Procedures
Breasts | Gynaecomastia
Gynaecomastia
Breast enlargement in men can vary in size. In some cases, it appears in the form of minor, limited lumps of glandular tissue positioned under the nipple, thus accentuating it. It is rather commonly manifested as a pending deposit of fat and glandular tissue, which pulls the nipples downwards. Breast enlargement, especially in adolescence, can cause significant psychosocial problems, ranging from the evasion of some sports activities to difficulties in communication with the opposite sex.
BEFORE THE SURGERY:
Causes of gynaecomastia are often unknown. The enlargement can affect either one or both breasts. If it occurs before puberty, hormone examination is necessary; especially that of testosterone levels in blood. Breast enlargement in puberty is in most cases temporary, and lasts from one to three years. Hormone analyses at this age are necessary only in the cases of overpronounced breast enlargement, or if the phenomenon persists for longer than two years. Only in a small proportion of boys (about 7%), breasts remain enlarged after the age of 17, which might require surgical intervention. Post-puberty gynaecomastia in adults can be associated with serious diseases. If the cause is not clear, it is mandatory to carry out complete hormone examination of estrogene, testosterone and prolactin. In some cases, ultrasonic examination or mammography will prove necessary. Certain drugs, such as estrogenes, androgenes, corticosteroids, digitalis, spironolacton etc., may provoke breast enlargement. As a consequence of general obesity, breast enlargement is merely down to the accummulation of fat tissue. Hormone therapy is ineffective in the treatment of gynaecomastia.
DURING THE SURGERY:
The intervention is not advised before the age of 18, except in the cases of extreme enlargement, which is not showing tendency of resolving in the course of several months. It is performed in local anesthesia and intravenous sedation, or in total anesthesia. Depending on the size of the operation, it can last between one and two hours. Before LIPOSUCTION was introduced, the only method of choice had been direct surgical removal of enlarged glandular and fat tissues through the incision made around the nipple. Today, most commonly used method is LIPOSUCTION, which allows the tissue removal through a distant incision with no scars left in the breast region. A 5mm incision is made in the armpit. First, a special solution containing local anesthetic is injected in the breast tissue. After that, blunt canules are used for mechanical or ultrasonic softening of fat and glandular tissues. Parallelly, suction under negative pressure is carried out. Additional procedures are necessary if firm nodules remain under the nipple, or if the nipple is too lowly positioned. Such procedures involve incisions in the breast region.
AFTER THE SURGERY:
The patient usually remains in hospital for one day. Elastic compressive garment should be worn for several weeks. During the first few days, breasts are moderately swallen and painful. Bruises can be visible. Sutures are removed after five days. Swelling and bruises are resolved after a week. Depending on the size of intervention and the recovery course, the patient can be back to work after two weeks. Strenuous physical activities should be avoided for one month. The scar in the armpit remains almost invisible.
