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Gynecomastia Surgery

Gynecomastia is originated from the Greek words for woman-like breasts. The definition for gynaecomastia surgery is the abnormal development of glandular tissue of the male breast resulting in breast enlargement. A true excess glandular breast tissue in men is not normal. Gynecomastia is a very common condition in men and can result in embarrassment, teasing, and social trauma. The male gynecomastia condition can occur physiologically in neonates, in adolescence, and in the elderly. In newborn the effect is due to the passage of female hormones from the mother but both in adolescence and elderly it is an abnormal condition associated with disease or metabolic disorders.
The causes of gynecomastia have been attributed to high levels of sex hormone-binding globulin in males which result in low levels of free testosterone or the tissue responsiveness to them. But the root cause is rarely determined for individual cases. Gynecomastia caused by transient changes in hormone levels due to growth usually disappears on its own. Gynecomastia that develops in puberty and persists beyond two years is referred to as persistent pubertal gynecomastia. Malnutrition and recovery from malnutrition have both been shown to create a hormonal environment that may lead to gynecomastia.

The common causes of Gynecomastia could be aging, obesity, chronic liver disease, steroid abuse or other estrogen enhancing medications, familial Gynecomastia or Klinefelter's Syndrome. Breast prominence may be the result of hypertrophy of breast tissue, chest adipose tissue and skin or a combination of all. Gynecomastia is associated with certain medical conditions including hyperthyroidism, chronic kidney failure, and cirrhosis of the liver. Bilateral gynecomastia can also be associated with human immunodeficiency virus (HIV) infection

Gynecomastia should be distinguished from muscle hypertrophy of the pectoralis muscles. When performing surgery the gland is sent to the lab to confirm the presence of gynecomastia and check for tumors under a microscope.


  • A puffy nipple is the most common forms of gynecomastia characterized by a glandular tissue accumulation typically confined to the areola resulting in a dome shaped appearance
  • Pure glandular gynecomastia is common in bodybuilders. The use of anabolic steroids may get converted to estrogen.
  • Unilateral / asymmetrical gynecomastia in which one breast is larger and the other breast is typically normal in both size and shape.
  • Gynecomastia due to age: Skin elasticity get reduce and excess skin cause gynecomastia.
  • Congenital or hereditary gynecomastia: Symptoms get evident by 12 to 18 ages in boys.
  • Pseudogynecomastia: Eexcessive areola projection. But instead of glandular tissue it is adipose tissue. It looks much like typical gynecomastia but requires different treatment.
The primary symptom of gynecomastia is enlargement of the male breasts, which is symmetrical in location with regard to the nipple and has a rubbery or firm feel. Gynecomastia can be unilateral in some cases. The enlargement may be greater on one side even if both sides are involved. Tenderness and sensitivity may be present and no associated severe pain is observed. The most important distinction of gynecomastia from male breast cancer is that cancer is confined to one side, is not necessarily centered around the nipple, feels hard or firm, and can be associated with dimpling of the skin, retraction of the nipple, nipple discharge, and enlargement of the underarm lymph nodes.

Treatment and Male Breast Reduction Surgery:

  • Compression garments can camouflage chest deformity and stabilize bouncing tissue.
  • Medication is hardly effective for mature gynecomastia that is larger than 1 inch in diameter.
  • Surgical excision of the breast gland is paramount and results in a permanent and consistently reliable outcome. Breast reduction should be done for men with exceptionally dense glandular breast tissue and are removed using a scalpel followed by a closure using stitches. The treatment of choice for a combined pseudogynecomastia and true gynecomastia is a combination of surgical excision and liposuction for men which gives a better breast contour.
  • Liposuction does not remove the breast gland and instead is used to remove the surrounding adipose tissue. The goal for liposuction of the male breast is to improve the individual's physical appearance by removing maximum fat as possible while protecting the skin or muscles. Male patients with excessive fat in their breasts can expect significant improvement with tumescent liposuction. This is most effective for pseudo-gynecomastia. Power assisted or even routine wet liposuction followed by gland excision is in practice in India for the treatment of gynecomastia and which are giving gratifying results. The procedure may be done in conjunction with a liposuction of the abdomen. When the two procedures are done at the same time it is called as Body contouring. Pressure garments are necessary to be worn for a period of four to six weeks following the procedure.
  • Radiation therapy is sometimes used to prevent gynecomastia in patients with prostate cancer before estrogen therapy.
  • For treatment of severe Gynecomastia there are a few modalities of treatment available. Periaureolar male breast reduction, Classical breast reduction with superior or inferior flaps and vertical incision breast reduction
Specific risks of male breast reduction surgery: Complications are infrequent when male breast reduction is performed by an experienced gynecomastia surgeon. The procedure in which incisions are done correctly and in the proper location can avoid scarring. Hypoesthesia is a condition occur post surgery in which the areola sensation is reduced. This gets resolved in months. Hematoma and Seroma may cause excessive swelling of the breast after the Gynecomastia treatment surgery which sometimes requires intervention. Hematoma is more common in high BP patients, people who take blood thinners like aspirin or anabolic steroids prior to surgery. Recurrence of the breast tissue is seen in some cases occurs after excision and male liposuction. If the areola size is large adequate thinning of the areola is done prior to surgery. In many cases this is enough to reduce the man boob size.


Medications: Testosterone replacement has been effective in older men with low levels of testosterone, but it is in effective in men with normal levels of the male hormone.

Surgical treatments: Reduction mammoplasty (breast reduction surgery) is effective in severe gynecomastia, long-term gynecomastia, or in cases in which medications shows no improvement.

Cost of Gynecomastia Surgery depends on the problem to be treated, can vary from surgeon to surgeon and around the world. Gynecomastia surgery price vary greatly because the gynecomastia surgery procedure itself encompasses a wide range of techniques that can be performed to different extents. The factors that determine the price for gynecomastia procedure are location, experience of the gynecomastia surgeons.Experience of the gynecomastia surgeons would also significantly affect the price of the gynecomastia surgery. The extra skilled the surgeon, larger the cost. You'll definitely rely on a proficient and experienced surgeon due to the delicacy and risks of this surgery. The cost of male breast / Gynecomastia surgery will also depend on the size / grade of the male breasts, category of room and time required in Operation Theater.

The safety record of keyhole surgery for Gynecomastia in India is excellent. The surgeons in India are widely known for their skill in cosmetic and plastic surgery like Male Breast Reduction, body contouring-tummy tucks and liposuction, facial rejuvenation and much more. These surgeons are dedicated to achieving natural appearing results, which balance and enhance their patient's existing features. Most hospitals have the most advanced apparatus, state-of-the-art amenities, extremely dedicated surgeons and doctors, highly compassionate nurses and very professional administration staff. Gynecomastia in India is extremely cost-effective procedure as the cost of facility or operating room fee, laboratory tests, nursing and facility staff fees, charges of the anesthesiologist, medications and surgical supplies are less. The cost of male breast reduction surgery in abroad can deter most of the patients. India can be a relief for such aspirants. In India patients can avail the benefit of low cost and high class services in all the cosmetic and plastic procedures.
Cosmetic Surgery in India
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