First of all, to make a general definition, gynecomastia is the growth of female type in breast tissue in men. However, let's not forget that breast growth in men is not always a finding of disease. The most common cause of gynecomastia is an unknown condition or obesity. It can also occur with the effect of some drugs or as a result of hormonal changes. Nipple glands are found in both women and men. Breast glands in men are normally small and underdeveloped. The fact that the mammary glands found in men begin to grow and develop causes a health problem called Gynecomastia.
Gynecomastia is a kind of hormone disorder disease seen in men. As a result of the expansion of the breast area tissue, the male breast appears to be full and bulging, as in women. Although the gynecomastia problem usually occurs in adipose tissue, it also appears to occur in glandular tissue. Besides, Gynecomastia can form in both breasts or a single breast. When the formation of gynecomastia is seen, gynecomastia surgery is performed as a result of the preference of the patients and the appropriate opinion of the doctor.
Before deciding on gynecomastia surgery, it is necessary to know correctly what type of Gynecomastia is encountered. Gynecomastia can be defined in three different types, from the mammary gland, oily gynecomastia, from adipose tissue, and from mixed type both mammary gland and adipose tissue. The growth of glandular type mammary gland structures is at the forefront. If it is an oily type, there is an increase in adipose tissue around the breast tissue, not breast tissue. This type is especially common in patients who often gain weight and drink alcohol. In mixed types, two types of growth at certain rates coexist. Ultrasonography can be used to determine the gynecomastia type. The primary step is choosing the correct treatment method and ensuring that treatment is effective for the diagnosis of gynecomastia. Before the diagnosis of gynecomastia, it is necessary to reveal what kind of problem the patient has while examining the symptoms. Symptoms of gynecomastia are; Excessive sensitivity in the breast, pain when touched the breasts, swelling tissue in the breast area, effluence in either one or both breasts, divergent sized breasts, and solid swelling at the bottom of the areola.
If the expressed symptoms are observed, the patient must contact the doctor and ask for an examination. The doctor should physically examine the patient's breast tissue, abdominal area, and, genitals before diagnosing gynecomastia. It is also seen that blood tests and mammograms are requested for a complete and accurate diagnosis when the doctor is not satisfied with the physical examination. Apart from these methods, it is seen that CT, MRI, or tissue biopsy is used.
Two different surgeries are performed according to the structure of the mammary gland. If it is soft and oily; degreasing surgery (liposuction) may be sufficient. For hard and large gynecomastia; it must be removed with open gynecomastia surgery, which leaves no visible scars in the area. The mammary gland is removed from here by making a semicircular cut at the junction of the nipple and the colored part. If necessary, liposuction application is also done. It is a small and painless surgery that can be done without any necessary hospitalization. You can return to your daily routines after 4 days. However, when deciding on Gynecomastia surgery, the patient's current health status and age are important criteria. Sometimes gynecomastia heals all by itself without any medical interventions, which is seen in newborn babies or during adolescence. However, if Gynecomastia disturbs the patient excessively and continues to increase the patient's complaints regardless of the age, it should be treated. Medicated treatment, hormone therapy, liposuction, and surgical intervention options are encountered in the treatment of gynecomastia.
To undergo gynecomastia surgery, it should be certain that no other treatment is found sufficient to cure gynecomastia. Gynecomastia surgery is seen as the only solution in cases where the males feel extremely unhappy due to prolonged and ineffective treatment methods tried. The age and the body development of the patient are crucial to plan the surgery. Gynecomastia surgery is not prescribed in men who have just completed their puberty and whose testicle sizes do not fully reach the adult testicle size. Because the development is not fully realized, gynecomastia plausibly will repeat itself over the years. If the patient has completed adequate development and has no disruptor condition for surgical intervention, a gynecomastia decision can be made.
The bleeding that may occur is blood accumulation on one side of the breast called "hematoma". The risk of infection can alert you with a one-sided swelling that may occur around the fifth day after surgery. Its solution is to clear the infection and take prescribed antibiotics. Asymmetry is one of the problems that may be encountered after this surgery. In these cases, revision surgery may be required.
If the gynecomastia surgery is performed by complying with the general conditions mentioned above, the success rate is very high. Correct diagnosis of the disease, the decision of surgical intervention to the right patient, and the correct application of the surgical intervention method are the keys to a successful gynecomastia treatment. Another criterion that most affects the success rate is the expertise of the surgeon who will perform the operation. It should be noted that an aesthetic and plastic surgery specialist who is experienced in gynecomastia surgery should operate.
To summarize;
Anesthesia type: Local anesthesia is sufficient, but sometimes general anesthesia is preferred.
The place of the surgery: In a full-fledged surgery room.
Duration of surgery: 1-3 hours.
Hospitalization: Most of the time, same-day discharge. In some cases, patients can be prescribed to stay for a night at the hospital.
Post-operative pain: 2-3 days of mild pain. Simple painkillers, usually taken orally are enough.
Swelling, bruising: Between 5 and 10 days, moderately.
Drains: It is rare to use drains after gynecomastia surgery.
Medical dressing: Completely removed in 2–3 days.
Stitches: None.
When to get back to work: 4 days.
Physical Activity: Long walks after 2 weeks, gym after 5 weeks.