Gynecomastia (Male Chest) | Gynecomastia Surgery: Basic Questions

Male breast enlargement typically involves excess fatty tissue and firm glandular tissue under the areola. At Kalpana Aesthetics, Dr. Vishal Purohit uses a dual-modality protocol combining circumferential VASER or power liposuction with sharp periareolar gland excision. Liposuction debulks fatty chest tissue through two small entry points along the anterior axillary line, while glandular tissue is removed directly through an inconspicuous hemi-periareolar incision along the lower areolar border. Grades 1 to 3 are performed under local anaesthesia, while grade 4 requires general anaesthesia. Excised tissue is sent for histopathology, and patients wear a compression vest 24/7 for 4 to 6 weeks.

Dr. Vishal Purohit identifies an ideal surgical candidate as a man whose target BMI is within the normal range, though slightly overweight individuals may also proceed without delay. Obese and massively obese men are excluded because procedural risks are elevated and subsequent weight reduction causes skin laxity requiring re-operation. For teenagers, surgery is scheduled at least two years after completing puberty. Candidate assessment involves direct physical palpation, selective ultrasound or MRI imaging, and routine pre-operative anaesthesia evaluations including CBC and renal function tests. Anabolic steroid or prohormone users must cease consumption for at least six weeks, preferably three months, prior to surgery.

Hospital admission depends directly on surgical grade and anaesthesia selection. Dr. Vishal Purohit operates grades 1 to 3 under local anaesthesia, which takes 60 to 120 minutes without preoperative fasting. Because bed rest is never advised, these patients walk immediately and return home the same day with 24x7 clinic support. Conversely, grade 4 gynecomastia requires general anaesthesia, 6 hours of preoperative fasting, surgical drains, and up to about 4 hours in surgery. For these extensive procedures, a minimum 24-hour hospital stay for monitored observation is strictly mandatory. Sedation is never used in Dr. Purohit's practice.

Dr. Purohit's surgical protocol combines circumferential VASER or power liposuction with sharp periareolar gland excision through an inconspicuous hemi-periareolar incision along the lower half of the areola border. Histopathology is routinely performed on all excised tissue. In Dr. Purohit's practice, true recurrence is biologically not possible once the breast gland is removed surgically, as the excised tissue cannot grow back. Any persistent postoperative fullness represents residual tissue rather than regrowth, which requires a planned return to the operating theatre. To support optimal skin redraping, patients wear a custom medical-grade compression vest day and night for four to six weeks. If contour refinement is required, touch-ups are scheduled after eight to nine months.

Male breast anatomy comprises glandular ductal tissue with stroma alongside subcutaneous fat. In his clinical protocol, Dr. Vishal Purohit combines circumferential liposuction with sharp periareolar gland excision through an inconspicuous lower areolar border incision, sending all excised tissue for histopathology. Because excised glandular tissue cannot grow back, true recurrence does not occur. Any fullness noticed years later is biologically residual tissue or reaccumulated adipose tissue in pseudo-gynecomastia from significant weight gain. While medical literature describes new true glandular proliferation from hormonal disturbances, chronic diseases, or medications, Dr. Purohit affirms that properly excised gland tissue cannot biologically regenerate.