Gynecomastia is overly developed breast tissue in males. Though it is medically benign, gynecomastia can cause significant psychological discomfort. Men with gynecomastia may be viewed or view themselves as not completely masculine. In an attempt to disguise their shame or embarrassment, they sometimes attempt to hide this condition by avoiding exercise, swimming, and other activities. Although gynecomastia cannot be resolved through diet and exercise programs, Dr. Sreekar can effectively remove the enlarged breast tissue through his advanced award-winning gynecomastia surgical procedure (Scroll down for Videos).
Gynecomastia generally appears during puberty. Sometimes this condition normally disappears by the time a boy reaches adulthood, in some cases however the excess breast tissue remains. The use of certain medications, such as antidepressants, high blood pressure drugs, and anabolic steroids, has also been linked to gynecomastia.
Irrespective of the exact cause of gynecomastia, this condition can be resolved through male breast reduction surgery. As a highly experienced gynecomastia surgery expert, Dr. Sreekar uses two techniques to eliminate the excess tissue – liposuction and sculpting with special surgical instruments. The procedure includes the use of small liposuction incisions and then removal of the excess breast tissue. These are combined in one procedure called Lipo-Excision. This technique no longer needs postoperative drains or a prolonged recovery. Gynecomastia surgery typically requires two hours to complete and is done on a day care basis.
Dr Sreekar Harinatha’s pioneering techniques have been presented at many conferences and congresses including at IMCAS Taiwan and Paris. Watch the videos below for more details.
(The photograph is of a Bangalore based model. He graciously let us use his photograph after the surgery.)
Clinically gynaecomastia is graded as follows:
Grade 1 : Small enlargement, but without excess skin over the chest
Grade 2a: Moderate enlargement, without excess skin over the chest
Grade 2b: Moderate enlargement with extra skin over the chest
Grade 3 : Marked enlargement with extra skin over the chest.
Treatment depends on the grading of enlargement.
Grade 1 men can be treated with liposuction alone with very good results. Such surgeries are simple day care procedures with fast recovery.
Grade 2a men require a procedure called lipo-excision wherein, liposuction of the chest is combined with removal of the breast tissue. Here the chest is contoured to match a normal chest using liposuction and then the breast tissue is removed using a 2-3cms incision near the areola. Around 90% of the breast tissue is removed to give the chest its normal male contour. Removing 100% of the breast or doing aggressive liposuction can lead to a sunken chest appearance (also called crater deformity). Such complications should be avoided when dealing with gynecomastia. Other rare complications include asymmetry, scar complications, collection of blood in the operated areas and bruising. Sometimes a drain (a plastic tube) may be placed at the operated site to drain out any collected fluid or blood. It is usually removed by the 2nd day after surgery.
Grade 2b men also can be treated with lipo-excision alone in >90% cases. Some may require another surgery after about 3-6months for skin tightening to tackle the excess skin.
Grade 3 generally always requires skin tightening.
Dr Sreekar Harinatha’s modified gynecomastia grading is now widely used and includes skin tone in assessment fo a patient. It was published in the prestigious Brazilian Journal of Plastic Surgery. It is as follows.
Grade IT: Small enlargement, no skin excess, and normal skin tone
Grade 1L: Small enlargement, no skin excess, and poor skin tone (indicating laxity)
Grade IIAT: Moderate enlargement, no skin excess, and normal skin tone
Grade IIAL: Moderate enlargement, no skin excess, and poor skin tone
Grade IIBT: Moderate enlargement, minimal skin excess, and normal skin tone
Grade IIBL: Moderate enlargement, minimal skin excess, and poor skin tone
Grade IIIT: Marked enlargement, a lot of excess skin, and normal skin tone
Grade IIIL: Marked enlargement, a lot of excess skin, and poor skin tone
Following any gynecomastia surgery, pressure garments (Compression garments) are advised to prevent collection in the operating cavity and for better adherence of skin to the chest. All gynecomastia surgeries can be done on day care basis with admission for 9-10 hours only. Watch the videos at the bottom of the page for more clarity.