Unusual Approach to Gynecomastia?
- Asked by asbestos in London, UK
- 5 years ago
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Gynecomastia. Is the location of the incision important?
The best possible and barley visible incisions will be on short(About 1 inch) and in the lower part of the areolas(nipple) .The excision and liposuction can be done from the same incision, and therefore there is no need for more incisions.Scar is important to men and a surgeon will try to minimize it. Of course everyone heals differently but there are a few important points ,like location, size and numbers of the incisions that can improve the results.
Areola Incision for Gynecomastia Treatment
What you are describing is not unusual.
Your surgeon must customize the procedure to give you the best result. There are many different incision approaches we use on a regular basis.
Gynecomastia can be treated with several different methods
- Liposuction only (preferably power-assisted liposuction)
- Liposuction along with surgical excision
- Excision of the glandular tissue (subcutaneous mastectomy) only.
Surgical excision can be performed using semicircular incisions along the lower border of the areola or small 'stab' incisions along the areola. The appropriate method chosen will depend on the underlying problem.
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Gynecomastia surgery: Choice of Liposuction Incision Sites
Gynecomastia can occur in young children, adolescents, and seniors. It also persists into adulthood in some males.
Liposuction is a valid treatment option for gynecomastia without excessive skin redundancy.
In choosing liposuction incision sites, the ideal incisions should be placed at points which provide safe exposure to all aspects of the treatment area and which are relatively inconspicuous. In certain patients, based on anatomic characteristics of the chest wall, the incision sites may have to be altered.
There is no one specific incision pattern for liposuction of gynecomastia. There are, however, many options to improve the scar if you do not like the current scar pattern.
Raffy Karamanoukian, MD
Gynecomastia is the growth of glandular tissue in male breasts. It is usually a benign condition that can cause significant psychological distress. Patients present with an increase in breast tissue, which is unilateral in one third of cases. Enlargement is usually central and symmetric. Gynecomastia associated with medications is usually unilateral; however, in pubertal and hormonal cases, the changes are often bilateral. The most common cause in the US is obesity.
The Simon classification of gynecomastia is as follows:
Group 1 is minor but visible breast enlargement without skin redundancy.
Group 2A/2B is moderate breast enlargement without skin redundancy (2B is minor skin redundancy)
Group 3 is gross breast enlargement with skin redundancy that simulates a pendulous female breast.
Patients in groups 1 and 2 require no skin excision, but the breast development associated with group 3 is so marked that excess skin must be removed. In my practice for patients with minimal skin excess I always consider ultrasonic liposuction. It is an effective way to remove the dense male gynecomastia tissue and provides some degree of skin tightening. The challenge with this technique is what is called "the breast bud" with can be an especially dense area behind the areola (the dark area around your nipple).
In some cases, this tissue is too dense for even ultrasonic liposuction and needs to be resected primarily and usually can be accessed by making a small incision at the edge of your areola where it can be camouflaged by the color change.
Your surgeon may have also used more than one port site for the liposuction. Each treatment must be individualized of course but my typical incision sites for my liposuction for gynecomastia patients is at the anterior axillary line (the side of the chest) which is usually not seen when looking straight on. For mild gynecomastia I usually don't need a second port. If I do, sometimes I consider the base of the breast or if I think I'm going to need to resect the breast bud I would use an incision that allows me to remove the breast bud at the same time in addition to my lateral lipo incision. If a patient needs skin resected then there are a variety of skin resection patterns.
The key here is that the skin excision pattern is significant different than a female breast reduction where the goal is to create a skin envelope that creates a round well shaped breast. I hope this helps.
Steven Williams, MD
Tri Valley Plastic Surgery
Scars for gynecomastia
I see that in all of the posts no 1 mentioned the"Scarless". This uses a tiny incision in the armpit And liposuction is performed first With the gland Being removed using a special instrument To liquify it so it can be suction out through that same small incision. this totally eliminates the scar around the areola which in some skin types can be very visible.
Most gynecomastia can be treated with tiny scars.
1) When treating gynecomastia in New York City, we use only small incisions inside the lower nipple in 95% of men. These scars fade to near invisibility.
2) In very few cases, there is loose excess skin which must be removed. This requires more scarring. For these patients, we use either an incision all the way around the nipple, or, in extreme cases, longer incisions.
Surgical planning is paramount
On a case-by-case basis, different incisions are required to either address the tissue in its entirety or to make the incision more covert. In some scenarios, an incision like that would be appropriate.
Typical case of gynecomastia
Gynecomastia surgery incisions
There are many different patterns of incisions used for removing excess male breast tissue. These range from tiny liposuction scars, to scars along the lower border of the areola, to scars on the areola plus lateral or medial "tennis racket" extensions, to scars in the crease below the breast, to full inverted "T" breast reduction scars. It al depends on your own anatomy and the experience of the surgeon. You should know up front what scar pattern will be used on you so it isn't a surprise.
Web reference: http://www.randcosmeticsurgery.com
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