Gynecomastia
All men have gynecomastia, which is slightly dysfunctional. For a minority of men, the breast gland develops and causes a more feminine appearance. Gynecomastia This condition can be normal and physiological in infancy and adulthood (about 65% of these cases will spontaneously disappear until the age of 17). Only in a minority of cases will a female breast mirror remain, of which about a third will be unilateral breast growth. Known causes of gynecomastia are: obesity, changes in the balance of sex hormones, increased growth of the lipid component, diseases, genetic syndromes, and regular use of drugs. In most cases, no one can be found for non-surgical treatment. On the other hand, due to the mental factor, the perception of the body and the social problem that accompanies these cases (simple and complex), these men are referred for surgical repair.
For a minority of men, the breast gland develops and causes a more feminine appearance.
Who is the surgery for?
A healthy young man who does not take medication, but is overweight, may suffer from increased breast tissue in both breasts, especially the left. Because of the presence of peripheral fat that produces estrogen, the breasts develop, but in most cases it will suffice with pumping or dissolving fat. In isolated cases (especially in obese or obese men in the past), the breast tissue that can not be pumped must be removed.
Preoperative Surgery:
First check the patient's health status, permanent medications, genetic diseases, etc. Sometimes we will need blood tests and endocrinology counseling before deciding on surgery. In breast examination we look for lumps and glandular tissue (which produces milk). We evaluate the percentage of fat tissue in this breast. This stage is important for the future surgery (the glandular tissue can be removed only while the fatty tissue can be removed by pumping and fat mass). Important tip: An open-wound surgery with a scar ensures much more results, reduces complications and saves a lot more, and requires further surgery to repair excess tissue. For the most part, you can not and should not just settle for pumping or dissolving fat. It should be remembered that breast gland tissue can not be pumped.
We rank gynecomastia according to the following division:
First rank:
It is possible to treat local anesthesia without medication. In this case, the main complaint is a prominent nipple that is usually pronounced through the shirt, and can cause social embarrassment. In this situation, the nipple can be shortened under local anesthesia only.
Second rank:
Can be treated with local anesthesia and without hospitalization: in this situation the glans and nipple protrude above the breast outline. The nipple and the styra stand out mostly in the heat and contract nicely in the cold. In this condition, only local anesthesia can be performed with a small incision in the border between the glans and the skin. There is no need for hospitalization.
Third rank:
Local or general anesthesia may be treated: breast tissue growth is moderate. In this situation, liposuction alone or the removal of glandular breast tissue may be difficult, requiring the opening of a scar on the border between the skin and the glans.
Fourth rank:
Surgery required: Feminine breast growth in all respects. The skin is broad and prominent with excess skin and a large internal application. In this situation, a mastectomy should be performed while preserving the nipple and the penis. In this operation, the scars are located around the glans and from the urethra to the armpit. In some cases, incision may be performed with limited incisions (inside or around the glans)
Surgery:
The surgery was conducted in a hospital under general anesthesia (except for cases where surgery is performed under local anesthesia). The surgery takes about an hour and a half. In liposuction surgeries, we create an opening near the armpit and under the glans (hidden places). At the end of the operation, the incisions are worn and an elastic belt is worn with it for about two weeks after surgery. In surgeries where we perform mastectomy, we perform an incision in the lower line of the glans. We cut the tissue and design the new breast. At the end of the operation, we sew internal seams and absorb the incision, leaving a drainage drain, which removes excretions for several days. After bandaging, we use an elastic belt for about two weeks.
Scars:
As mentioned, the location of the scars depends on the type of surgery. In liposuction surgery, the scars are less than 0.5 cm long and located in the armpit area and the glans line. In moderate surgeries, scarring at the lower crown of the urethra is usually performed in larger surgeries. The location of the scars varies according to the surgical and aesthetic needs.
** Complications and side effects: Side effects vary according to the degree of gynecomastia and type of surgical treatment.
The general complication of all types of surgery is the sagging of the nipples and the esophagus, which is usually caused by excessive excision of the breast tissue. We treat these surgeries with the necessary caution to avoid this complication. This may require additional surgery to repair the excess, but we believe that ``it is preferable to spend a little more than to fill back ...`` ``Hemorrhages are about 3% of all operations performed (more common in liposuction). Infection in the surgical wound is less than 2% Surgery Pain: </ b> The postoperative pain and limit varies from person to person. For the most part, it is possible to return to stress-free activity several days after surgery. The sensitivity lasts for an average of about two weeks (and sometimes more) asymmetry between the demons. Although in most cases the cause of the operation is related to asymmetry, in most surgeries we improve the asymmetry but not completely. This condition is rare and its likelihood increases as the surgery is more complex. Sinking of the nipple and the urethra and the creation of a ``reverse plate`` condition. This complication becomes more common when you are interested in too large an incision and in a non-conservative way. Sensory changes in the nipple area. There may be numbness in the nipple area, which in most cases will return to normal about a year after surgery. In a minority of cases the sensation is lost altogether and in some cases the feeling will be increased. Wide scars or scalloped scars are visible.
Repair of gynecomastia surgery
An unsuccessful surgery of gynecomastia may leave a large defect in the chest. Most of the complaints stem from a deep, sunken deep scar, a sunken nipple that sinks deeper when the chest muscle is constricted and, in particular, irregular chest skin. These problems leave signs that cause great embarrassment, especially when you remove a shirt. Gynecomastia repair surgery is much more complex than regular gynecomastia. We usually perform fat injections to the chest and breasts to add volume to the sunken areas.
32 years old, gynecomastia repair 12 years ago, scars and sunken glans accompanied by asymmetric filling of the breasts
32 years old, gynecomastia repair 12 years ago, scars and sunken glans accompanied by asymmetric filling of the breasts
50 years old, gynecomastia surgery in the upper abdomen, a sagging scar and chest fall on the left. After correction and injection of fat
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