The spreading of suction-assisted lipectomy (liposuction) from the eighties brought significant change in the surgical treatment of gynecomastia. The adipose tissue around the gland is previously sucked through a small incision of 2-3mm; it will significantly facilitate the removal of the mammary gland which is done through the lower edge of the teat (mamilla). Later the incision will heal with a slightly visible, small scar. The skin is able to draw back even in the event of significant volume reduction, so the skin excision involving longer and more visible scars – which is otherwise regular for the reduction mammoplasty operations of the female breast – can be avoided. In rare cases, if the enlargement of the breasts is caused by the augmentation of the adipose tissue which mainly appears in adiposity, good results can be achieved by the application of liposuction only.
In our clinic, we have been performing liposuction for several years with the most advanced vibro-liposuction, vibrating cannula procedure. The American Micro Aire apparatus based on the PAL technique and used by Dr. Csuha is ranged to the best ones both with regard to its efficiency and safety of operation. The use of the apparatus is especially favourable for the typically more adherent tissue of male breast.
The gynecomastia surgery can be done under narcosis or local anaesthesia. We recommend the narcosis because in local anaesthesia we cannot achieve 100% painlessness. Prior to the operation, laboratory examinations and ECG are done in each case. Mammary ultrasound examination and in some cases endocrinological examination may also be necessary. Following the operation, the biopsy of the mammary gland can exclude the more serious disease.
The average duration of the gynecomastia surgery is one or one and a half hours. Following the operation done in local anaesthesia, the patient may leave after half or one hour’s rest, reasonably by car, but the patient should not drive. After narcosis, one day’s (night’s) observation will be necessary then you can leave on the next day in the morning, but certainly you should not drive at that time either.
Gynecomastia or originally gynaecomastia is a word of Greek origin; it means the unmanly enlarged mammary glands in males. The unmanly enlargement of the male breast is very embarrassing aesthetically, so it requires plastic surgical solution.
Gynecomastia is a word of Greek origin, meaning the abnormal enlargement of mammary glands in males. Most frequently gynecomastia appears on both sides symmetrically, but it may be unilateral in rare cases. Rarely the phenomenon may be accompanied to a hormonal disease, more rarely breast tumour is at the back of it. It is important to screen out these cases by the previous examinations because their treatment is not the task of the plastic surgeon. Most frequently, however, gynecomastia starts already in adolescence, develops genetically or is accompanied to adiposity. Body-building food supplements and steroid hormones growing the muscle mass also frequently cause such deformation in male breasts.
Just after the operation, a special compression waistcoat is put on the treated area, which helps the skin adhere to its base and thereby quicken the healing.
This medical wear which can be obtained at our clinic is selected before the operation because the proper size is very important. The medical waistcoat should be worn for one-one and half months, for two or three weeks by night and day, then for further three weeks only by day. You should not take it off till the first change of the bandage which will be due after six days. At that time the sutures are also removed and then you may have a shower. Then you may already take the waistcoat off for this half-hour. After one week’s rest at home, you may perform light physical or mental work.
You should avoid hard physical work, intensive sport, exercises, tennis, swimming, wider motions of the trunk for one – one and a half months. In later times, you will not have any restriction; you can continue your earlier lifestyle in every respect and enjoy all types of sport.
Pain: Following the operation, dull pains similar to muscle strain will appear in each case for several days, more rarely burning pains. The motion is painful, the area where the operation was done is stretching and the waistcoat is quite tight. Simple analgesics sold without prescription are always sufficient.
Haematoma, purple skin discoloration: With various intensity, purplish or greenish yellow discoloration often appears in the area subjected to operation /similarly as after a stronger beat, injury /. It will usually disappear in one or two weeks.
Swelling: During the days following the operation, more or less tissue moisture will accumulate in the surgical area which will show itself in the form of swelling. Similarly to the skin discoloration, it will disappear in one or two weeks. In majority of the cases, these phenomena will have been disappeared by the time the patient can take off the waistcoat.
Surgical scar: The two 2-3 mm long scars of liposuction and the scar running along the edge of the areola will heal with a slightly visible, small scar in several months.
More compact, thick feel of the surgical area: This phenomenon may occur in 10-20% following the intervention and may exist for several months.
Haematosis: The more significant effusion of the surgical area is quite rare; its frequency is not more than 1% because it cannot injure greater veins as a result of the special design of the suction cannula. Smaller haematosis will react well on icing and creaming, but in some cases they may cause harder, more compact and slightly rough feel of the sucked area.
Inflammation: More serious inflammation requiring intervention, surgical approach is very rare: thousandth probability.
Abnormal scarring, disorder of wound healing: The surgical scars are very short, fit together without stretching therefore the disorder of wound healing may only occur in persons liable to keloid production.
Skin feeling problems, stiffening and anaesthesia: Feeling disorder or lack of feel may occur in 3-4% in the surgical area. Their final form is very rare but the full regeneration may last for more than one year.
Rough skin, loose skin: The covering skin of the breast concerned with gynecomastia is usually sufficiently flexible for it can fully draw back after the operation. Slight roughness of the skin surface is a problem occurring rarely in the male breast. With the introduction of the vibration cannula, its probability of occurrence significantly decreases. It can be well treated by vacuum massage (ENDERMOLOGIE).
Permanent discoloration on the skin: In very rare cases, patients gone through liposuction tell that the discoloration caused by haematoma on the skin of the sucked area does not disappear after several months, either. In these cases, the colour difference can be seen very slightly, under certain light conditions and usually it will disappear after several further months.
Pigment lack of the teat: In the area of the teat (mamilla), above the incision in several percents of the cases a lighter spot lacking pigment may be formed which usually will become darker in several months and the areola will recover its original colour.
Sagging of the teat area: Also in several percents of the cases, the slight sagging of the teat area may be experienced which will be filled during the subsequent months and the surface of the skin will become smooth.