Gynecomastia

The existence of breasts in the adult male in an established and permanent way, is a generally unwanted condition, in most cases. It may be due to a multitude of circumstances, which depending on the time of appearance can be medically treatable, however, once the correction is definitively established, it is exclusively surgical.

As a complementary part of the diagnostic orientation, hormonal determination studies can be performed, in addition to imaging tests such as ultrasound examination.

Clinically there are several presentations such as: 1. pure glandular developments (gynecomastia vera), 2. adipose accumulations ( lipomastia ), and 3. so-called mixedcombined forms ( gyneco-lipomastia ). The previous clinical differentiation is crucial to indicate the precise therapeutic option.

Generally, although the right and definitive treatment depends on the examination physical consultation, the first must be resolved by subtotal removal of glandular development (subcutaneous mastectomy) and may also result when this indicated, reduction or areolar remodeling; the latter are tributary of liposculpture, while the latter may require combined techniques. Always depending on the elasticity of the skin surplus, the resulting scars can be very discreet and in the best cases almost non-transparent, while in others, it is necessary to reshape the tissues due to elastic deficit of the skin envelope.

We attend frequently, patients who have already been treated in other centers by different specialists , with incomplete results since they have not indicated with absolute precision the appropriate surgical option, which entails the need to reintervene to correct undesirable or at least insufficient results, frequently intervened again and again without having solved the original gynecomastia, and only adding complexity to the problem.

RESULTS

The disappearance of the breasts and when they exist, of fat overloads, is immediately noticeable obtaining a new contour of the thorax, masculinized and permanent, which usually improves even more with the progression of time.

RISKS

Those associated with any intervention, such as hematoma, lymphatic effusion or seroma, infection wounds, in addition to those of the intervened area such as induration or differences in symmetry. The scar is usually confined to the border between more pigmented skin; according to the skin surplus, in a minority of cases there may be more extensive scars.

POSTOPERATIVE PERIOD

The majority of these interventions are outpatient, so convalescence usually takes place at home, applying as a bandage an elastic containment band for several weeks, to prevent blood spills and lymph, also facilitating the readaptation of tissues to the new form of the chest. Depending on the magnitude of the mastectomy, drains are often associated, which are not used in pure liposculptures.

In successive visits we review dressings and fine sutures that are resorbable. In major gynecomasties the resumption of physical activity of irruptive effort is delayed at least one month.