LIPOSUCTION FOR GYNECOMASTIA

Gynecomastia (gyno) is the abnormal enlargement of male breast tissue.  Although all men (and women!) have breast tissue, in most men for most of their lives it is too insignificant to be either seen or felt through the skin.

However, under certain conditions a man can develop man boobs, or gynecomastia. Breast tissue responds to hormone levels: high levels of testosterone stop it from growing, while high levels of estrogen encourage it to grow.

At some stages in life a man’s the hormonal balance can shift – favouring estrogen and causing the breasts to grow.

This is so common during puberty that it can almost be considered normal. Other things such as certain medications, recreational drugs or diseases can also cause the male breasts to grow.

Pseudogynecomastia

In many men gyno is the result of both enlarged breast tissue and fat tissue that builds up over the chest area. In men who are overweight or obese, a higher proportion of the swollen chest will be made up of fatty cells – and in some men the breast tissue itself may be normal size with fat making up all of the swelling.

When man boobs are caused by fatty tissue they are sometimes called pseudogynecomastia.

normal breast and pseudogynecomastia

Treatment for pseudogynecomastia

Many men will be keen to find ways to get rid of their gynecomastia. If a man is overweight, then the most effective treatment is usually weight loss and exercise. Weight loss reduces the amount of fatty tissue around the breast area (along with the rest of the body) and reduces the size of the gyno.

In addition losing weight can reduce the size of true gynecomastia. This is because fatty tissue encourages a man’s body to produce more estrogen (by converting some other hormones). The rise in estrogen can be enough to upset the hormonal balance a little and cause the breast tissue to grow.

Exercises targeting the chest area can help to improve muscle definition and improve the aesthetic appearance of the chest.

Other treatments are available over the internet, which are often marketed directly at men suffering from gynecomastia. Many of these are weight loss or dieting supplements. These may help speed the process of weight loss, and reduce gynecomastia – but often the best and most long-lasting treatment will be diet and exercise.

If this does not work, or if the gyno is particularly significant or distressing, a man may seek other possible treatments. Surgery for gynecomastia can provide immediate results, and is often the most effective treatment option.

However, surgery is expensive, and a big decision – the pros and cons of any surgical procedure should be carefully considered and discussed with the surgeon before agreeing to proceed.

Treatment options for gynecomastia:

  • Time – particularly for adolescents
  • Diet and exercise – especially good if the man is overweight
  • Diet pills and supplements
  • Medication from doctor – rarely recommended
  • Specific pills for gynecomastia – can be expensive and benefits unproven
  • Surgery – liposuction for fat and/or mastectomy to remove breast tissue

Liposuction for gynecomastia

Among the treatments for gynecomastia and pseudogynecomastia, liposuction is often discussed as a ‘minimally invasive’ surgical solution. Minimally invasive surgery is procedures which are carried out without leaving large or unsightly scars.

Liposuction – also sometimes called ‘lipo’ – is the process whereby fatty tissue is surgically removed from a specific area of the body using a surgical probe. Over recent years it has become a very popular technique and is used by cosmetic surgeons on many different areas of the body.

Traditional liposuction involves manually breaking down the fatty tissue before the probe ‘sucks’ it out of the area. This surgery causes minimal scarring as the probe is relatively small. The scar can also be sited away from the treatment area and is therefore ‘hidden’ – for example under the arm.

Liposuction tackles fatty tissue; it will not remove breast tissue. So, for a man with pseudogynecomastia where all (or nearly all) of the breast swelling is caused by additional fat, liposuction without any other surgery may give a very good result.

In men where all (or nearly all) of the swelling is caused by enlarged breast tissue, liposuction would not be the right choice.

For the majority of men, man boobs are caused by a combination of the two types of tissue. Many surgeons will therefore suggest both liposuction and a mastectomy to remove the breast tissue.

This combined surgery will result in an additional scar – as the mastectomy will usually be carried out through an incision around the nipple area – but often gives the best and most long-lasting result.

Offering liposuction without a mastectomy is more unusual. This option might be preferable as it is ‘minimally invasive’, leaves scars which are small and discreet and is usually cheaper than combined surgery.

However, liposuction will only deal with the fatty tissue, so any breast tissue will be left behind. This means that even if the breast itself is only enlarged enough to make the nipple jut out, this will remain after the surgery.

The man may be disappointed with the results, and possibly even end up requesting further surgery to deal with the remaining breast tissue. Liposuction without a mastectomy is really only an option for a small group of men with gynecomastia.

This option should be carefully discussed with the surgeon involved before a decision is made to ensure that the man has realistic expectations of what the result will look like.

Vaser lipo for gynecomastia

One of the problems with traditional liposuction is that it relies on manual force to break down the fatty tissue to make it small enough to be ‘sucked out’ by the probe. This means the treatment is very non-specific.

Not only will fat cells be destroyed, but any other soft tissue in the area (for example blood vessels and nerve endings) may be damaged by the process. This can lead to a lot of bruising after the procedure and quite significant post-operative discomfort.

Recently several new techniques for liposuction have been developed which aim to combat some of these problems. One of these techniques is called ‘vaser’.

Vaser liposuction uses ultrasound waves to break down the fatty tissue. The vibration caused by the high frequency sound waves destroys the fat cells and turns them into a thick liquid. This can then be removed by the liposuction probe.

Vaser has been designed to try and focus only on the fat cells and minimise damage to other soft tissues in the area. This should mean that bruising and pain are reduced after the procedure.

Using ultrasound waves in vaser is also said to make the treatment more specific, meaning particular areas can be accurately targeted and the treatment can be used to ‘sculpt’ areas of the body.

Many surgeons are using vaser for gynecomastia. Some say it is especially good at breaking down the dense fatty tissue that is sometimes found in the breast area with minimal pain and bruising.

Some describe using vaser in combination with other types of liposuction to target different types of fatty tissue. Many surgeons will offer vaser in addition to a mastectomy procedure to remove the true breast tissue and make the final appearance as good as possible.

Surgery for gynecomastia

The decision to seek surgery for gynecomastia is a big one. Any surgery carries the risk of unwanted complications or side-effects, and of course surgery can be very expensive. Finding a certified surgeon who is experienced in male gynecomastia surgery is the most important thing.

They will be able to discuss the pros and cons of any procedure with you, and they should be happy to talk you through the different procedures and what they can offer.

For many men liposuction will be offered as part of the surgery – often alongside a mastectomy procedure to remove breast tissue. There are several different types of liposuction available. All of them are surgery designed to specifically remove fatty tissue.

Which technique each surgeon uses can be influenced by many things, including personal experience and availability of equipment. There is no universally agreed ‘gold standard’ surgery for gynecomastia – and each surgeon will use their experience and judgement to suggest treatment for each unique case.

Surgeons may ask for imaging tests including ultrasound and possibly MRI scans to help them decide on which treatment might give the best possible results in that particular patient.

What to expect after liposuction

Liposuction scars are placed away from the chest– often in the area under the arm. They are usually small and discreet, measuring only a few millimetres in length. The breast area will usually be sore or tender after the procedure, and there will often be some bruising over the area.

Bruising after a surgical procedure can take several days to ‘come out,’ and the appearance may get worse before it get better. Any excessive bruising or worsening discomfort should be discussed with the medical team who carried out the procedure. The chest area should immediately have a different shape, and the benefits should be obvious.

Once the discomfort and bruising have settled, many people are very happy with the final appearance following liposuction. However, occasionally problems do occur including an uneven appearance or ‘dimpling’ of the skin where the liposuction has been done.

Liposuction is, unfortunately, not necessarily permanent. If the man gains weight after the procedure, new fatty tissue can build up in the area and cause the man boobs to ‘regrow’. However if the man maintains his weight and continues to exercise, the improved appearance should last for a long time.

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