I was wondering what is the best surgical method for gynecomastia. I am especially interested in the surgery that goes through the arm pits instead of the incision along the areola. What are the cons through having the surgery done through the arm pits?
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Gynecomastia Surgy
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Gynecomastia in young men is relatively common. It can be a combination of fatty and fibrous tissue. Liposuction is the preferred method of treatment, but usually there does involve that fibrous tissue removal. This can be done through small incisions under the fold or on the side of the chest. The tissue take-out and liposuction will help to flatten and contour the chest in one stage. If there is excess skin, an upper body lift is preferable to liposuction.
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The best method of treating gynecomastia is whatever will correct the problem with the least scarring and the best cosmetic result. There is almost always breast tissue present that has to be removed. Although when there is minimal gynecomastia and the skin is elastic, this can be done from the axilla (the arm pit), it is much easier, safer and less likely to cause irregularity when done from a periareolar incision. If the gynecomastia is larger or the skin is non-elastic, a larger incision is necessary. If the gynecomastia is essentially like a female breast, the nipple will need to be reduced and moved.
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If you want to avoid the scars you may consider Laser liposuction. It will melt the tissue and help with skin tightening. Consult a Plastic Surgeon close to your area who can explain the procedure to you.
In short if the excess tissue is mostly fat then liposuction techniques (e.g. incision nearer the armpit) work well, but if hard tissue a more direct surgical excision is necessary.See the the following video explaining the various gynecomastia techniques and why each method should be choosen: http://www.realself.com/video/male-breast-reduction-who-s-a-good-candidate
Usually a combination procedure of liposuction and excision of glandular gynecomastia tissue is performed. The liposuction component could be performed to some degree at the arm pits. It would be difficult to excise the gynecomastia tissue through only an arm pit incision. Usually, a periareolar incision is performed for the glandular excision component.
In all cases of gynecomastia we use power assisted liposuction (PAL) using the principles of SAFE liposuction. Incisions are usually in the axilla. Specially designed disposable cannulas are used with the PAL system. Then, if needed we make a small periareolar incision and remove any glandular tissue which remains. In the rare cases of skin which is severely sagging a complete incision is made around the areola and directed down to reposition the nipple areolar complex and shape the breast to normal. Postoperative Topifoam compression and custom garments are used to decrease bruising and lessen the recovery period. Best of luck.
If your gynecomastia is mostly due to fatty tissue, then liposuction thru the arm pit will work just fine.
If however, you have glandular breast tissue that needs to be removed surgically, then an incision thru the lower part of the areola often provides the best access to do a thorough job of removing glandular tissue. The arm pit incision will not be as good an access point for removing tissue that is often peri-areolar.
If however, you have glandular breast tissue that needs to be removed surgically, then an incision thru the lower part of the areola often provides the best access to do a thorough job of removing glandular tissue. The arm pit incision will not be as good an access point for removing tissue that is often peri-areolar.
It can be difficult to remove all the glandular tissue when done just by an incision in the armpit. This has been attempted using a curette-like instrument called a tendon passer. Liposuction alone, whether regular, vaser ultrasonic or laser, does not remove glandular tissue, only fat. So to the extent that there is residual glandular tissue (breast tissue) and not just fat causing the breast enlargement, it would be difficult to remove this without a direct incision. A small incision at 6 'clock at the lower curve of the areola is all that is needed, and this usually heals as a barely perceptible scar. Lipoplasty can be done either through this incision or in the anterior axillary fold for fat removal alone.
Depending on your age and the quality of your skin, liposuction is a great option for male breast reduction. The one major disadvantage of going through the armpit is it limits your surgeon's ability to shape the chest and reach certain areas. Keep in mind, when done appropriately, the border of the areola is a pretty favorable place for scarring.