Procedures: Gynaecomastia


What is Gynaecomastia

Gynaecomastia is a term used for increased Glandular tissue and Fat in males, resembling female breast.The severity may vary from puffy nipples to significantly enlarged female like breast. It is often a cause of embarrassment and lack of confidence in boys and adult men. Gynaecomastia can affect one or both sides of chest, but most cases are bilateral


Grades of Gynaecomastia

In 1973, Simon et al identified four grades of gynaecomastia

Grade 1– small enlargement, without skin excess.
Grade 2a – moderate enlargement, without skin excess.

Grade 2b – moderate enlargement, with skin excess.

Grade 3 – marked enlargement with skin excess, resembling female breast with ptosis.


Causes of Gynaecomastia

1. IN MOST CASES, gynaecomastia result due to IMBALANCE BETWEEN TESTOSTERONE AND OESTROGEN for a brief period DURING PUBERTY. The oestrogen levels become high and out of balance with testosterone.

2. Some MEDICATIONS can also cause gynaecomastia
• Anti-androgens for eg.- Finasteride, Spironolactone .
• Anabolic steroids – commonly used illegally by athletes to build muscle mass and to enhance stamina .

• Anti-anxiety drugs- Diazepam
• Ulcer medication- Cimetidine
• Cancer treatment drugs
• Cardiac drugs – Digoxin and calcium channel blockers.

3. ABUHISIVE DRUGS AS MARIJUANA & HERION

4. ALCOHOL

5. SOME HEALTH CONDITIONS also cause gynaecomastia as
• Liver Cirrhosis
• Kidney Failure
• Hypogonadism as in Klinefelter’s syndrome or Pituitary insufficiency
• Hyperthyroidism
• Tumours involving testis, adrenal gland or pituitary glands.

Sign and symptoms

• Enlarged breast like tissue 
• Breast pain and tenderness.

Investigations

There are NO special investigations to diagnose gynaecomastia.
It is a clinical diagnosis made easily by examination by a Plastic Surgeon.

Treatment of Gynaecomastia

There is NO MEDICAL TREATMENT to revert back the increased size of glandular tissue and fat. It can be treated by an Aesthetic Plastic Surgeon by
Liposuction & Gland Excision surgery.

• It is a day care procedure; you will be sent home in the same evening.
• The surgery takes about 2 hours and is done under local or general anaesthesia.
• Through a tiny incision at side of each chest, fat is aspirated out by Liposuction using fine cannulas.
• By circum-aereolar key hole incision, the gland is also excised using fine instruments.


Recovery

• Immediately after surgery, you may feel some discomfort or soreness in chest area.
• You will be worn a pressure garment.
• You will be sent home in the same evening by your accompanying attendant.
• You can do all the normal activities at home such as walking around, watching television, talking on phone, eat anything etc from next day only.
• You are advised to visit our clinic after 2 days for inspecting the treated areas and to change the dressing.
• You can take shower after first follow up i.e., after 2 days.
• Second follow-up is after 7 days of surgery to remove sutures (if any).
• You can join back your desk or office work after just 2-3 days.
• The pressure garment is to be worn for 3-4 weeks.


Risks or Complications

• Infection
• Seroma formation
• Haematoma formation
• Swelling and pain
• Bruising
• Asymmetry of chest on both side
• Saucer deformity of nipple areola – The nipple is depressed inside and looks ugly, as more tissue is excised from under the nipple areola area
• Unsatisfactory result
• Risks of anaesthesia


Insufficient skin retraction

– in patients with Grade 3 Gynaecomastia
– with loss of skin elasticity due to excessive weight loss
– and in old patients.

Skin retraction is better and fast after treating with Ultrasonic Liposuction method.


Result

Dr. Vikas Gawri has skillfull hands and an artistic eye to chisel your chest by Advanced 3D Liposculpting by Ultrasonic or VASER technology. The results after ultrasonic liposuction can be seen immediately due to fast Skin Retraction. You can appreciate the result as early as just 2 days and all our clients are happy. The results are Promising and Permanent.

Dr. Vikas Gawri has changed lives of thousands of young men” Ultrasonic Liposuction achieves a Muscular Definition to the male pectoral area. By 3D Liposuction, we can achieve certain areas of elevation and depression, visible as light falls on the chest.

Dr. Gawri is passionate to give a Midline chest groove and to remove Axillary Fat from sides. (not aimed at by other surgeons.)


Our Advantages- At KYRA Aesthetic Clinic

• Kyra Clinic is an Advanced centre for‘Liposuction & Fat Grafting’. All forms of Liposuction technologies are available and used, as per different cases.

• Kyra Clinic is the first in North India, to introduce Ultrasonic or VASER Liposuction since 2011.

• Kyra Clinic is the first and the only clinic in North India to start Waterjet Liposuction and LIVE Fat Grafting since 2013.

• Kyra Clinic is certified for high standards of Sterilisation and Aseptic Methodology.

• Clinic has State of Art Infrastructure, latest Medical equipment and Well Trained Staff to ensure safety of our clients.

• Dr Vikas Gawri is world renowned Liposuction Surgeon. He is pioneer to bring 3D LIPOSCULPTING in this part of the country.

Over the years, he is experienced to predict “How the Skin Retracts & Redrapes over Underlying Muscles.


Before & After

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F & Q’s

Q. How long does Gynaecomastia surgery take?
A. Gynaecomastia surgery takes about 2 hours.

Q. What type of anaesthesia is used for gynaecomastia surgery?
A. Gynaecomastia surgery is done under general or local anaesthesia, decided as per case.

Q. How intense is the pain after gynaecomastia surgery?
A. Pain is described by most of our clients as mild and oral analgesics are prescribed for 5 days.

Q. When can I join my work after Gynaecomastia surgery?
A. You can resume desk or office work after 2-3 days.
Jobs involving heavy work can be started as per doctors’ advice.

Q.When can I take shower after gynaecomastia surgery?
A. You can take shower after 2 days.

Q.How long should I wear pressure garment?
A. A pressure garment is to be worn for 3-4 weeks. Pressure garment helps in skin retraction.

Q.When can I resume my exercise?
A. You can go for
• an outdoor walk at 1 week
• brisk walk with sweating at 2 weeks
• jogging and light exercises at 3 weeks and lastly
• weight training and swimming at 4 weeks.

You are advised to wear pressure garment during your walk.

Q.Is the result of Gynaecomastia surgery permanent?
A. Yes, the result is permanent.

Q.What is difference between ultrasonic liposuction and conventional liposuction?
A.

Q.Will there be any scar after the surgery?
A.There is a tiny incision at both sides of chest, measuring just 0.5 cm, forentry of liposuction cannula. We do not suture back these tiny incision as it heals well leaving no or minimal scar.

Second incision will be in the areola (dark or pink coloured skin around nipple)for gland excision.It will be sutured back with a fine thread and leaves no or minimal scar.

Overall the aim of the gynaecomastia surgery is no or minimal scar, so that no one can make out that any procedure has been done even if you are bare chest.

Q. Will there be any drains after the surgery?
A. No,we don’t use any drains

Q.Is Gynaecomastia surgery safe?
A.Yes, it is a safe surgery in the hands of an experienced Aesthetic Plastic surgeon and at a certified clinic.

Q.What is the cost of gynaecomastia surgery?
A. Cost varies according to
• Type of Liposuction technique opted
• the Grade of Gynaecomastia
• whether there is Fat at sides of chest or axillary region.

To get a quote in your case,
• you can visit our clinic for examination and consultation or
• for distant clients, you can send us pictures of your chest from front and sides(no need to include your face).

Dr Vikas Gawri will review your pictures and advice.

You can send us your pictures by email at [email protected]
or by whatsapp at +91 80548 02500 – Dr Rajni
+91 81466 66880 – Dr Shareen

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