Gynecomastia

Gynecomastia is a benign proliferation (or hypertrophy) of the male mammary gland resulting from an increase in the ratio between the action of estrogens and androgens. It is generally accompanied by an excess of fat, known as adipomastia. It affects one boy in two at puberty, and sometimes disappears spontaneously. However, it can persist and present several degrees of severity, ranging from a simple mammary bud to the actual presence of a male breast. It can also occur at an older age, often in connection with hormonal changes or weight gain. Gynecomastia is often a major problem for patients, leading to great psychological suffering and reduced self-esteem. Some men avoid sporting activities or experience discomfort in intimate relationships.

Gynecomastia is most frequently idiopathic (with no known cause). It may be linked to hormonal changes (perinatal period, adolescence or andropause), obesity, the use of certain medications or steroids, or simply hereditary. Although most often benign, gynecomastia is sometimes the symptom of a serious illness (endocrine pathologies, brain tumors, testicular cancer, etc.). It is therefore essential to carry out a complete check-up to determine the origin of breast hypertrophy before considering surgical treatment.

In the absence of a known etiology that needs to be treated, volume reduction is achieved by liposuction and/or direct removal of the gland. During a consultation at Leman Aesthetic Clinic, a clinical examination will enable us to advise you on the most appropriate surgical modality. In fact, the gland may be very dense, and liposuction alone (or combined with Vaser) will not achieve sufficient volume reduction, so direct removal will have to be combined. Sometimes, an extensive procedure such as a mastectomy more or less associated with a facelift may be indicated (high gland/fat volume and/or excess skin). Depending on your expectations, high-definition liposuction may be proposed, with remodelling of the surrounding anatomical structures (lipomodelling of the pectoral and/or deltoid muscles).

Other surgical modalities such as hyaluronic acid injections or silicone implants were proposed a few years ago, but we no longer recommend them since the introduction of ultrasound-guided fat reinjection (U-GRAFT).

Pre-operative consultations are essential to study your expectations and advise you on the treatment best suited to your situation. A complete hormonal assessment will be prescribed, as well as a mammogram and breast ultrasound. Imaging tests are used to analyze the composition of breast hypertrophy. If gynecomastia is essentially of fatty origin, liposuction may suffice. If there is a significant presence of mammary gland, removal of the glandular tissue is indicated. These procedures can be combined and complemented by pectoral reshaping using fat transfer.

Gynecomastia cure

• Duration: 1-2 hours
• Anaesthesia: General or local +/- sedation
• Hospitalization: Usually not required
• Time off work: 7-10 days

Pectoral reshaping by fat transfer

• Duration: 1-3 hours
• Anaesthesia: General or local +/- sedation
• Hospitalization: Not required
• Time off work: 5-7 days

Liposuction causes minimal aches and pains.

Removal of the mammary gland, on the other hand, generates moderate pain for the first few days. Painkillers are always prescribed to reduce discomfort. Bruising and swelling are not serious and resolve spontaneously. Showers can be taken the following day. The scar does not require nursing care, but must be cleaned daily. A support garment must be worn day and night for liposuction for 4-6 weeks. Lymphatic drainage sessions will be prescribed depending on the amount of fat aspirated.

It is advisable to avoid lifting arms and carrying heavy loads, and to refrain from sporting activities for 1 month.

The effects of gynecomastia treatment can be seen in the disappearance of edema after a few weeks. The skin is gradually repositioned against the pectoral muscle. Scars are hidden in the pigmented nipple area. The final, stable result is assessed after 3 months. The flat chest restores harmony to the silhouette. The aesthetic gain is accompanied by major psychological benefits. Surgical treatment of gynecomastia significantly improves patients’ quality of life, self-confidence and self-esteem.

The cost of gynecomastia treatment starts at CHF 5,000. It varies according to the surgical techniques chosen and the complexity of the procedure. The surgeon will provide you with a treatment plan and a personalized estimate.