Unilateral pseudogynecomastia, what is the best approach? (Photos)

Thank you for your query. I would recommend doing nothing on the good side and gynecomastia removal and lift on the affected side. Grafting is not needed and can be unreliable. Please discuss your options with an experienced Plastic surgeon. All the best

Gyno is an abnormal accumulation of breast tissue in the male breast, usually due to hypersensitivity of the estrogen, receptors in breast tissue. Pseudogynecomastia is excess fat that can also feminize the male chest. It’s important to be able to recognize the difference between them because the treatment options are different. You have an access of fat and likely a little bit of breast tissue in the right chest along with some excess skin. Skin excision with free nipple graft as an option, but I generally reserve it for more severe cases. Liposuction with a skin tightening procedure such as Renuvion (J-plasma) can give a very nice result without the need for skin excision.

In order to correct both volume discrepancy and nipple size and positions breast reduction/mastectomy will be needed on larger breast. Hope this help.

Unilateral pseudogynecomastia, where there is excess fatty tissue or glandular tissue development on one side of the chest, can often be addressed in a few ways, depending on the severity and the underlying cause. Here are some potential approaches:
1. Liposuction: For cases where the excess tissue is predominantly fat, liposuction can be an effective solution. It is minimally invasive and removes fat without significant scarring. If the pseudogynecomastia is mainly fatty tissue, liposuction is often the first option to consider.
2. Liposuction with Glandular Tissue Removal: If the tissue involves more glandular components (firmer and more dense tissue), a combination of liposuction and excision of the gland may be necessary. This approach can help achieve a smoother, more natural chest contour.
3. Hormonal Evaluation and Management: Since pseudogynecomastia can sometimes be linked to hormonal imbalances (e.g., excess estrogen or low testosterone), a consultation with an endocrinologist to evaluate and correct any hormonal imbalances might be beneficial. In some cases, medications may be prescribed to balance hormones and reduce the tissue growth.
4. Laser Lipolysis: For some individuals, laser liposuction or laser-assisted lipolysis may be an option to treat fat and tighten skin simultaneously, giving the area a more contoured look.
5. Surgical Excision: If the tissue is dense and resistant to liposuction, or if the individual has skin laxity after fat removal, a direct surgical excision may be the best approach to remove both fatty and glandular tissue and achieve a flatter chest profile.
Consulting with a board-certified plastic surgeon specializing in body contouring is important to determine the best individualized approach based on the extent of the pseudogynecomastia and the patient’s overall goals.