1. Can you remove the whole gland? min 00:25
During gynecomastia surgery we leave a bit of breast tissue under the areola, so that the areola doesn’t sink in. This means that what we leave behind is as important as what we take out. So that’s the reason why the gland can grow back, because we’ve left behind a little bit of tissue to support the areola.
Some patients can get away with removing the whole gland. That’s another question, doctor, can you remove the whole gland? In some cases yes, but not in everyone. So if you have thick skin, if you have well-built muscles and very little fat, then probably yes, but I make that judgement during surgery.
But yes, sometimes we can remove the whole gland.
2. How do I know if I need Gynecomastia surgery? min 1:15
Some patients ask us how do they know if they have gynecomastia and need surgery.
Here we look at what is causing the problem. Usually it’s appearance. And that can be caused by enlarged breast tissue or fat.
So it may be that you just need to lose fat. But if it’s gland then surgery unfortunately is the only solution.
However, this is cosmetic surgery. If the causes are benign, not sinister, whether it’s gland or fat, we can remove that for you.
So you can go through exercise and diet first and if that doesn’t work you can first consult your GP to rule out sinister causes and then you can consult with a gynecomastia surgeon to consider your treatment options.
3. How painful is Gynecomastia surgery and how long does it last? min 1:36
Everyone's pain threshold is different, luckily with our experience we are able to manage this including the anxiety and apprehension that comes with having this. We use local tumescent anaesthesia meaning you are awake during surgery. We start with injections which can sting initially but goes numb and we are able to do the surgery. Following surgery, the majority of the patients have some soreness for 2 days or so and In fact we only give Paracetamol which is usually enough.
Depending on what type of gynecomastia surgery you are having done, it usually takes about 1 to 2 hours, depending on whether you're having skin excision, VASER liposuction or radiofrequency skin tightening.
4. How we treat gynecomastia? min 2:16
For glandular tissue only surgery can get rid of it as far as we know. And the way we treat gynecomastia depends on what you’re presenting with, the grade of your gynecomastia, it ranges from puffy nipples to large pendulous breasts with excess skin.
That means the treatment can just mean removal of gland or just liposuction only or both, which is more common in our practice ie both gland removal and liposuction for contouring.
Some patients need debulking and chest contouring. If the skin is not taut or it is slightly loose, skin tightening modality like BodyTite or jplasma may be a worthwhile approach or if the skin excess is severe then skin excision is an option.
My approach is to do these procedures using local anaesthesia because I feel it's safer and in my hands it's more efficient and quicker so patients don't have to stay in a hospital and they don't have the downtime they have with general anaesthetic. Also the patient somehow participates in the treatment, is aware of what is happening and can communicate to patients what exactly is happening during the surgery.