What's my case ? Which Degree of gynecomastia? (photos

I already saw a doctor and said it's gyno and it needs liposuction..when i asked if I need a glandular removal he said we'll see during surgery..Isn't it clear to tell if he needs or not ? Even during the consultation ? And what about the scars !? Is it permanent ? Large and clear ? How long should it take to play soccer ? Can i go to college next day of surgery ?

Doctor Answers 13

Types of Gynecomastia & Treatment Options

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There are several common factors which contribute to gynecomastia. These include excessive levels of #estrogen, natural #hormone changes, use of recreational drugs or alcohol, medications and their associated side effects, and, various health conditions. Also, there are different types of #gynecomastia.

Normal Gynecomastia is usually apparent in boy between the ages of 12 to 15 years old and older men 65 years old or more who experience a drop in their testosterone levels. This type of Gynecomastia takes about one to two years to regress on its own.
Pure Glandular Gynecomastia is seen more commonly in body builders and is caused by steroid use. Surgical removal of the gland is required for treatment.
Adult Gynecomastia – Fat deposits are apparent in the glandular tissue. This type of gynecomastia is the most common. Doctors may recommend surgery for treatment of the condition.
Adolescent Gynecomastia is hereditary and usually appears in 30% to 60% of boys between the ages of nine to fourteen. Many cases of adolescent gynecomastia resolve on its own as the boy grows into adulthood. Some may choose to undergo surgery to correct the situation, this usually happens at the age of 18 or above. In severe cases in young boys, the physician and child development specialists will need to speak to the parents regarding the severity of the gynecomastia and if surgery is an option before the age of 18.
Assymetric or Unilateral Gynecomastia appears in either one or both breasts at different degrees. In many cases one breast appears larger than the other. Surgery is a common treatment for this type of gynecomastia.
Pseudo-Gynecomastia is composed of adipose tissue instead of glandular tissue. This type of gynecomastia can be treated with diet, liposuction or surgery
Severe Gynecomastia commonly affects those who have lost skin elasticity at an older age and those who have been obese or overweight at one point in their life and lost weight may have saggy skin and breasts that are severely enlarged. Surgery is the recommended treatment for severe gynecomastia. 

There are three types of surgical treatment options available that treat gynecomastia. The doctor will recommend the one that is best suited to each individual case. Consulting with a board-certified plastic surgeon in person, is highly suggested in order to determine if you are a surgery candidate and what treatments are best for you.

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Glandular Removal

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It is difficult to say what you need from photos alone. However, the extent at which your nipple protrude indicates that you have some excess breast tissue that won't be removed with lipo alone.

What's my case ? Which Degree of gynecomastia?

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I would have to examine you to give you the best recommendation. Look at reviews and before and after pictures as well as credentials to select your surgeon.

Kenneth Hughes, MD

Los Angeles, CA

Gynecomastia Questions

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It appears that your case of gynecomastia is relatively mild, but that's not what's important. If it troubles you, then surgery is appropriate to consider.

An in-person consultation is essential in developing a surgical plan. In my experience, however, most cases require both liposuction and gland excision for best results. Both techniques are required to sculpt smooth, masculine contours and assure no trace of puffy nipples remain. You'll need to plan for at least a few days of rest after surgery, and you'll need to refrain from strenuous activities like soccer for a few weeks. You'll heal faster with some rest and it will all be worth it!

Your scars should be tiny--nearly invisible. To see examples, have a look at the photo gallery on our website.


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Without an in person consultation, or more photos, it is not possible to deterine the appropriate treatment. Surgery for gynecomastia should focus on two primary concepts: limiting surgical incisions and the associated permanent scars as much as possible, and respecting the fact that skin laxity may limit the amount of fat and breast tissue that can be removed in a single surgery. No one with gynecomastia wants to trade the appearance of having excess breast tissue for a set of obvious scars, or for sagging skin that looks like surgery gone wrong. Either way you still won’t want to take off your shirt at the pool.

First, the scars: incisions limited to the inferior areolar border will result in most cases in scars that are faint to even invisible. In many patients that is the only incision you need. In patients with significant chest hair, small liposuction access incisions in the subpectoral fold (the crease at the bottom of the male pectoral area) are acceptable as they will be invisible, but not in patients with little to no chest hair. When needed, an axillary incision can be used for liposuction cannula or arthroscopy shaver access, and a well-designed incision in that location is also minimally noticeable to invisible in most cases. Surgeons who are experienced with and proficient at gynecomastia surgery limit the incisions to areas where the scars will be imperceptible.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 121 reviews

Gynecomastia surgery

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I would suggest that you will need a small cut-down (particularly on the left) to remove some of that dense glandular tissue in addition to liposuction. I've found omitting that step tends to leave just a hint of too much nipple projection with cases like yours.

Gynecomastia options

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If there is fat in the area the degree of glandular involvement can be hard to determine. I do agree that a liposuction and then a possible gland removal is what I would consent you for. At times if the gland is small it can be removed with the liposuction alone, it just depends on whether the gland is really firm.As to returning to school the next,day, you might be tired and groggy is all, but OK as long as you do not lift anything. Typically the scars are small and fade in time. I would release you to play soccer in 3-4 weeks if you heal well.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

What's my case ? Which Degree of gynecomastia?

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Poorly posted photo therefore I recommend ONLY IN PERSON opinions.. I think combination liposuction + glandular excision are needed but not sure./...

What's my case ? Which Degree of gynecomastia?

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Based on the photograph, you are probably dealing with a mild case of gynecomastia. Generally speaking,  assuming a young man has achieved a long-term stable weight and there are no “causative agents” involved, surgery may be indicated to treat persistent gynecomastia.  It is often best treated with  partial excision of the prominent glandular tissue  as well as liposuction surgery of the peripheral chest area.  If the prominence of the chest wall is caused by adipose tissue, then liposuction surgery may suffice.  You may find the attached link, dedicated to gynecomastia surgery concerns, helpful to you as you learn more. Best wishes. 

Gynecomastia surgery

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Most of the time I go with liposuction for cases such as yours and prepare patients that they may need a direct excision in the future if the tissue under the areola is more glandular and not amenable to suctioning. This way there is a potential for only a small incision laterally or medially on the chest and not an incision around the border of the areola.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.