The strengths:

1/ This is a simple and painless surgery that treats an important complex in some men

2/ A cure of gynecomastia can be covered  by the health insurance if it has a glandular component and if an endocrinological examination has been done and turns out negative.

3/ We almost systematically associate liposuction with surgical excision of the glandular nucleus to obtain the most harmonious result.

Principles of Men’s Gynecomastia

The male gynecomastia corresponds to an abnormal development of the mammary gland in men. This is a common condition with simple and effective surgery.

Male gynecomastia is most often related to an unusual increase in the ratio between female hormones (estrogen) and male hormones (testosterone) in a male.
This may be related to decreased testosterone levels or increased estrogen levels.
There are many causes for this phenomenon which can be reversible.
These include:
– endocrinological diseases: hyperthyroidism, addison’s disease.
– liver diseases, including alcoholic cirrhosis
– tumors of the testis or lung or pituitary gland (prolactinoma)
– taking medicines, doping agents or cannabis
– fat overweight

Therefore, before any surgical male gynecomastia treatment a clinical, biological and radiological check-up must be done in case there is a cause that may be accessible to medical treatment.

 

There are 3 major types of gynecomastia :

– Glandular male gynecomastia: it’s about a pure excess of mammary tissue.
– Fatty male gynecomastia (or adipomastia): it’s a pure fat excess without excessive glandular tissue. It is often associated with diffuse fat overweight
– Mixt gynecomastia which represents most of the cases
Fat gynecomastia is treated by liposuction. Cannulas are passed through incisions of less than 4 mm (usually 2) and the fat excess is being sucked up

Pure glandular gynecomastia is treated by surgical removal of the mammary gland by an incision concealed in the areola (trans-areaolat incision under the nipple).

The surgical treatment of mixed gynecomastia involves liposuction of all the mammary area and an ablation of the residual mammary gland by an incision concealed in the areola.

In rare cases, additional scars are required:
– a full peri areolar scar if the diameter of the areola is too large (round-block technique)
– a T or horizontal scar of mastectomy if the volume of the breast is so important that it caused its ptosis.

In Practice

The surgery of a gynecomastia usually takes place under general anesthesia but can be considered under local anesthesia plus sedation (neuroleptanalgesia) in the simple cases.
A specific compression garment (Roméo de Medical Z) must be worn within 15 days after surgery.
It most often requires a day at the hospital (ambulatory surgery).
An anesthetist must be seen no later than 48 hours before surgery.
No medication containing aspirin should be taken within 10 days of surgery.
A specific compression garment (Roméo de Medical Z) must be worn within 15 days after surgery.

Questions and answers

What are the possible complications ?

A hematoma (blood clot) can occur within the hours following the surgery. Treatment requires emergency room recovery.
Later, postoperative lymph effusion may occur between 5 and 15 days after surgery. It can be monitored if it is low in abundance or requires a puncture.
Sensitivity issues of the areola and nipple may be present within 6 months after surgery.

Is it a painful procedure ?

Usually not.
However, if extensive liposuction is associated, moderate pain may be present within 7 days following the gynecomastia treatment.

Can we resume sport activity soon after the intervention ?

Moderated physical activity (running) may be considered 10 days after surgery. The resumption of working out, in particular of the pectorals must not be considered before 1 month after the cure of gynecomastia.

Is a cure for gynecomastia taken care of by health insurance ?

This intervention is assured by the health insurance if your gynecomastia has a glandular component (the isolated adipomasties are not reimbursed) and an endocrinological examination has been made and does not find a medically treatable cause.

How much does it cost ?

If your gynecomastia treatment is covered by the national health insurance, our fees vary from 1500 to 2300 €.
In case of adipomastia not reimbursed by the health insurance, the total cost of the intervention is between 3200 and 3800 €

Photos

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