Surgery Details

Gynecomastia is an increasingly treated problem. The gynecomastia website was created to educate people about the various aspects of the surgery. This is partly due to the increased incidence and also due to the availability of better treatment options than just excision that was followed until a few years ago. Now, the recommended treatment for any stage of gynecomastia is a combination of Liposuction and Excision, also known as Lipo-Excision.

While liposuction deals with the removal of the fat so that the chest is better contoured aesthetically, excision deals with the removal of the excess breast tissue. When used in combination, Lipo-Excision consistently yields excellent and predictable results. Before we proceed with surgical details, let’s take a look at the basics of Gynecomastia.

Gynecomastia is a problem worldwide and is known by various names like man boobs, moobs, male chest enlargement, etc. It literally translated to female-like breasts in a man. There are reports that up toΒ 60% of men may be affected by it to a varying extent. Even in Bangalore, there is an increasing incidence of Gynecomastia along with increasing awareness.

What causes gynecomastia is not fully known. Most of the cases of gynecomastia fall into a category called Idiopathic Gynecomastia which means that gynecomastia occurs without any reason. And the second category is called Secondary gynecomastia wherein there is a known cause of breast enlargement like hormonal issues, chromosomal anomalies, Liver disorders, drug abuse, etc. they account for a very minority of the patients.

Depending on the amount of breast tissue and the amount of loose skin on top of it, Gynecomastia is graded in three grades. They are Grades 1, 2A, 2B and 3 (Sometimes these are referred to as four grades, but technically they fit into these three grades).

Grade 1 is someone with a mild amount of breast tissue without any skin looseness. They sometimes just come with puffy nipples. Here are some examples.

Grade 2A is the presence of a moderate amount of breast tissue without loose skin. The size of the gland is bigger than grade 1.

Grade 2B is where there is a moderate amount of breast tissue with some amount of extra skin.

Grade 3 is when there is a large amount of breast tissue with a lot of loose skin.

Dr Sreekar Harinatha’s modified gynecomastia grading is now widely used and includes skin tone in assessment fo a patient. It was published in the prestigious Brazilian Journal of Plastic Surgery. It is as follows.

Grade IT: Small enlargement, no skin excess, and normal skin tone

Grade 1L: Small enlargement, no skin excess, and poor skin tone (indicating laxity)

Grade IIAT: Moderate enlargement, no skin excess, and normal skin tone

Grade IIAL: Moderate enlargement, no skin excess, and poor skin tone

Grade IIBT: Moderate enlargement, minimal skin excess, and normal skin tone

Grade IIBL: Moderate enlargement, minimal skin excess, and poor skin tone

Grade IIIT: Marked enlargement, a lot of excess skin, and normal skin tone

Grade IIIL: Marked enlargement, a lot of excess skin, and poor skin tone

You can read the article here.

Once a patient is graded, the treatment plan is Lipo-Excision. The procedure works perfectly for all grades irrespective of the size, age or loose skin. During the procedure, first, the fat is removed from the chest wall by liposuction and then the gland by excision. During the removal of the gland, sometimes a small quantity of the gland is retained intentionally for better reshaping. That decision is based on the overall shape of the chest and the nature of the overall shape of the body.

However, in patients with a lot of loose skin, it is suggested that they review after 3-6 months of lipo-excision to check the status of loose skin that remains. There are surgical and non-surgical options to get the skin tightened and better contoured.

Before the procedure is done, a few basic tests are necessary to check if you are fit to undergo the procedure.

The procedure takes around 90 minutes to complete and is always done on a daycare basis. That means you can go home on the same day. You, however, are advised to take off from work for two days to recover better. Working from home is allowed during this period. You will have to come back for a checkup after 2-3 days. You have to wear a compression vest (Pressure garment) for 6 weeks to 3 months to get the skin nicely reshaped and contoured.


Summary of Gynecomastia Surgery

Procedure time: 90 minutes

Admission: Daycare basis (9am to 6pm)

Stitch Removal: No (Absorbable stitches)

Leave from Work: A total of three days including the day of surgery. Follow-up consultation after 2 days. Gym, swimming and workouts can be resumed after three weeks.

Cost of Gynecomastia Surgery in Bangalore: Rs.55,000 plus 18% GST 9,900= 64.900 plus cost of the compression garment (around 3000): Total: Approximately 67-68,000

Whatsapp your pictures to Dr. Sreekar Harinatha at 9902223733