Gynecomastia In a man the benign enlargement of the breast that resembles the female growth pattern is named gynecomastia. This enlargement may involve the ductal tissue , the surrounding fat and/or the skin. Men that develop gynecomastia feel embarrassed because they are unable to hide their chest and are thus becoming targets of various comments by friends and relatives.

There are three distinct types:
In pseudogynecomastia which is accredited to fat deposit due to obesity or to skin laxity after weight loss. True gynecomastia involves the overgrowth of ductal tissue.
γυναικομαστία,ψευδογυναικομαστία,αληθή γυναικομαστία

What are the causes?
In pseudogynecomastia which involves obesity and the rapid loss of weight, this case is the one that needs no further screening and is directed for surgery. In true gynecomastia there is an underlying hormonal imbalance that needs to be identified. In this case after this imbalance has been healed and the gynecomastia persists then a surgical solution can be sought.

This hormonal imbalance may arise:
Normally because of fluctuation in blood hormone levels Birth, maternal estrogens circulating are transiently higher than normal but this usually resolves. Adolescent , 66% of adolescent boys develop gynecomastia due to normal hormone increase. The gynecomastia is in most cases mild , its psychological impact negligible and in most cases is resolved on its own. Old age, when the testosterone levels are declining and the ratio between testosterone and estrogens tilts towards the estrogens. Intrinsic due to gland disfunction or failure. In this case a panel of examinations is needed in order to pinpoint the cause and its remedy. Any surgical approach ought to be reserved for a later time. Drug induced. Hormones, antiandrogens , cardiovascular drugs or even abused drugs ( alcohol, heroin etc) can be the cause of gynecomastia.
The operation
Depending on the case general anesthesia or local anesthesia with mild intravenous sedation can be applied. When the gland excision needs to be applied general anesthesia is favored.

The whole operation is performed through a tiny incision on each breast and through the power assisted liposuction device the fat is removed. The operation is safe, fast and leaves no scarring. After the operation the patient needs to wear a pressure garment but can go home on the same night. The stitches are removed on the 8th day after the operation whereas any swelling and ecchymosis need 1 to 2 weeks to get absorbed. A rough estimate of the result of the operation can be made 30 days later.

When the excess skin needs correction a periareolar incision is used and then meticulous stiching ensures that no marks will remain after all wounds are properly healed.