drsanjayparashar

Villa 898, AL RAAJI Street, Al Wasl Road 40453 Dubai, UAE
Phone: 971 4 3884589
Gynecomastia

Gynecomastia

Hi, I’m Dr. Sanjay Parashar; an aesthetic and plastic surgeon with over 25 years’ experience. I have performed more than 10,000 surgeries overall, which include 300+ gynecomastia surgeries.

Here I will provide you all the information you need to make an informed decision regarding gynecomastia surgery, and to prepare yourself for it. If after this, you still have more questions, I’d be delighted to answer them in an in-person consultation. Read on…

Gynecomastia Surgery – A surgery to achieve masculine appearance of breasts

GYNECOMASTIA surgery, also known as male breast reduction surgery, deals with the removal of excess fat and tissue in male breasts, to alleviate their swelling and largeness, making them more masculine looking.

The surgery is the best treatment for the condition of gynecomastia (enlarged male breasts), in both boys and men. It can help restore your confidence in your appearance. Whatever your reason, before you decide to undergo this surgery, you should have adequate knowledge of the pros and cons.

Here are the 3 stages that will take you towards the aesthetic chest contours you desire:

Stage 1: About Gynecomastia Surgery - What you need to know before your initial consultation

There’s a certain degree of information you should have regarding surgery for gynecomastia even before your initial consultation with me. This information will help you be better prepared and have a more meaningful consultation session.

Gynecomastia is a medical condition in which there is a non-cancerous enlargement of a boy’s/ man’s breasts. This could happen due to hormonal imbalances, specific thyroid conditions, certain types of cancers, use of growth hormones, narcotics and steroids, or injury to testicles that affects the production of testosterone (the male growth hormone), or even due to obesity. To treat gynecomastia, a surgery is the most effective option. The surgery seeks to restore normal masculine contours to your chest by removing excess fatty tissue and glands.

Gynecomastia surgery can be performed both in boys and in men.

It is usually done under general anesthesia, and might require one night’s stay in a hospital or clinic.

Most boys show an increase in breast development during puberty and adolescence. This is usually temporary gynecomastia, and disappears on its own within a couple of years. If, however, the reversal does not happen naturally within 2 years, then medications are generally ineffective, and surgery would be the best treatment.

The objective of a gynecomastia surgery is to transform your chest contours to a normal masculine appearance.

Gynecomastia surgery is an effective option if you are unhappy with the size of your breasts, have pain in your breasts, are uncomfortable going shirtless, have differently proportioned breasts, or feel conscious of your masculinity

The condition of gynecomastia is widespread, with 75% of males experiencing it, to some degree, within their lifetime.

It is very essential for me that you are clear on why you are considering surgery for gynecomastia. So, even before your initial consultation, you should reflect on some questions:

  • Are you clear about what is wrong with your breasts?
  • Are you thinking of gynecomastia as a life-changing procedure?
  • What are your goals and expectations from the surgery?
  • Will you be comfortable and confident with the changes from the surgery?
  • Do you understand that your body contours could change over time?
  • Do you accept that minor flaws are likely to remain?

I will be asking you these questions in my initial consultation, and your answers will help me to assess whether you are a right candidate for this surgery.

If you are an adult male, in generally good health, ideally a non-smoker, have a positive attitude, and have realistic expectations from the surgery, you are potentially a good candidate for gynecomastia.

Gynecomastia is appropriate for men who:

  • have asymmetrical breasts
  • are concerned about the size and largeness of their breasts
  • uncomfortable with their chest silhouette
  • conscious of their masculinity due to large breasts
  • have emotional or psychological challenges due to your breasts
  • have painful breasts or nipples
  • unsuccessfully tried alternate methods of breast reduction – via diet, exercise and medication

Gynecomastia correction surgery can also be done for adolescent boys, but it’s possible they would require corrective or follow-up surgery in some years, if the breast development continues after surgery.

I will be keenly assessing your suitability for gynecomastia through your answers in our initial consultation, and will proceed only if satisfied that you are a good candidate.

While gynecomastia can in some cases be treated via non-surgical means, through diet control, exercise, medication, or ultrasound (“ultrasonic liposuction”), or lipolysis – this page is restricted to surgical correction of gynecomastia.

Surgery for correction of gynecomastia is usually done in either of the following ways depending upon your specific circumstances – extent of correction to be done, the position of your areolas and nipples, your skin elasticity, and the desired outcome.

  • Gynecomastia correction via Liposuction
  • Gynecomastia correction via surgical excision

Gynecomastia correction via Liposuction

This technique is used when mild correction is required, and the patient’s skin elasticity is good. Under the procedure, a small incision is made along the areola, a thin cannula or pipe inserted with attached suction, and excess fat suctioned out therefrom (liposuction). Once fatty tissue has been removed via liposuction, excess glandular tissue is pulled through the incision, and finally the incision is closed.

This technique is especially useful when gynecomastia is largely due to extra fatty tissue.

Gynecomastia correction via surgical excision

This technique is used when the correction needed is more extensive, and the patient’s skin elasticity is not very good. When performing surgical excision, the type of incision needed to achieve the best results, is determined first. This requires the surgeon to also be an artist, to be able to visualize the type of correction needed, and the outcome.

The most common incision type is the Webster Incision, or Intra-areolar incision, wherein the incision is made along the areola, in the lower part of the breast.

In select cases, depending on specific circumstances, a Transverse Nipple-Areola incision or Triple-V incision may be done.

For very extreme gynecomastia correction, an elliptical incision is used along with a nipple-areola graft (Letterman technique).

The latest approach in gynecomastia surgery, is “keyhole” surgery, where the incision size is reduced to 2-3 cm, and all the excess glandular tissue is removed piecemeal through the “keyhole”.

The technique I will use for you will be determined after a complete evaluation of your anatomy and based on your desired aesthetic goals.

A gynecomastia surgery has lasting results, when done with a competent gynecomastia surgeon. If you keep a stable weight, your surgery results can last for decades. Change could also occur over time due to use of drugs and steroids, or from future hormonal imbalances.

The surgery itself takes 2-3 hours, is usually an inpatient one, requiring one-night stay at the hospital/ clinic. Most men resume work within 7-10 days, and might need just 1 week leave from work along with 2 weekends.

Basic exercises, and routine daily activities can be done within 1-2 weeks.

I will prescribe what exercises will need to be done to aid recovery, medication, etc. Heavy exercises should only be resumed after my consent.

Every surgery carries some risks, but at this stage of my experience and expertise, the risks that my patients have are minimal. Standard risks include:

  • Anesthesia risks
  • Bleeding
  • Infections of any kind
  • Scars (though these will fade over time)

Risks are minimized in the hands of an expert surgeon, by doing the surgery in a good, licensed clinic or facility, following proper protocols; and by the patient carrying out all given instructions – both before and after surgery.

Gynecomastia cost varies based on the following factors:

  • Type of surgery and the extent of correction needed
  • Whether it involves overnight stay
  • Hospital/ Clinic used for the surgery
  • Skill & expertise of the gynecomastia surgeon

A gynecomastia surgery is typically a cosmetic procedure, and insurance does not cover the cost. In some cases though, where gynecomastia is linked to a serious medical condition, such as extreme pain in the breasts, or where the condition is caused by certain types of cancers, all or part of the cost may be covered by insurance. Please check with your insurance provider about your policy entitlement.

Another significant aspect to take into consideration, besides just the initial surgical costs, is your comfort factor with the gynecomastia surgeon, and your faith in the surgeon’s expertise. Pay a bit more – but be sure, and be comfortable with your surgeon.

To know the cost applicable for your specific case, please book a consultation.

The choice of the surgeon for gynecomastia surgery is a decision to be made with due care. While cost is a relevant consideration, there are other more important factors that should determine your decision:

  • Qualifications and certification, specifically plastic surgery related certifications and memberships, such as membership of American Society of Plastic Surgeons (ASPS)
  • Years of experience as a plastic surgeon, number of surgeries done
  • Number of gynecomastia surgeries done
  • Proof of work – before/ after images
  • Patient testimonials
  • Surgeon reputation
  • Your comfort factor with the surgeon, his manners, his patience in answering your questions
  • Surgeon’s philosophy regarding patient safety

You are planning a significant surgery, and one that requires very specialized training and even artistic flair, so it’s extremely important that you decide wisely. Pay more if needed, but choose a gynecomastia surgeon who has an extensive portfolio of successful surgeries. Make sure that you are fully comfortable with your surgeon.

I have done over 300 gynecomastia surgeries, including revision surgeries for patients unsatisfied with results of prior surgeries done elsewhere. You can read my full profile here.

The clinic or hospital for your gynecomastia surgery done should be carefully chosen. Ensure that the facility is licensed. A hospital is not necessary for a gynecomastia surgery, an accredited/ licensed clinic is just fine.

The clinic should have a licensed anesthetist on board, competent nursing and operations staff, and the surgical room should be clean and hygienic.

Ministry of Health (MOH), Dubai regularly conducts inspection of all medical and surgical facilities in Dubai and license is granted or renewed only if the prescribed conditions regarding hygiene, safety, etc. are met.

My medical center – Cocoona Center for Aesthetic Transformation, Dubai is an MOH-licensed clinic, and we are permitted to perform surgeries under local anesthesia. We also have competent anesthesiolgists on board, and a full team of caring and professional nurses, patient counselors, and other support staff.

For surgeries that need to be performed under general anesthesia, we do it at another licensed facility of your choice, or where we have a tie-up.

Now that you have all the base information regarding gynecomastia, you should take the next step of booking the initial consultation.

Stage 2: Initial Consultation – My questions to you, Chest examination, Explaining the procedure, Your residual questions

During our initial consultation, I will first ask you certain questions, conduct a chest examination, then explain the gynecomastia surgery procedure to you, and finally answer all your remaining doubts and concerns.

At the end of the consultation session, my goal is to have clarified to you fully and clearly what you can realistically expect from your surgery, assessed your eligibility for the surgery, satisfied all your concerns and doubts, and assured you of my capability to provide you the best results. Having done that, I will connect you with my patient counselor, who will handle the routine aspects of preparing you for your prospective surgery.

  • What aspects of your chest are bothering you the most?

This is a very specific question that helps me identify what is bothering you and I can compare your concerns with actual physical findings. If it matches, I am confident of giving you a good result.

  • What is your medical history?

I will inquire about any past surgeries, pregnancies, medical illnesses, allergies, ongoing medications, etc., to gauge your suitability for surgery, and which technique of surgery will be best for you.

After I’m through with my initial questions to you, and upon getting an idea of your expectations from the surgery, I will do a breast examination. I will evaluate the following:

  • Breast proportions – size, symmetry, nipple height and position
  • Breast footprint
  • Volume and quality of breast tissue
  • Skin elasticity

I use computer morphing to display and discuss the final post-procedure possibilities. That gives a visual idea of the possible outcome. I discourage extensive computer morphing, as it can be unrealistic and causes misunderstanding between patient and doctor.

Based on my findings from the examination and our earlier discussion, I will determine which method of breast surgery would be most suited for your specific case.

In some cases, to rule out any serious underlying medical reasons for gynecomastia, you might also be asked to do an ultrasound.

The basic gynecomastia process involves making incisions at specific places, based on type of surgery and other factors; removing excess fatty tissue and glandular tissue through the incision, reshaping the remaining tissue, repositioning the areola and nipple, if needed; and then closing the incisions.

Your surgery will be done either at an accredited day care surgical facility such as my medical center in Dubai – Cocoona or a hospital, depending upon your choice, and anesthesia considerations.

Understanding the process involves knowing about anesthesia, basic surgery steps, post-procedure recovery, return to normalcy, risks involved, and expected results.

  • What anesthesia is used?

The procedure involves general or twilight anesthesia.

  • What type of gynecomastia will be done for you?

The type of gynecomastia technique that will be followed for you is a decision that I will arrive at based on your anatomy, the extent of changes that are needed to achieve the desired shape, and your cosmetic expectations from the surgery.

There isn’t one best approach and technique – I will customize your surgery plan exclusively for you.

  • How is a natural looking shape attained?

The key to performing a natural looking gynecomastia surgery is to understand the proportions of the breast in relation to the rest of the anatomy – which is both a science and an art, correct the aesthetics, and have minimal visible scarring.

As a surgeon who takes immense pride in his work, I always strive for results that look perfectly natural relative to my patients’ body contours. That objective is best achieved, not by excessive changes, but by proportionate changes. It is for this reason that I restrict computer simulations, and refuse to do excessive structural modifications.

At this stage, you are likely to have few more questions for me to clarify. Some such questions are covered herein. I will be glad to answer these and any other concerns you have.

  • What is the recovery phase immediately after the procedure? 

After the surgery, you will be up and about in a few hours, and be able to go back home the following day.

Following the surgery, your chest will be bandaged, and you will be given a pressure vest for comfort. There will be pain for a couple of weeks, which will be minimized through medication. Swelling and soreness will subside within 3 weeks. You will be prescribed ointments, pain medication and antibiotics to help recovery.

Simple exercises such as walking are recommended after 3 days of surgery, but vertical lifting of arms is not permitted. You should also avoid carrying weight in the first 2 weeks.

Most of my patients return to work in 10-14 days. Intensive exercise should be undertaken only after 4-6 weeks, and with my consent. 

  • What should be done post-surgery to improve the results? 

Strictly follow the recommended post-surgery plan for faster recovery – including taking your medications, and keeping your follow-up appointments schedule. The surgical wounds will require regular dressings and you will be given the schedule.

Wearing the prescribed support garments will provide comfort and help minimize swelling.

Keep a generally healthy lifestyle to retain your results. If your gynecomastia was due to drug or steroid use, you should refrain from using them. Keeping a stable weight is also advisable.

  • When will the results be visible? 

Your final chest contours will be fully visible around 3-6 months after surgery, though improvement will be noticeable within 3 weeks once the swelling starts to subside.

The scars from the incisions will gradually fade, and some may be hidden under the natural chest contours.

Stage 3: The Next Steps …

After our detailed initial discussion, almost all matters would have been clarified. You will then get a handbook that explains the details of before and after care, medications to avoid, risks and complications, financial agreement, consent and permission forms, medical history form, etc. Please spend some time reading the booklet completely.

My patient coordinator will get back to you with cost details applicable to your surgery, and the booking protocol, and will also answer any questions you may have in the run-up to the surgery.

Then a pre-operative appointment will be arranged wherein we will do a complete medical checkup, measurements, surgical planning, photographic documentation, and other necessary paperwork.

You might also be required to get an ultrasound before proceeding for the surgery.

Finally, on the appointed day, I will perform the gynecomastia surgery, transforming your chest contours to the desired one.

It is advisable to have a family member or friend to drive you back home after the surgery.

Have a look at some of the testimonials from my patients, and here are some ‘Before & After’ pictures too. You might also want to spend a few minutes watching the video below to better understand the gynecomastia process.

You can also access my full profile here.

Do not hesitate to get in touch with me in any of the following ways:

Call: 800 362636 or +971 4 394 1090

Contact Form: Please complete the appointment form.

Email: info@drsanjayparashar.com

I look forward to hearing from you.

GYNECOMASTIA surgery, also known as male breast reduction surgery, deals with the removal of excess fat and tissue in male breasts, to alleviate their swelling and largeness, making them more masculine looking.

Gynecomastia

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