Gynecomastia

The first consultation is essential to understand your request and your motivations. A preliminary clinical examination and a precise questioning will allow our specialist to define the most appropriate type of surgery for your case.

An assessment to identify the cause of gynecomastia will be conducted. This assessment determines your type of gynecomastia and defines the type of surgery to be performed.

In obese or overweight men, a diet combined with physical exercise is implemented, as weight loss can reduce or even eliminate gynecomastia (referred to as adipomastia).

Based on the anatomical context, your surgeon’s preferences and practices, and your wishes, a surgical strategy will be decided. The surgical technique employed and the location of the scars will be discussed during the consultation.

A preoperative check-up will be carried out in accordance with the prescriptions.

In some cases, gynecomastia surgery is performed on an outpatient basis under general anesthesia, but most often local anesthesia with sedation may be sufficient.

The choice of the technique will be made between you, your anesthesiologist and your surgeon.

A consultation with your anesthesiologist will take place a few days before your procedure.

Your surgeon will adapt his operating strategy according to your particular case in order to obtain the best possible result. The goal of corrective surgery is to restore normal anatomy as much as possible, with the principles of reducing breast volume through direct surgical excision (subcutaneous mastectomy) for glandular forms, or through liposuction for fatty forms.

In cases of mixed forms, the surgeon must then combine both techniques. The surgeon will then reduce the excess skin. Generally, the reduction in glandular volume allows for skin retraction. This skin retraction is enhanced by liposuction but is more pronounced in younger men with good skin quality (firm, elastic skin without stretch marks).

Certain post-operative procedures such as massage may help skin retraction. When gynecomastia and excess skin are very significant, the surgeon may need to make longer and therefore more visible scars. These scars may then be peri-areolar (around the areola), horizontal, and extend on either side of the areola.

In extreme cases, the surgeon may need to graft the areola and nipple. Other types of scars are possible (vertical, racquet-tail, etc.), depending on each particular case. During the procedure, a drain may be placed depending on the technique used and the surgeon’s practices.

This drain serves to evacuate blood and lymphatic residues that could accumulate at the surgical site. At the end of the procedure, a “shaping” dressing is applied, often with an elastic bandage.

The duration of the procedure will depend on each case; it lasts approximately 1 to 2 hours.

Post-operative recovery from gynecomastia can sometimes be painful during the first few days. Pain medication, adapted to the intensity of the pain, will be prescribed for a few days.

In the case of isolated liposuction, the patient may experience local pain similar to “severe muscle soreness.” Edema (swelling), bruising, and difficulty raising the arms are common initially.

The first dressing is removed after a few days. It is then replaced with a lighter dressing. Often, the initial dressing is compressive, then quickly a lighter dressing is combined with a compression vest to be worn day and night for a certain period.

This compression aids skin retraction and promotes uniform healing. The total duration of time off work varies from five to twenty-one days. It is recommended to wait one to two months before resuming sports activities.

Provided by our expert physiotherapist, manual lymphatic drainage from the first days, followed by Endermologie® drainage, will accelerate the resolution of edema and optimize healing.

The improvement is often clear and immediate. However, a period of two to three months is necessary to appreciate the final result. This is the time required for post-operative edema to disappear and for excess skin to retract. Beyond this period, the tissues will gradually gain suppleness.

The reduction in breast volume provides physical comfort, particularly when dressing. Finally, the result is often very beneficial psychologically, as gynecomastia is often considered a shadow on masculinity.

Regarding the stability of the result, several scenarios are possible. For pure glandular forms, glandular excision generally prevents recurrence.

However, significant weight gain may be accompanied by a new increase in breast volume (adipomastia), and this is more common for forms with a predominant fatty component.

The goal of this surgery is to bring an improvement and not to achieve perfection. If your wishes are realistic, the result should give you great satisfaction.