Gynecomastia

There are several reasons that cause the growth of the breast in men.

• During puberty (teenage), the level of hormones increases and breast growth may appear. It is often only a temporary condition with no need of operation. Therefore, surgery is delayed until the age of 18.
• Gynecomastia may have a relationship with a family history.
• Numerous drugs or diseases are associated with mammary gland growth - this is due to stimulation of receptors to which the gland responds (hormones, antiestrogens, steroids, corticoids, cardiovascular drugs).
• Diseases: liver and adrenal diseases, pituitary and testis tumors, renal failure and other. 

Before planning the operation, it is very important to undergo an examination, which includes:

• hormonal status and endocrinological examination
• breast sonography
• sonography of the testicles

Sometimes the volume of the breast is caused only by an increase in fatty tissue (pseudogynecomastia).

The size of gynecomastia is classified according to Simon, distinguishing the following grades:

• Grade I. (mild gynecomastia)
  • Ia: Slightly enlarged gland without excess skin.
  • Ib: Slightly enlarged gland with small to moderate excess skin.
• Grade II. (moderate gynecomastia)
  • IIa: Moderate breast enlargement without excess skin.
  • IIb: Moderate breast enlargement with excess skin.
• Grade III. (severe gynecomastia)
  • The breast is significantly enlarged, has excess skin, and an appearance similar to a female breast.

The operation is performed under general anesthesia and the type of surgery approach depends on the amount of gland tissue, fat tissue and skin excess.

• Liposuction is suitable for pseudogynacomastia (more fat as breast gland tissue).
• Excision of the gland through incisions aroud the lower half of the areola is used in most patients.
• More skin excess requires circumareolar incision with skin stretching or a surgical procedure similar to breast reduction used in women.
• Good results are achieved with a combination of liposuction and excision.

Gynecomastia provides a resection of the gland and fatty tissue.

After the surgery, drains (plastic tubes with negative pressure) are usually inserted to drain blood and fluids for a few days.

The chest is stretched and a compressive garment (elastic underware - short vest) is worn for 4 - 6 weeks.