Aesthetic plastic surgery

Gynecomastia

Gynecomastia means woman-breast and refers to an enlargement of the male breast caused by an increase in glandular, stromal or fat tissue. 
Gynecomastia may be associated with a variety of dissimilar causative factors but the final common pathway usually involves a relative or absolute excess of circulating estrogens, a deficiency of circulating androgens, or a defect in androgens receptors. Physiological gynecomastia is noted in newborns and with aging (involutional). Other causative factors are congenital syndromes , specific drugs and familial. Following a proper clinical evaluation, the treatment is usually surgical reduction of excess gland or fat and skin in some instances. This is achieved by either liposuction alone or in combination with surgical tissue removal.
Consultation
Dr. Spyriounis will first ask about your general health. Then you will be asked about: your expectations and the desired result, medication that you are on, allergies and previous operations. Testosterone and estrogen circulating levels will be checked as well.
 
Preoperative evaluation
Dr. Spyriounis will check your chest area. He will present you with the options available in your case. He will take pre-op pictures and he will thoroughly discuss the possible result and the usual complications following the procedure as they are presented in recent scientific papers. He will also discuss about anesthesia and recovery.
 
Before surgery
FBC, U&Es and other hematological exams will be done. avoid the use of aspirin or other antiinflamatory medication that predispose to bleeding well in advance before surgery.
Gynecomastia- the procedure
Αnesthesia
Usually general anesthesia is need.
 
Surgical technique
1. Liposuction
In case that the excess tissue is mostly fat and there is not much skin redundancy, liposuction alone may well be enough. This is done through 1cm. incisions that are camouflaged in the natural skin creases.
 
2. Gland removal ( with or without liposuction)
Both gland removal and liposuction is need when:
Moderate gynecomastia exist ( the mostly often encountered) :
When breast gland enlargement exists, combined treatment including breast gland removal and liposuction is need. This is done through a litlle semiareoral cut, within the areola margin.
 
Severe gynecomastia :
When the patient suffers from severe gynecomastia, the skin excess has to be addressed. This may well lead to more obvious scarring. The concentric circle technique is most often used. In few cases however, other techniques that involve bigger skin excisions and result in even bigger scars may well need.
 
After surgery
The procedure is usually done as a day case and you will probably leave the clinic the same day. A special pressure garment has to be worn for 3 weeks following the operation.
 
Recovery
Analgetic tablets will be prescribed and you should use them liberally. The swelling and bruising, will  be gradually reduced within the first post-op week. Dr. Spyriounis will be in close contact in order for you to have an uneventful recovery.

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