An unusual Approach to Gynecomastia procedure? Tri Valley Plastic Surgery

I am a 32 year old male who had Liposuction procedure of breasts about a year ago. Also, my surgeon chose to address the gynecomastia through incisions below and medial to my nipples. Is this an unusual approach?

Gynecomastia treatments

Gynecomastia is the growth of glandular tissue in male breasts. It is usually a benign condition that can cause significant psychological distress. Patients present with an increase in breast tissue, which is unilateral in one third of cases. Enlargement is usually central and symmetric. Gynecomastia associated with medications is usually unilateral; however, in pubertal and hormonal cases, the changes are often bilateral. The most common cause in the US is obesity. The Simon classification of gynecomastia is as follows: Group 1 is minor but visible breast enlargement without skin redundancy. Group 2A/2B is moderate breast enlargement without skin redundancy (2B is minor skin redundancy) Group 3 is gross breast enlargement with skin redundancy that simulates a pendulous female breast. Patients in groups 1 and 2 require no skin excision, but the breast development associated with group 3 is so marked that excess skin must be removed. In my practice for patients with minimal skin excess I always consider ultrasonic liposuction. It is an effective way to remove the dense male gynecomastia tissue and provides some degree of skin tightening. The challenge with this technique is what is called "the breast bud" with can be an especially dense area behind the areola (the dark area around your nipple). In some cases, this tissue is too dense for even ultrasonic liposuction and needs to be resected primarily and usually can be accessed by making a small incision at the edge of your areola where it can be camouflaged by the color change. Your surgeon may have also used more than one port site for the liposuction. Each treatment must be individualized of course but my typical incision sites for my liposuction for gynecomastia patients is at the anterior axillary line (the side of the chest) which is usually not seen when looking straight on. For mild gynecomastia I usually don't need a second port. If I do, sometimes I consider the base of the breast or if I think I'm going to need to resect the breast bud I would use an incision that allows me to remove the breast bud at the same time in addition to my lateral lipo incision. If a patient needs skin resected then there are a variety of skin resection patterns. The key here is that the skin excision pattern is significant different than a female breast reduction where the goal is to create a skin envelope that creates a round well shaped breast. I hope this helps. Steven Williams, MD Tri Valley Plastic Surgery