What is gynecomastia & what causes it?
Gynecomastia, the enlargement of the male breast, is believed to be caused by an imbalance in the sex hormones (testosterone and estrogen). The most common cause is the persistence of chest fullness after breast development in adolescence. Less common causes are medical problems, medications, and the utilization of prohormones by weight lifters. Regardless of the cause, gynecomastia is a benign condition. Its negative impacts are more psychological than physical, as patients feel like no matter what they do, their chests will never look the way they want.
Most patients seen at the AGC fall into two groups.
The first comprises patients who developed gynecomastia during puberty that didn’t go away as it usually does. The second group developed gynecomastia after using prohormones or hormones used for bodybuilding or hormone replacement therapy.
Gynecomastia is not confirmed with a blood test, and there are no clinical criteria to confirm the diagnosis definitively.
It’s just as much a matter of the patient’s perception as a doctor’s diagnosis, and there are several facts to keep in mind when diagnosing this condition.
The bottom line is that gynecomastia is all about perception—and perception is reality. If you think you have it, you certainly will behave as you have it, and you will suffer for it. Patient satisfaction with this procedure is very high. It is essentially like a “rebirth.”
Choosing Your Surgeon
Choosing the right surgeon is very important because this will determine the quality of your outcome. First, make sure you choose a board-certified plastic surgeon. Experience matters when it comes to any procedure, and in the case of gynecomastia, most surgeons don’t see many of these cases. At the AGC, we see over 400 patients every year for treatment.
Our patients travel from across the nation and overseas. It is vital to consider surgeons who have proven expertise in this area and have a reputation for successfully treating gynecomastia. Think twice about the surgeon who only occasionally treats gynecomastia in their practice.
The timing of gynecomastia surgery is essential.
When gynecomastia occurs during adolescence and does not resolve within a year, it is highly recommended that treatment be considered. This is a critical time in the emotional and social development of young men. The longer the gynecomastia persists, the more significant the negative psychological impact on the individual.
To delay is to deny yourself the benefits of treatment. Diet and exercise rarely improve the appearance of gynecomastia. It is a surgical problem that you really don’t have much control over. In fact, building muscle and losing weight usually makes gynecomastia look more prominent. Resist the temptation to try Internet-promoted pills or diets, as they will not improve gynecomastia and may, in fact, make the condition worse. It’s snake oil—don’t fall for it.
Treatment of gynecomastia is straightforward but requires great skill and artistry. Every case is different to some degree, challenging your surgeon to make appropriate adjustments and modifications, so the best result is realized. The primary focus is on the reduction of excess volume in the chest area. This is usually performed with a combination of liposuction and glandular tissue removal. The need for skin removal, producing chest scars, is uncommon. It is quite impressive how well skin retracts after the removal of excessive chest tissue, even in patients who have saggy skin. If loose skin persists after treatment, it is always possible and even advisable to contour the excess skin as a secondary procedure.
Gynecomastia treatment may not be limited to the breast area. Some patients have fullness under their arms and around the abdomen and love handle areas, and seek treatment in these areas as well. Expert treatment means seeing the whole picture and treating all the areas that need contouring so your result is the best it can be. Do keep in mind; however, that abdomen and flank fat will go away with weight loss.
Surgeons use different techniques to contour the tissue. Fat is contoured with some liposuction, and the dense glandular tissue that cannot be removed with liposuction requires removal through an incision. Ultrasonic liposuction has proven to be a tool particularly suited to treat gynecomastia. My use of the VASER™ ultrasonic liposuction machine has improved my treatment of gynecomastia compared to standard liposuction. Focus on the skill level and experience of your surgeon and not on a particular technique or device. Your goal is a smooth result—keep your eye on the big ball. Beware of marketing gimmicks to get your business.
Anesthesia alternatives depend on the amount of tissue to be removed, the procedure’s complexity, and the patient’s personal wishes and comfort level.
Small accumulations of breast tissue (localized tissue under your nipple and areola) can be removed under local anesthesia. Larger volumes usually require the use of general anesthesia for your comfort.
Adequate pain-free anesthesia is needed so that your surgeon can appropriately and carefully contour the tissue and minimize the chance for irregularities or complications. Many patients who choose local anesthesia for their treatment report that they probably should have chosen general anesthesia because the procedure was somewhat uncomfortable. Why not have your procedure performed without pain or anxiety? Why not fly first class if you have the choice? Most procedures take less than an hour and a half to complete.
Revision gynecomastia – Refers to secondary procedures to enhance the results from previous gynecomastia surgery. There are many reasons why someone would want additional treatment. The most common is glandular material that was incompletely removed, poor overall contouring with significant irregularities, and over-or under-resection of chest tissue.
Secondary gynecomastia revisions are more challenging, but are fixable when you choose a board-certified plastic surgeon like Dr. Caridi. Non-surgical treatments – Non-surgical alternatives offered for treating gynecomastia are not particularly effective. Several studies have shown a small reduction in the size of gynecomastia and less pain, if present when anti-estrogens are used.
But treatment must be started early in the course of the condition to be effective. After a year has passed and the tissue becomes more “fibro fatty,” it is unlikely that medical, non-surgical treatment will result in much improvement, and it’s very unlikely that a gynecomastia patient could be completely “cured” with non-surgical treatment alone. Successful, satisfying outcomes involve gynecomastia surgery.
Patient satisfaction with this procedure is very high. This is a great opportunity to start your life off with a new you, no longer hindered by gynecomastia. Most patients agree that the procedure has positively impacted their lives. In many cases, it has been revolutionary.
The AGC has been so successful because Dr. Caridi and our team are well versed in both the experiences of our patients and the art of gynecomastia surgery. He cares about his patients and helps reduce fears and uncertainties with his compassion and candor. The successful treatment of gynecomastia has been Dr. Caridi’s most professionally rewarding procedure, and fulfills our purpose and our professional oath to help those in need. Quite simply, we take great care of you.
At The AGC, we believe no man should have to go through the struggles of gynecomastia alone. The Gynecomastia Brotherhood is all about helping those who suffer from the burden of gynecomastia. Join the Gynecomastia Brotherhood today.
Our team at AGC is here to answer your questions, assist with scheduling your appointment, or help you with any other matters related to your treatment. Book your consultation online for specific questions regarding a personalized surgical plan.
A further detailed discussion with Dr. Caridi and his team will follow this inquiry. If you are seeking more general information or are a previous patient needing to contact medical staff, always feel free to call our office.
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