Gyneocomastia

Gynecomastia can be developed from hormonal imbalances from puberty, specific medications, weight gain, loss of testosterone from aging, and anabolic steroid use. 

If enlarged male breasts have affected your self-confidence and made you feel uncomfortable in your own body, then consider undergoing gynecomastia reduction surgery. At Millennial Plastic Surgery, Dr. David Shokrian offers gynecomastia reduction surgery to male patients interested in increasing their self-esteem and improving their masculine appearance.The Liposuction Method

Gynecomastia reduction can be performed using multiple different techniques, depending on the needs of each patient. If the patient’s excess breast tissue is comprised mostly of fat and little to no skin sagging is present, then liposuction is often the preferred surgical technique.

Either general anesthesia or local anesthesia with intravenous sedation will be used to numb the patient prior to surgery. Multiple incisions are then made to allow insertion of the liposuction cannula, a thin metal tube that is used to suction out fatty tissue. Incisions are small and may be located on the border of the areola, along the natural crease of the lower chest, and on the side of the chest.

Using multiple incisions allows the surgeon to more naturally sculpt the chest from different angles. The incisions used during the procedure will vary between patients. After the cannula has suctioned out the excess tissue, the incisions will be sutured shut.

The Tissue Excision Method

The excision method is best for patients whose enlarged male breasts are comprised of glandular tissue. The tissue excision method is also performed under general anesthesia or local anesthesia with intravenous sedation. After the patient has been numbed, a small incision on the lower border of the areola is made to provide access to the underlying gynecomastia tissue.

After the glandular tissue has been loosened underneath the skin, it is directly excised through the periareolar incision. Patients with moderate-to-severe amounts of excess tissue and skin sagging are good candidates for this technique. If fatty tissue is present in addition to glandular tissue, then the liposuction and excision methods may be combined to provide a comprehensive treatment. If excess skin is also an issue and needs to be removed, additional incisions may be made to create a tighter and more masculine contour. 

Recovery and Results

After undergoing gynecomastia reduction surgery, patients should expect to spend two to three weeks recovering. Most patients can return to work within one week, regardless of which technique was performed. Exercise and more strenuous activities may be resumed starting two to three weeks after surgery. If surgical drains and non-dissolvable sutures were used, they will be removed about one week following surgery. Patients’ chests will be wrapped in a compression garment immediately following the procedure to provide support to the tissue as it heals and help minimize swelling. In addition to swelling, common side effects include tenderness, bruising and loss of sensation in the treated area. Any loss of sensation is typically temporary and will gradually recover over several months. A difference in chest size will be immediately noticeable, although final results will take two to three months to develop fully as swelling and side effects continue to diminish. Results provide lifelong satisfaction, although weight gain, steroid use and certain medical conditions can result in new development of excess tissue.

Q&A with Dr.Shokrian

Am I a good candidate for gynecomastia reduction surgery?

Adult men with enlarged breasts who are healthy and have realistic expectations about the procedure make the best candidates for gynecomastia reduction surgery. To learn if you are a good candidate based on your desired results and anatomy, schedule an in-person consultation with us.

Which surgical technique is best for me?

Without an in-person consultation, determining which method we would need to perform to treat your gynecomastia is difficult. Schedule a consultation to receive a personalized evaluation so we may better determine which method will provide the best results for you.

How noticeable are the scars?

While every patient would like to avoid noticeable signs of surgery, scarring is an inevitable part of gynecomastia reduction surgery. We will take every precaution possible to ensure that your results are not affected by distracting scars. We always place scars as inconspicuous as possible to hide them within the natural folds of the skin. Once your scars mature about 12 to 18 months after the procedure, they will take on the appearance of fine white lines.

For how long will I need to wear the compression garment?

Most patients need to wear their compression garments for three to six weeks to ensure optimal results. Compression helps the body recover more quickly and will mitigate any residual swelling that can temporarily affect visible results. We will discuss post-surgery instructions and recommendations with you in more detail before the date of your surgery.

Which age is best for undergoing gynecomastia reduction surgery?

Adult men of any age can undergo gynecomastia reduction surgery to eliminate their male breasts. The earlier the procedure is performed in a patient’s life, the better. Gynecomastia can have adverse psychological effects on the patient’s self-esteem, so we recommend coming in as soon as you are willing to undergo surgery. 

Liposuction 

Liposuction surgery is a procedure that directly slims and reshapes areas by removing pockets of fat resistant to exercise and diet to improve body contour and can also be selectively used to mimic the appearance of a defined chest or abs. 

Liposuction can give you many amazing results such as:

• Tightened stomach from weight gain or pregnancy

• Sculpted arms and thighs

• More defined abdomen

• Sculpted, masculine chest

• Contoured chin and jawline

At Millennial Plastic Surgery, Dr. David Shokrian offers body contouring through liposuction and lipo contouring procedures. If you have failed to receive the results you want from diet and exercise, then liposuction may be the resource you need to finally achieve your dream body. 

Liposuction Procedure

Liposuction is completed under either general anesthesia or local anesthesia with intravenous sedation. After the patient has been numbed, the surgeon will make several small nicks in various locations in the targeted areas. These nicks are small and allow for the insertion of a cannula, a thin metal tube. The cannula is drawn in a back-and-forth motion below the skin to loosen the fat cells and suction them out of the body.

After the targeted fat has been successfully eliminated, the nicks will be sutured shut. The surgery lasts between one and four hours depending on how many areas are targeted during the procedure and how much fat is removed. 

Recovery and Results

Recovering from a liposuction procedure takes several weeks. Patients can return to work within one week, although they will need to wait about two or three weeks before returning to normal levels of exercise. Results from any liposuction procedure are immediately visible, although swelling will temporarily distort the new contours.

Common side effects include bruising, swelling, numbness and mild pain in the targeted areas. Most side effects diminish within the first couple of weeks of recovery, although swelling can take up to six months before subsiding fully. Compression garments will be placed over the targeted areas to help reduce swelling and facilitate healing. Regular use of compression over the first several weeks will promote quicker recovery and faster results.

Dr. Shokrian gives all liposuction and body contouring patients specific instructions on what they can expect following surgery and how they can best maximize their recovery for optimal results. 

Abdominal and Pectoral Etching Procedure

Abdominal and pectoral etching is performed under general anesthesia or local anesthesia with sedation. Prior to the procedure, the surgeon will mark out the ideal contours on the patient’s chest or abdomen to use as guidelines during the lipo contouring procedure. A few small nicks are then made in the skin in specific locations to allow for precise removal of the targeted fat.

During chest etching, fat deposits are removed from the lower and outer edges of the pectoral muscle, providing the chest with a more pronounced and masculine shape. During abdominal etching, fat is targeted along the natural lines of the underlying muscles to give them a more well-defined appearance. In both cases, a modest amount of fat is left over the muscles to contrast the areas where the fat deposits have been removed, creating the appearance of raised and developed abs or pectorals. The procedure lasts between one and two hours. 

LIPOSUCTION 360

360-degree liposuction is a more comprehensive procedure that combines liposuction of the entire midsection to achieve an overall curvier, contoured figure from every angle.

While liposuction is usually done on one area at a time, 360-degree liposuction targets multiple regions of the midsection where stubborn fat may be a problem. This can help create a more balanced, proportional appearance.

Q&A with Dr.Shokrian

Who is a good candidate for liposuction?

Our preferred candidates for liposuction are patients are within 25 pounds of their ideal body weight, do not smoke, have realistic expectations about the procedure and have already tried diet and exercise to achieve their desired results with limited or no success. Liposuction and lipo contouring are not meant to replace a healthy lifestyle. These procedures should be used as a last resort option for patients who are struggling to shed stubborn pockets of fat resistant to diet and exercise. If you are unsure whether you are a good candidate for one of our liposuction procedures, then schedule a consultation so we can give you an in-person evaluation.

Can multiple body contouring procedures be completed simultaneously?

Yes, we can perform multiple procedures during the same surgery. Let us know if you have more than one area that you would like targeted so we may prepare a comprehensive body contouring strategy that addresses all of your concerns.

Will I lose a lot of weight after a liposuction procedure?

Liposuction is fat loss surgery, not weight loss surgery. You will notice a marked improvement in your body’s shape and contours, but not much difference on the scale. Some patients may experience a small decrease in their body weight, but that is not the goal or intention of liposuction procedures.

How long do the results last?

Results from liposuction and lipo contouring are lifelong. The fat that we remove is gone for good, although you are not immune from gaining more weight through an unhealthy lifestyle. Patients interested in liposuction or lipo contouring should be able to maintain a stable body weight following their procedure to ensure they do not affect their new contours.

Will I have loose skin after liposuction?

Ideal candidates for liposuction should have tight, elastic skin. Patients who already have loose or aging skin that has lost its elasticity may require a different fat loss method, as liposuction can exacerbate the issue. We will perform an in-person evaluation prior to the procedure to verify that your skin has enough elasticity to make you a good candidate. For patients who are good candidates for liposuction, the skin will naturally adjust and conform to the new contours in the targeted area.