Scar free male breast reduction

Whilst it is difficult to verify exact statistics, it seems that gynecomastia (male breast reduction) is the most frequent request for cosmetic surgery among males, competing with liposuction and rhinoplasty.

There is a multitude of reasons for the condition, we have clearly identified a few drugs causing it, and I personally see increasing numbers of steroid abusers. Other common culprits causing gynecomastia are a couple of antihypertensive drugs, hormonal problems, and often, simply genetic predisposition to gynecomastia (in other words bad luck).

What is the ideal age for operating a gynecomastia?

There is none because the problem can occur at very different ages. Depending on the cause, the ideal age is when the condition becomes unbearable for patients. The most difficult question is normally what to do with young patient. Whilst cosmetic operations on minors are obsolete, gynecomastia is not strictly cosmetic and psychological distress can be unbearable.

Under these circumstances psychological distress for patients may well be unbearable and needs relief.

Does social insurance pay for gynecomastia?

That depends. Some insurers, at least in Spain, accept grade II+ grades as medical indications. This reflects my opinion as well; certain degrees of gynecomastia are rather resonstructive by nature than cosmetic. Not all insurers share my opinion though.

In Spain the majority of cases are treated outside the social insurance system.

Can gynecomastia be solved by liposuction alone?

In selected cases yes. In most cases resection of breast gland will be necessary. However, this depends always of the individual case. As a rule of thumb, being deliberately vague, one can say that the older you are the more fatty tissue you will find and the more likely liposuction alone will be successful. However, we do not use “classical” liposuction” anyway. Both myself and all other surgeons of my team seem to find this a rather traumatic and outdated technique.

In gynecomastia, we prefer the endolaser technique (has become very popular as “Smartlipo” in the US). We have found that increasing the energy level of the laser to a higher level and changing into “cutting” mode enables us to destroy the glandular tissue with laser alone and no incision are necessary.

What scars are involved?

None. The endolaser technique, which is the technique that we prefer, does not leave any scars. The endolaser does lead to significant skin retraction, so there are no problems with lax skin. 92% of our gynecomastia cases are now done with the scar-free endolaser technique.

What is the biggest problem around gynecomastia?

Recurrence. The gland behind the nipple needs to be rejected in true gynecomastia cases; some part of it will usually remain and possibly lead to recurrence. There is no difference regarding recurrence whether classical surgical incision or endolaser is used, and the percentage is about 2-3% (higher in steroid abusers).

What is recovery time after a gynecomastia operation?

Usually very short, definitely depending on the extent of resection. The scar free endolaser technique for male breast reduction is an ambulatory day case procedure, and there is no physical recovery. I like to use a compression garment of a minimum of two weeks post surgery, possibly longer.

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