How is gynecomastia treated?
Gynecomastia is usually treated with a combination of liposuction and direct excision of breast tissue under the nipple area. The incisions are made along the lower half of the areolar circumference at the junction between the dark and light skin. These scars usually fade with time and are rarely conspicuous. Most mature men usually have some hair in this area that further contributes to obscuring the scars. Liposuction consists of injecting the breast area with a dilute anesthetic solution followed by sliding special tubes called cannulas back and forth through the breast tissue to dislodge and then extract the fat. Liposuction removes approximately 80 percent of the excess tissue but removes only the fat. There is also firm glandular breast tissue present that contributes to the condition and is not effectively removed by liposuction. Therefore after completion of the liposuction portion of the procedure the breast tissue is removed by excising it under direct vision through the incision described. The goal is to make the area flat while avoiding aggressive over-resection that could leave a dent. Extreme cases of gynecomastia with hanging breasts may require skin removal in addition to liposuction and tissue excision. The scars are much more significant when this is necessary.
Beyond adolescence beginning in the mid-twenties men will often develop prominent “love handles” around the waist in addition to gynecomastia. These areas can be conveniently treated at the same time with liposuction. The lower abdomen is another area that is commonly treated with liposuction concomitantly. While liposuction can remove bulges due to excess fat in these areas, it does not tighten loose skin. Therefore each patient must be carefully evaluated if liposuction of these other areas is being considered.