Enlarged male breasts, Gynaecomastia is a common condition causing significant embarrassment. Although it can be associated with hormonal imbalances and testicular tumours (age group 25-45 years), the majority arise in adolescent and middle-aged males in the absence of underlying pathology. Most teenage boys will experience some degree of transient gynaecomastia, which usually subsides in less than two years.
Surgical options very much depend on the degree of excess breast tissue and whether there is excess skin associated with it. It has been graded by Simon as:
Grade 1 small, but visible breast tissue with no redundant skin
Grade 2a moderate breast development with no skin redundancy
Grade 2b moderate breast development with redundant skin
Grade 3 marked breast tissue with significant excess skin
Treatment: Lower-grade gynaecomastia can be managed with simple excision and/or liposuction of the abnormal tissue (Grade 1–2a). Often, a fibrous disc is present beneath the nipple and this cannot be removed by liposuction alone and will require excision. Higher-grade gynaecomastia, especially that which appears as a female breast will usually require skin excision and, consequently, involves more extensive scarring,making a good aesthetic outcome difficult.
The attached photos are before and after combination of liposuction and open excision with a visible scar around the lower nipple, and additional scarring to remove excess skin on the right.
Surgical options very much depend on the degree of excess breast tissue and whether there is excess skin associated with it. It has been graded by Simon as:
Grade 1 small, but visible breast tissue with no redundant skin
Grade 2a moderate breast development with no skin redundancy
Grade 2b moderate breast development with redundant skin
Grade 3 marked breast tissue with significant excess skin
Treatment: Lower-grade gynaecomastia can be managed with simple excision and/or liposuction of the abnormal tissue (Grade 1–2a). Often, a fibrous disc is present beneath the nipple and this cannot be removed by liposuction alone and will require excision. Higher-grade gynaecomastia, especially that which appears as a female breast will usually require skin excision and, consequently, involves more extensive scarring,making a good aesthetic outcome difficult.
The attached photos are before and after combination of liposuction and open excision with a visible scar around the lower nipple, and additional scarring to remove excess skin on the right.
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