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Gynecomastia – Reduction of male mammary glands

Generally resulting from hormonal imbalance, undesirable breast growth may occur in men. This disease is quite common and affects about 30-40% of adult men and roughly 60-75% of adolescent boys. However, a slight increase in mammary glands at the time of puberty is a common phenomenon, which usually does not require medical intervention and will disappear in time.

However, if the condition is not treated and persists, it can be managed using a procedure called gynecomastia. First of all, it is necessary to undergo an endocrinological examination to ensure the correct diagnosis. If the diagnosis is confirmed, it is not a problem to treat this condition based on the endocrinologist’s recommendation.

There are several types of gynecomastia, so a specialist's opinion is needed for proper diagnosis and treatment of this disease. It may show a symmetrical growth or it can affect the glands in the chest separately. It occurs in several forms, and, in addition to the undesirable appearance, pain and stiffness in the mammary gland can be experienced.

Some men cope very well with gynecomastia, but this irregularity causes considerable problems and psychological complexes to many. Gynecomastia may cause considerable psychological harm especially during puberty, even though it is a very common phenomenon. However, the incidence of gynecomastia is not only an aesthetic issue as cysts can occur in the enlarged glands, which should not be underestimated. Breast cancer is not just a problem for women. Though this disease occurs in only a small number of men, it may be fatal, often due to late diagnosis.

If there is an accumulation of fatty tissue in the male chest area, this is called pseudogynecomastia. In this case, the disease can be treated with local liposuction. However, there are several types of gynecomastia, in which the disease needs to be properly diagnosed.

Preoperative preparation

It depends on how the procedure is performed. For local anaesthesia, the risk of blood clotting should be checked. In the case of general anaesthesia, internal preoperative examinations should be performed. The patient should not smoke or drink alcohol 48 hours before both types of treatment.

Surgical procedure

Real gynecomastia requires surgical treatment under general anaesthesia. During this relatively simple procedure, the excess part of the gland is removed. The procedure is performed through a small incision of around three to four centimetres. The incision is made along the edge of the nipple, specifically in the area where the darker colour of areola and skin in the lower half of the areola’s surroundings. A surgeon inserts temporary drains into the wound during the procedure to help improve healing.

In the case of surgical treatment of pseudogynecomastia, fatty tissue is suctioned out only under local anaesthesia, similarly to normal fat extraction (liposuction). Both treatments can be combined. In cases where the surgical site is enlarged to the extent that removal of excess skin is required. It is removed during surgery, and the wound is sutured. In most cases, the resulting scar is discreet.

Post-operative care and recovery

After surgery, drains are inserted into the patient’s body. The drains are usually removed on the second day after surgery. The patient also undergoes the first post-operative surgery. Inner sutures are used in the procedure. These are absorbable and thus do not need to be removed. It is then necessary to wear a special compression sleeve for 6 to 8 weeks. It is not recommended that the patient partakes in any intense physical activity for the first month after the surgery. Work incapacity after surgery is short and the return to non-demanding work is possible after 2 to 4 days. An unrestricted physical chest load is possible after about eight weeks.

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