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Gynecomastia Surgery

What is Gynecomastia?

Gynecomastia is the female type breast size seen in men. It is a condition that causes serious discomfort for men, especially in summer. Under normal conditions, the breast tissue of men is an undeveloped structure, but it is there even if a very small one. Gynecomastia, which occurs with the growth of this tissue or the adipose tissue around this breast tissue, or both together, is an occurance that can be fixed.

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Fat excess or breast tissue?

This question is a question asked to me many times by my patients. As I mentioned above, Gynecomastia is the female type breast size seen in men. Likewise, as I mentioned above, there are 3 different reasons for this:

1) Growth of Breast Tissue
2) Growth of Adipose Tissue present around the breast tissue
3) The situation where both Breast Tissue and Adipose Tissue growth are together

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Why Does Breast Tissue Grow?

I can say very clearly here that breast tissue size issue has been encountered more and more recently. Physiologically, the growth of breast tissue must be due to hormonal reasons. In other words, the increase of the estrogen hormone in the blood level, which is high in women but in trace amounts in the male sex, is the main reason for gynecomastia with breast tissue growth. It is not common for the estrogen hormone to increase in men. So, although it is not a common situation, why do we see it so much lately? I believe the main reason for this is changing eating habits.

Especially nowadays, the only reason why chickens come from the brooding period to the slaughtering period in only 21 days is the extra estrogen hormone given to them. As it can be understood from here, the frequency of gynecomastia development is higher in people who consume large amounts of chicken. Here I should point out that what I am saying is exactly what I observed in my own practice. Things I experience during conversations with patients who come to me for gynecomastia treatment.

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Are there different treatments for different causes?

Yes, in general, the treatment method for the cause of gynecomastia varies. There are open or closed surgery techniques as popularly known. Open surgery is a method that is made with an incision around the nipple and aims to remove the breast tissue inside. The closed method, on the other hand, is a liposuction procedure, which is inserted through small holes and this method is generally used to remove excess adipose tissue.

What are the differences between Open or Closed surgery?

As I mentioned above, choosing the treatment method for the cause is always one of the key points for patient happiness. There are differences between the open method, that is, the method made by cutting, and the closed method, that is, the liposuction process made through small holes. In the open method, that is, in the method made by cutting, the scar is placed around the nipple to hide the scar.

With this method, excess skin can also be removed, if any. The closed method, that is, liposuction, is a method that leaves much less traces. Depending on the size of the breasts, 2 or 3 0.5 cm incision scars remain. In the closed method, liposuction, the purpose is to remove the tissue by breaking it with a cannula. The tissues between the skin tissue and muscle tissue are broken down and taken out with the help of vacuum.

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How is it decided which method to do?

With a simple examination to be performed with gynecomastia patients , a simple test that will confirm the examination findings, the distinction is made very easily. What I call simple test is My Breast Ultrasound. Proportions of breast tissue and adipose tissue are revealed with ultrasound. It will be revealed whether it is breast tissue, adipose tissue or both.

Before and after surgery for liposuction method

As I have mentioned a few times above, in the case of excessive fat tissue, the liposuction method, which will be applied, will have very few surgical scars in the treatment of Gynecomastia. With the help of a cannula, the fat tissue is broken down by entering through small holes and then removed with the help of vacuum. The most important part of this method is the corset applied tightly on the breasts at the end of the surgery.

The main function of this corset is to apply an external pressure to the gap formed in place of the fat tissue taken out between the muscle tissue and the skin tissue, and to prevent a possible blood or body fluid accumulation. The corset must be worn for 5-6 weeks. Pain is not a very important issue for this method. By applying pressure in a way, the corset actually reduces the pain of the patient. The operation takes 1 – 1.5 hours on average. Generally, no hospital stay is required.

Before and after surgery for the Open Method

This method, which is preferred when there is a lot of breast tissue, is performed through the incision made around the nipple sometimes for half a moon shape and sometimes in a wider way. At the same time, if there is excess skin, it can be taken.

There is a group of patients that can only be treated with this method: patients with excessive sagging in the breast area after excessive weight loss. In this case, the aim is to properly remove the excess skin. In these cases, the scar is not only around the nipple. The operation lasts for an average of 1 to 2 hours after the surgery,  corset application can be performed but not always. Overnight hospitalization is often required.

If you want, you can read this subject in Russian.