Combining subcutaneous mastectomy with liposuction to treat gynecomastia is a proven method, targeting both firm glandular and excess fatty breast tissue. This article explains how this combination works, its benefits, and what to expect during treatment and recovery.
Disclaimer: Operation performed by Dr Bernard Beldholm. Adult content, surgery has risks; individual results vary, seek 2nd opinion. Please see the full disclaimer.
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Key Takeaways
- Gynaecomastia, characterized by the benign enlargement of male breast tissue, often requires medical intervention if persistent, with emotional and psychological implications considered in treatment decisions.
- The combination of subcutaneous mastectomy and VASER liposuction improves surgical outcomes for gynaecomastia, enhancing both the removal of excess tissue and the aesthetic result.
- Effective postoperative recovery and maintenance of results hinge on adopting a healthy lifestyle and regular monitoring of hormone levels, ensuring sustained satisfaction with surgical outcomes.
Understanding Gynaecomastia
Gynaecomastia is primarily caused by an imbalance in the oestrogen and androgen ratio in males, often triggered by factors such as:
- hormonal imbalances
- weight gain
- anabolic steroid use
- certain medications
This condition leads to the benign enlargement of male breast tissue, marked by an increase in glandular breast tissue rather than fat. These hormonal shifts are especially common during adolescence and aging, making gynecomastia a widespread concern among men of various age groups.
Common symptoms of gynaecomastia include lumps in the breasts, excess fat, and a palpable, tender, firm, mobile, disc-like mound of tissue under the nipple. Beyond physical discomfort, gynaecomastia often leads to significant emotional distress, embarrassment, and social anxiety. For many, the condition can affect self-esteem and daily interactions, making effective treatment essential. Studies have shown a marked decrease in embarrassment and social anxiety following successful treatment.
While some cases of gynaecomastia resolve on their own, particularly in adolescents, persistent cases may require medical intervention. Treatment is typically pursued when the condition is severe, persistent, or causes significant emotional or psychological issues. Understanding the different grades of gynecomastia, from mild (BB Grade 1) to severe (BB Grade 4), helps in determining the appropriate treatment approach, whether it be surgical or non-surgical.
Subcutaneous Mastectomy: A Surgical Approach
Subcutaneous mastectomy is a surgical approach that involves removing a significant portion of breast tissue while preserving the nipple-areolar complex, which helps maintain a natural appearance post-surgery.
Various techniques, including semicircular and transareolar methods, are employed in subcutaneous mastectomy, each presenting unique advantages and challenges. Complications can include haematomas, nipple necrosis, and aesthetic dissatisfaction, sometimes necessitating further corrective procedures. Despite these potential issues, the integration of liposuction with subcutaneous mastectomy has shown to improve surgical outcomes significantly, addressing both glandular and adipose tissue effectively.
The combination of subcutaneous mastectomy and liposuction enhances treatment results for gynaecomastia, offering improved efficacy and aesthetic satisfaction. This dual approach not only improves the removal of excess tissue but also contributes to a more contoured and natural chest shape, making it a preferred option for many seeking treatment.
Liposuction in Gynaecomastia Treatment
Liposuction, particularly VASER liposuction, plays a crucial role in the treatment of gynaecomastia. This technique utilizes ultrasound technology to break down fat cells, making them easier to remove. VASER liposuction is more targeted compared to traditional methods, efficiently breaking down fat while minimizing complications such as irregularities and unevenness. Patients also benefit from reduced bruising and shorter recovery times, enhancing the overall treatment experience.
Typically performed under general anesthesia, VASER liposuction enhances safety and reduces both surgery and recovery durations. This method is particularly beneficial for patients with excess fat tissue in the chest, aiding in achieving a more contoured and aesthetically pleasing result.
Combining liposuction with glandular tissue removal offers comprehensive solutions tailored to individual patient needs.
Combining Subcutaneous Mastectomy with VASER Liposuction
Integrating subcutaneous mastectomy with VASER liposuction provides significant benefits for patients suffering from gynaecomastia. This combination is especially beneficial for those with excess fat tissue, as it allows for precise contouring of the chest area, leading to improved treatment outcomes and satisfaction.
The dual procedure effectively addresses both glandular and adipose tissue, offering a tailored solution that meets individual patient needs.
For a detailed step-by-step guide on this procedure, please refer to my blog article “Surgical Treatment: Bilateral VASER Liposuction-Assisted Gynaecomastia Surgery for Grade BB 2a Gynaecomastia.”
Enhanced Efficacy and Cosmetic Effect
Combining subcutaneous mastectomy with liposuction provides a synergistic effect that significantly enhances the overall efficacy of gynaecomastia treatment. Patients typically experience reduced recovery times and fewer complications when these procedures are performed together. The dual approach allows for complete removal of glandular tissue along with excess fat, leading to a more definitive treatment outcome and higher patient satisfaction.
Patients report higher satisfaction levels due to the improved effectiveness and cosmetic results from the combined approach. Addressing both the aesthetic plastic surgery and functional aspects of gynaecomastia ensures excellent patient outcomes and a more natural appearance.
Disclaimer: Operation performed by Dr Bernard Beldholm. Adult content, surgery has risks; individual results vary, seek 2nd opinion. Please see the full disclaimer.
Suitable Candidates for surgical treatment of gynecomastia
Download our free guide: “Do I have Gynecomastia? Find out in 3 Easy Steps”
Candidates for the combined technique are typically those with significant breast enlargement and associated psychosocial distress, especially individuals who have not responded to non-surgical management. Ideal candidates are those with BB grade 2a, 3a and 4a gynecomastia seeking a surgical correction. These patients often have good skin elasticity, which is important for achieving optimal results.
BB Grade 2a is defined as:
- Moderate gynaecomastia
- No ptosis (sagginess)
- Dr Beldholm recommends VASER liposuction, followed by subcutaneous mastectomy with an infra-areolar incision for this grade
BB Grade 3a is defined as:
- Large gynaecomastia
- No ptosis (sagginess)
- Dr Beldholm recommends VASER liposuction, followed by subcutaneous mastectomy with supra-areolar incision. The skin above the areola is then removed in a semi-circle to tighten the skin and lift the NAC
BB Grade 4a is defined as:
- Gynaecomastia with ptosis (sagginess)
- the nipple sits between the lower breastfold and 2cm below
- Dr Beldholm recommends VASER liposuction, followed by subcutaneous mastectomy with supra-areolar incision. Excision of skin above the nipple to elevate NAC (Nipple areolar complex) and remove loose skin.
In my experience with performing these operations, the benefit of VASER liposuction is twofold: it removes fat and shapes the chest wall, lowering the chance of saucer deformity.
Health and realistic expectations are key criteria for candidates. Those considering this combined approach should maintain stable body weight and manage any underlying medical treatment conditions to ensure the best outcomes from the surgery.
Selecting suitable candidates ensures the combined procedure offers effective and satisfying results for those with gynecomastia.
Preoperative Examination and Planning
Identifying true gynecomastia involves a physical examination that can differentiate between glandular and fatty tissue. Ultrasound examinations are often used to confirm the presence of glandular tissue in suspected cases of gynecomastia. A thorough medical history, including medication use, is crucial for understanding the potential causes of gynecomastia and planning the appropriate treatment approach.
Standard laboratory tests, including hormone levels like testosterone, oestradiol, and luteinizing hormone, are necessary to assess any hormonal imbalances that may be contributing to the condition. Effective preoperative planning not only improves cosmetic outcomes but also lowers complication rates, ensuring a smoother surgical and recovery process for patients.
The Surgical Procedure
The average duration of surgery is around 1.5 hours. This surgical technique involves a series of steps, including anesthesia, lipolysis solution injection, VASER, liposuction, and subcutaneous mastectomy.
The procedure begins with the administration of general anesthesia to ensure patient comfort.
VASER liposuction involves three main steps:
- Injection of a wetting solution containing local anesthetic and adrenaline
- VASER treatment
- Suction lipectomy
After liposuction is completed, the breast gland is usually well defined. Depending on the need to remove skin, the incision is made either under the areola or above it. For more severe cases of gynaecomastia that may involve loose skin, the incision is made above the areola and a small amount of skin is removed to lift and tighten the areola and skin.
The sub-cutanous mastectomy is then performed by removing the breast glandular tissue though the areolar incision.
Drains are generally used for this operation.
Postoperative Care and Recovery
The typical recovery after gynaecomastia surgery is between 10 days to 2 weeks, with most patients able to return to work and resume light activities by the end of the first week. Initially, patients are advised to avoid strenuous movements to ensure proper healing. After two weeks, many men can start to resume normal daily activities, although vigorous exercise should still be postponed.
Most patients are cleared for normal exercise by the 3-4 week mark, with most swelling and bruising resolved by this time. Pain and tightness are common for the first 2-3 days post-surgery, but these can be effectively managed with pain medication. Compression garments are recommended to minimize swelling and aid in the healing process.
Potential risks include bruising, bleeding, fluid collections, visible scarring, infections, deep vein thrombosis, and contour irregularities.
See our article on “Effective Gynaecomastia Surgery Recovery Time: Tips & Timeline” for more information on recovering from gynaecoamstia surgery.
Long-term Results and Maintenance
Maintaining the long-term results of gynecomastia surgery requires a commitment to healthy lifestyle choices. A diet high in fruits and vegetables, along with proper hydration, supports overall health and helps in preventing hormonal fluctuations. To achieve sustained benefits, individuals need to keep their weight stable while adopting a nutritious diet.
Engaging in regular physical exercise is essential for maintaining the results of gynecomastia surgery. Incorporating regular physical activity into daily routines not only helps maintain the effects of the treatment but also promotes overall well-being.
Monitoring hormone levels and making healthy lifestyle choices can help sustain long-term results and ensure continued satisfaction with the surgical outcomes.
Dr Beldholm’s Final Words
Combining subcutaneous mastectomy with liposuction offers a comprehensive and effective treatment for gynaecomastia. This approach not only addresses the physical aspects of the condition but also significantly improves cosmetic outcomes, leading to higher patient satisfaction. By understanding the procedures, benefits, and necessary postoperative care, individuals can make informed decisions about their treatment. Ultimately, this combined technique provides a promising solution for those seeking to alleviate the physical and emotional burdens of gynecomastia.
Download our free ebook: “Gynaecomastia Surgery – Must know facts”
Frequently Asked Questions
What is the purpose of gynaecomastia surgery?
The purpose of gynaecomastia surgery is to remove excess breast tissue in men resulting from hormonal imbalances, thereby restoring a flatter and more contoured chest appearance.
What conditions can lead to gynaecomastia?
Gynecomastia can arise from hormonal imbalances, weight gain, the use of anabolic steroids, and specific medications. It is crucial to be aware of these factors to manage this condition effectively.
What is the recovery timeline after gynaecomastia surgery?
The recovery timeline after gynecomastia surgery typically spans 10 days to 2 weeks. Most patients can return to work and engage in light activities within a week.
What are the potential risks of gynaecomastia surgery?
Gynecomastia surgery carries risks such as bruising, bleeding, fluid collections, visible scarring, infections, deep vein thrombosis, and contour irregularities. It is essential to weigh these potential complications before proceeding with the procedure.
What lifestyle changes can help maintain long-term results after gynecomastia surgery?
To maintain long-term results after gynecomastia surgery, it is essential to maintain a stable weight, adopt healthy lifestyle choices, and regularly monitor hormone levels. These practices will support your recovery and help preserve the surgical outcome.
