When you decide to pursue gynecomastia surgery, you are placing your trust in my ability to reshape and re-contour your chest. This is a task I take very seriously.
True male chest contouring is a blend of technical skill and artistry. There is no “one-size-fits-all” procedure.
I want to walk you through the advanced surgical techniques I use, from simple liposuction to combination procedures, to ensure your treatment plan is perfectly customised to your unique anatomy and aesthetic goals.
The goal of gynecomastia surgery is to restore a flatter, firmer, and more masculine chest contour. The procedure must be carefully tailored to each patient’s unique needs. The precise surgical approach is determined by a definitive diagnosis regarding the composition of the enlarged breast tissue.
Technique Selection Depends on Tissue Composition (Diagnosis)
Liposuction (Fat Removal)
Liposuction is a foundational technique, essential when the enlargement is primarily due to fat. This surgical technique removes excess fat deposits from specific areas of the body using a suction hose (cannula) through small incisions.
This method is effective and best suited for cases of Pseudogynecomastia, where fat is the main concern. As we discuss in our guide on differentiating true gynecomastia from pseudogynecomastia, this “false” gynecomastia is often seen in men with obesity and does not involve true glandular tissue. This minimally invasive method results in short recovery times and minimal scarring.
Liposuction alone usually will not fully correct a significant proportion of gynecomastia cases because the glandular tissue is dense and fibrous, making it resistant to removal. The persistence of this tissue increases the risk of recurrence.
Studies have reported that treatment by liposuction alone was found to result in a high percentage (41.5%) of “residual gynecomastia,” which appears 1 or 2 months after surgery, often requiring touch-up procedures later.
Gland Excision (Tissue Removal)
Gland excision is necessary when the core problem is dense, rubbery breast gland tissue that cannot be suctioned out. This is the surgical removal of excess glandular tissue and/or skin.
Excision is preferred when glandular tissue is excessive. This technique is also needed if noticeable skin sagging is present. This is typically seen in patients with Grade III or Grade IV gynecomastia. A small incision is typically made near the areola to allow for the removal of the excess tissue and chest reshaping.
Complete glandular excision must be meticulous. Overzealous removal can lead to unsatisfactory results, such as a concave defect or “crater” deformity. To prevent this, surgeons must ensure Retromammary Fat Tissue (RMFT) preservation in the area to reduce the need for reoperation because of undercorrection or overcorrection
Combination Approach Maximises Aesthetic Results (Core Technique) – The Gold Standard for Grades I and II
In modern gynecomastia surgery, achieving a definitive, natural-looking masculine chest rarely relies on a single combination technique. The combination of advanced liposuction and precise glandular excision is the most commonly used technique.
This comprehensive approach, which forms the core of your customised gynecomastia treatment plan, allows the surgeon to address both the fatty component and the dense glandular tissue simultaneously. This leads to optimal aesthetic outcomes and provides a permanent, anatomical solution.
For patients seeking gynecomastia treatment in Jaipur, the gold standard in modern male chest contouring involves technologies designed to be both highly effective and minimally invasive. Liposuction technology is central to achieving the most aesthetically pleasing, virtually scarless results.
Lipocontouring Defines Precision
Expert surgeons in Jaipur utilise specific, advanced tools to break down tissue and fat, enabling precise and gentle removal.
- Liposuction Technology: This uses appropriate suction to disrupt the bonds among fat cells, loosening them to deeper tissues to help remove fat more effectively, without damaging the nearby structures.
- Combination Tool Use: I always use Liposuction in combination with gland excision techniques to break the gland and then remove the glandular tissue. This is crucial because, unlike fat, glandular tissue cannot be removed by exercise.
Achieving Scar-Free Results on the Front of the Chest
The application of liposculpting allows surgeons to perform the necessary excision through strategically hidden entry points. This directly addresses the patient’s anxiety about visible, permanent scarring, a topic we cover in depth in our guide on scarless results.
Regardless of the technique, satisfactory results are dependent on inconspicuous resultant scars that respect the boundaries of aesthetic units
Combination gynecomastia surgery is the best technique for giving almost scarless results with the fastest recovery. The procedure is performed by making a tiny incision (no more than 2cm in size).
The tiny incision is placed along the lower border of the areola, ensuring that the procedure leaves no cut or scar on the front of the chest. This ensures the surgery doesn’t lead from one aesthetic concern to another, and the minimal invasiveness contributes to a shorter expected recovery timeline.
Subtotal subcutaneous mastectomy, which leaves a small disc of tissue beneath the nipple, is necessary to prevent nipple retraction and dimpling
Skin Reduction and High-Grade Management (Grades III and IV)
For patients with severe enlargement, marked ptosis, and skin redundancy, typically classified as Simon Grades III and IV, skin resection is mandatory.
Scar-Shape Trade-Off
Achieving the desired aesthetic result in these complex cases requires prioritising chest flatness and masculine shape over minimal scarring. Patient surveys indicate that 86% of patients would rather have more scars for a flatter chest wall.
Technique Selection for Severe Grade Gynecomastia
- For Grade III gynecomastia, skin-sparing techniques are generally not sufficient, and eliminating excess skin necessitates periareolar removal of epidermis.
- Advanced techniques like the postero-inferior pedicle, designed for Grade III, are utilised to preserve neurovascular function and sensitivity, or the Superior Pedicle NAC Flap is used to ensure the nipple is correctly repositioned while preserving viability.
Limitations of Minimal Access: For severe gynecomastia (Grades III and IV), the limits of minimally invasive or endoscopic treatment are exceeded, requiring extensive excision, like the double doughnut technique or free nipple grafting in massive weight loss patients.
Specialised Access: For Grade III cases, techniques like the inferior pedicle reduction technique or the complete circumareolar technique, combined with purse-string sutures, allow broad resection of excess skin while avoiding unattractive scars on the patient’s chest.
Specialised Patient Considerations
The surgical approach must be tailored to unique patient factors:
Anabolic-Androgenic Steroid (AAS) Users:
In bodybuilders with a history of AAS use, who often present with a high gland-to-fat ratio, more aggressive dissection is often required to remove glandular tissue adhered to the superficial fascia.
Drain Management
While techniques like the pull-through aim to avoid drains, surgeons must discuss with patients the benefits and risks of drains after subcutaneous mastectomy.
Your Consultation in Jaipur
Your specific diagnosis dictates the procedure. To determine the precise composition of your tissue and customise your permanent male breast reduction plan, I invite you to book a consultation.
To book your personalised, confidential consultation, please reach out to my team at Kalpana Aesthetics.
- Call or WhatsApp: 7718183535
- Visit Us: Kalpana Aesthetics, 2nd Floor, Jaipur Hospital, Mahaveer Nagar, Tonk Road, Jaipur
Disclaimer: The information provided on this webpage is for educational purposes only and does not constitute medical advice. The choice of surgical technique depends on individual patient factors and anatomy. Please consult with a qualified, board-certified plastic surgeon to discuss which procedure is right for you, as well as the potential risks and benefits.
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