Gynecomastia operations should only be performed in very well organized work environments, i.e. a hospital environment with a fully equipped surgical facility. The infrastructure of a fully equipped surgical facility may appear to be an excessive requirement for dealing with a reasonably minor operation such gynecomastia correction, but it is always best to be over-prepared in terms of organization and resources, even if these turn out to have been unnecessary.

The patient is given a choice of anaesthesia’s type.

There are two main methods for correcting overlarge breasts:

SUBCUTANEOUS MASTECTOMY:

An incision is made at the lowest point of the nipple, 3 cm in length. Through this incision, the plastic surgeon removes the excess fat or the mammary gland via an open method, i.e. with full visibility. Once the removal is complete, the incision is sutured. The mark left by the incision will heal in time. In general, nipple scarring tends to be very faint and does not pose an aesthetic problem.

LIPOSUCTION:

This is performed similar to standard liposuction, i.e. via a small incision into which a metallic cannula is inserted, which siphons the fat. In order for this method to be undertaken, we must be certain that we are dealing with fat and not a hypertrophic gland. In any case, as explained above, in 99% of cases fat is the problem that we are dealing with. Standard liposuction was the main technique employed to treat gynecomastia for a very long time. Nowadays, however, correction via LASER lipolysis or/and Power Assisted Liposuction have also become viable techniques. Laser lipolysis has the edge, as it offers results of very good quality, a greater maximum quantity of removable fat, the shortest recovery period, and also helps to tighten the skin. The technique is exactly the same as LASER liposuction, which is performed on other parts of the body, and as such can be combined with such procedures. This means that many patients may, in tandem with correcting their gynecomasty, choose to have laser liposuction performed on the front or side of their belly, or wherever else they need.

Whichever method is employed, a compression bandage will have to be placed on the chest after the operation, in order to aid the tissues to reattach correctly. In addition, an operation can be performed at the same time to reduce the nipples’ diameter. In this case, however, the incision must be made around the circumference of the nipple, and will of course leave a small, circular scar.

Patients who suffer from sagging skin around their breast may require special treatment. If the degree of sagging is not too large, then the removal of the mammary gland alone may resolve the problem. When dealing with a large degree of sagging, however, we may well need to remove skin. The disadvantage of this method is that it leaves many more scars.

There are techniques available wherein, up to a medium degree of sagging, one can have their problem corrected without having to be subjected to additional incisions. Laser lipolysis, for example, can also help with this, thanks to the tightening it causes in the skin.
The aforementioned methods come in several variations. For example, an open removal can be combined with a liposuction of the entire area, for even better results.

It is important that the surgeon has a vast experience on those procedures, so that he will be able to determine which the best technique to apply to each case is.