize. You can go to the gym, swimming, party, attend public meeting or go for marriage.

Physical Benefit

Some people with gynecomastia bends forward unconsciously to hide enlarged moobs giving a hunchback look. Cosmetic procedure will improve your look as well as posture. A reduced chest will help you to indulge in physical activities of your choice and keep yourself fit.

The candidates in the man boobs reduction include men who want to improve their chest look by reducing abnormal growth of breast tissues some men.

• The breast growth is more than 12 months.
• The breast growth in some men has stabilized.
• Whose enlargement of the breast has become a cause of concern.
• One who hasa realistic expectation.
• Healthy individuals who have good health or do not have any serious illness that impairs healing.
• Non-smokers (stop smoking) and non-drug user

One get have lot of information on net .. But during consultation. You come to know about status of your concern, procedure, expected result, recovery, complication and other detail specific for you . You have an opportunity to know the cosmetic surgeon and his practice before going ahead with him.

During consultation be prepared to discuss:

• Your surgical goals
• Medical conditions, drug allergies, and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
• Previous surgeries

Your Cosmetic surgeon will also:

• He will physical examination of breast, type , content and grade of male breast enlargement
• General examination for the cause of gynaecomastia
• Evaluate your general health status and any pre-existing health conditions or risk factors
• May take photographs
• Recommend a course of treatment
• Discuss your gynecomastia surgery options
• Discuss likely outcomes of male breast reduction surgery and any risks or potential complications.

One may have a number of questions to ask hence, it is good to make a list of important questions before proceeding for the consultation step.

Consultation

The cosmetic surgeon will listen to your concern, examine your breast and evaluate the case of the procedure with respect to your age, problem status, and anatomical as well as physiological strata. He will explain to you the detail and plan the procedure according to your goal & expectation.

Pre-operative Preparation

The medical general fitness assessment is done. Any associated medical condition is controlled on the day of the procedure, your goal and plan is again discussed with you and marking is done.

Anesthesia

Man boobs Reductioncan be done under local anesthesia or general anesthesia. It will depend on the gradation of gynecomastia, surgeon’s expertise and patient psychological built up. The latest technology, i.e., Vaser help to do gynecomastia under local anesthesia very comfortably.

Liposuction Technique

Most of the time liposuction is done by making a small tiny hole at the periareolar border. Rarely,the second puncture is done at the inframammary line. They mix so well with surroundings that they are hardly visible once healed.

Excision Technique

Glandular tissue is excised through the same tiny periareolar incision.

Combination of Liposuction & Excision Techniques

Commonly, both the liposuction and the excision method are used to treat Man Boobs Reduction. As the gland is removed practically, there is no chance of recurrence of the male breasts.

Excision of skin

The combination of laser & vaser gives better skin tightening . One is advised to wait for 6 to 8 month before skin excision procedure which is rarely needed in only grade 4 or severe gynaecomastia.

See the Gynecomastia Surgery related video:-

https://youtu.be/HDOY–AuO5w

One can see the breast reduction and flat chest on the operating table only. Major improvement will be seen within a month. The final result will be visible within 6-8 months. According to your goal chest can be made flate or muscle can be highlighted. 4d sculpting of chest or vaser assisted high defination liposulpting combine fat injection in to chest muscle to make pectoral more muscular.

After the procedure is completed, dressings or bandages will be applied to your incisions. An elastic band or support garment is used to fasten recovery and mold the chest shape. One can go home same day. One can resume an office job in a day or 2. Can drive in 3 to 4 days . Cardio like activity after a week and gym can be started after 2 weeks’ time. One can fly in 2 to 3 days. There is no dietary restriction after surgery.

Any surgery  have some risk related to anesthesia and surgical procedure . However risk and complication of gynaecomastia surgery are very rare, including but not limited to bleeding, infection. Irregularity, asymmetry of shape, crater deformity. Wound healing to drug reaction to simple allergy reaction of pressure garment.

Dr. Milan Doshi is an expert Gynecomastia Surgeon:

Dr. Milan Doshi, M Ch (plastic surgery), is an Indian board-certified plastic cosmetic surgeon with 20+ years of experience in cosmetic surgery.

He has a credit for performing more than 1000 gynecomastia surgeries in his career.

He regularly performs minimal, moderate, and severe male breast reduction surgery in local anesthesia.

He performs surgery through single tiny hole. Which gives scar less flat chest. He is expert to highlight chest muscle and known for male chest sculpting with 4d or vaser assisted high definition liposculpting.

He has a credit for many presentations for gynecomastia or moobs reduction at various national & international conferences.

We have two centres in MUMBAI with state-of-the-art facilities; the cosmetic surgery clinic at Andheri West is for the non-surgical procedure where one can get the pre-procedure consultation, post-procedure follow-ups. The Andheri West centre of Allure Medspa is a prime attraction for celebrity people as it is a hotspot destination for production houses and their offices.

The cosmetic surgery hospital/centre in Goregaon West are ISO 9000:2008 and NABH certified with night stay facility.

The two separate modern operation theatre, advanced patient’s monitoring system during operation and post-operative care add to the safety of procedure.

We are all updated with the latest technology. We recommend the particular option of the technology/method of the procedure according to the patient’s need, expectation and desired goal of cosmetic surgery.

Due to the facilities of equipment such as an ultrasonic cleaner, ETO-sterilization, autoclave, fumigation and stringent protocols we ranked highest in the safety and hygiene measure.

With an indoor overnight facility one can find the best ambiance in our centre where the patient’s comfort is kept in mind with in-suit bathrooms & rooms are equipped with all the necessary things such as microwave, refrigerator, LCD TV, landline phone, etc. and make a homely feeling for the patients during their hospital stay.

The staffs at Allure Medspa take all precautions to make your journey of fine to fabulous a pleasant experience. One can have a homely feeling even with cosmetic surgery.

Our cosmetic surgery centre is committed to providing exceptional care, standard facilities, and advanced measure for the surgery and all under a single roof.
We have the most priority for the patient’s PRIVACY and CONFIDENTIALITY!

The Male Breast Reduction cost depends on:

• Cosmetic Surgeon’s Fee
• Anesthesiologist fees
• Medicines/consumables and pressure garment during surgery
• Cosmetic Surgery centre
• Technology used
• Immediate post-operative follow-ups

Following are the factors that are NOT included in the cost determination:

• Preoperative fitness test
• Post-operative medications (to be taken at home) After the Reduction surgery
• Rare and unforeseen health circumstances experienced by the patients
• Insurance doesn’t cover the Gynecomastia surgery cost as the finance service provider doesn’t assist you in planning cosmetic surgeries.

How Various Factors affect the cost of Gynecomastia Surgery?

1. Patient’s Profile: The patient’s profile includes the need for Gynecomastia, type of surgery used to correct the concern, as well as the body structure, general health of the patient and the goal of surgery.
2. Cosmetic Surgeon: Cosmetic surgeon must be an Indian board-certified surgeon, especially the Male boobs Reduction surgery. Who has expertise in performing the Gynecomastia surgery and recognized by various national & international cosmetic surgery organization, i.e., ASPS, ISAPS, Surgeon performance for giving consistently good result weigh the cost of Gynecomastia Surgery
3. Anesthesiologist Charge: Anesthesiologist makes your surgery painless and monitors your vital parameters during surgery and his expertise is important for the safety of the surgery.
4. The Cosmetic Surgery centre: It is always important to choose the accredited centre rather than the daycare centers as it can assure you about safe and successful Gynecomastia surgery. NABH accredited centre is counted as the best centre/clinic that confirms the safety & hygiene associated with the surgical procedure. Operation theater monitoring equipment, level of sterilization, a used instrument for special purposes.
5. Hospital Stay: The facilities of in-suite room, cleanliness & hygiene as well as 24/7 staff support system.
6. Medicines: Medicines include anesthesia, surgical medicine, disposable and consumables.
7. Follow-ups: The required session of post-op follow-ups may enhance the cost of the procedure.

Most health insurance plans do not cover surgery or its complications, but many plastic surgeons offer patient financing plans, so be sure to ask. The cost of Gynecomastia surgery generally ranges from 50,000 to 100000 INR.

Is gynecomastia always associated with low testosterone blood levels?

No. Many patients seen at Allure Medspa had testosterone levels checked that are well within the “normal” range. There could be many other reasons like the ingestion of drugs or medical ailment like kidney issues. If other secondary sexual characteristics are normal, probably the hormone level will be normal.

Why gynecomastia is seen in Infancy?

No, breast enlargement occurs quite often in both male and female babies in the first month or so of life. The reason behind this could be the presence of maternal estrogen, which crosses the placenta prior to birth. This ’neonatal gynecomastia’ seen in male babies generally goes away in 4-6 weeks of birth. Interestingly, ‘neonatal gynecomastia’ does not occur in children who are born prematurely.

What’s the Best Age for Gynecomastia Surgery?

The cosmetic surgery is allowed to perform after 18 years of age and who considered a right candidate if they are physically and mentally fit to undergo surgery. However, if a person is below 18 and feeling embarrassment, theprocedure can be done with parental consent.

Does nipple piercing interfere with gynecomastia surgery?

Patients need to rest and let the body heal immediately after the surgery. Indulging in rigorous exercise could lead to large blood or fluid collections which can lead to infection or contour irregularities, ruining a great result. One should try avoiding repetitive arm and chest motions, heavy lifting, and straining or excessive trunk motion for 2 weeks following surgery.

Can gynecomastia surgery be done at the same time as another procedure?

Yes, other cosmetic procedure can be done with Gynecomastia surgery. There is an added advantage that the recovery period is same and a single anesthesia is enough to administer.

Will the scars be visible in gynecomastia surgery?

The scars for the liposuction and gland excision are 4-5mm long and placed right in the peri areolar area or at the inframammary fold, armpit crease, so they are not visible once healed. To avoid an obvious ‘operated on’ look, these scars are purposely placed asymmetrically.

Can gynecomastia turn into cancer?

There is no written proof of a gynecomastia and male breast cancer. It is a known fact that excess estrogen compared to androgens increases the risk of both benign (gynecomastia) and malignant (cancer) growth of male breast tissue. Examples of risk factors for such abnormal growth of male chest tissue would include aging, obesity, alcoholism, liver disease, and estrogen treatment for prostate cancer &Klinefelter’s syndrome.