Treatment

Gynecomastia Surgery l Bliniq Cosmetic Surgery Centre I Dr Ashwani Kumar, Plastic Surgeon



Gynecomastia means a man developing breasts. It’s prevalence has been found to be 60-70 percent in normal adult males.It has become a leading cause of anxiety, social stigma, teasing in school, ridicule and in some cases even leading to depression.

Causes
1. Physiological
a) Infant: It presents at the time of birth and can persist upto 1 year. It occurs due to presence of maternal hormones in the blood supply of the infant, leading to formation of firm tissue under nipple-areola complex. Some milky discharge may also be seen on pressing the swelling. It resolves on its own without any intervention.

b) Adolescence:
At the time of puberty there is a surge of hormones in the male body. In some males the female sex hormones tend to form in a higher amount than male sex hormone and the body under the imbalance of these hormones starts forming breasts in a male body. This imbalance resolves on its own but the glandular component needs surgery.

c) Old Age:
At the time of old age the hormonal imbalance due to slowdown of metabolism in the body may give rise to breast tissue formation in the body.

2. Medications or Substance Abuse
a. Estrogens
b. Anti-androgens
Spironolactone
Cimetidine
Ketoconazole
Ranitidine
Glutamine
Finasteride
Flutamide
c.Cardiovascular Drugs
Amiodarone
Digoxin
Nifedipine
Reserpine
Verapamil
d. Abused Drugs
Alcohol
Heroin
Marijuana

3. Endocrine Abnormalities
a. Androgen resistance syndrome
b. Hyperprolactinemia
c. Hyperthyroidism
d. Hypogonadism
e. Klinefelter’s Syndrome

4. Systemic Disorders
a. Chronic kidney disease
b. Obesity
c. Chronic Liver Disease

5. Neoplasms
a. Adrenal
b. Testicular
c. Lung
d. Liver

Surgical Treatment
Liposuction with glandular excision is the gold standard of treatment for gynecomastia. The procedure is performed through a small incision inside your nipple-areola complex. The advantage of this incision is that it leaves no obvious scar in the post-op period. The surgery is performed in 4 stages:
1. Tumescent Anaesthesia Infiltration
2. VASER emulsifying the fatty tissues
3. Liposuction of emulsified fatty tissues
4. Gland excision

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