Gynecomastia is female breast enlargement in men. Most breast growth in adolescence returns to normal within 1-2 years. Breast enlargement that persists for more than 2 years is considered gynecomastia. Many reasons can play a role in the formation of gynecomastia. These are the drugs used (such as some antidepressants, alcohol, amphetamine), hormonal imbalance, some diseases (liver, thyroid, testicular tm etc.), steroid and protein-supported drugs used by athletes to develop the body, such as obesity. Even without any of these reasons, gynecomastia may develop due to the response of the breast tissue to the normal hormone level (end organ response).
Gynecomastia often leads to social and psychological problems. In addition, the shoulders are brought forward to hide the breasts, which causes posture disorders.
There are 3 classifications of gynecomastia.
1 Slightly large breasts.
2 The breasts are enlarged, but there is no sagging of the skin.
3 The breasts are extremely large and there is also sagging of the skin.
The surgery can usually be performed with local anesthesia. Depending on the patient’s request and breast size, sedation or general anesthesia may be preferred. The surgical technique is selected according to the breast ultrasound and examination findings. If the breast tissue is low and the fat content is high, the breast can be reduced with liposuction. If there is excess breast tissue and excess skin, it is more appropriate to remove it surgically. In some cases, both techniques are used in combination.
In 1st and 2nd degree gynecomastia, that is, in cases where there is no excessive sagging of the skin, the breast tissue is reached with a half-moon incision made from the nipple and excess tissue is removed. If fat around the breast is common, liposuction is preferred. Even if surgery is performed, the adipose tissue in the surrounding tissue must be removed by liposuction, otherwise there will be a level difference between the nipple and the surrounding tissue. In 3rd degree gynecomastia with excess skin, it may be necessary to remove the excess skin with horizontal or vertical incisions.
Postoperative hospitalization is not required in 1st and 2nd degree gynecomastia. Arm movements may be slightly painful for 1-2 days. On the third day, the patient returns to work. In 3rd degree gynecomastia (with skin excision), 1 night hospitalization may be required, and depending on the incision type, there may be scars on the breast that vary from person to person and decrease over time.