Gynaecomastia Treatment in Chennai

                        GYNAECOMASTIA AND PSEUDOGYNAECOMASTIA

What is true gynaecomastia and what is psuedogynaecomastia?      

            True gynaecomastia is increase in the size of the male breasts due to glandular enlargement. Psuedogynaecomastia is excessive fat tissue in the male breast with normal glandular breast tissue. The common male problem in an Aesthetic clinic, Gynaecomastia, is truly Pseudo gynaecomastia with only fatty tissue and minimal glandular tissue. The condition is a part of the co- existing obesity disorder and is rarely, a standalone entity. The treatment options shall include an approach to answer the issue of obesity as a whole, not rest contented with surgical removal of the enlarged breasts alone. In fact, what is seen and what is being treated, is just a tip of the iceberg.

Gynaecomastia, an innocuous condition that affects 35-70%of male population immediately after birth, during adolescence and old age, is rarely brought to notice as the sufferer makes all attempts to hide it because the condition brings with it a sense of shame and pain in public places and mental suffering. The surgery is sought after often as the conditions lower the self- esteem and plunges down the self- confidence levels irrespective of age, young or old.

Herein starts the search for the treatment. Medical and multifaceted surgical options evolved over centuries, with the current general opinion being fat removal by any one form of liposuction and the gland removal by direct excision.

Physiological gynaecomastia of puberty that normally regresses with age, tends to stay back being sustained by the modern lifestyle changes. Processed foods and environmental pollution of air and water, the cosmetics used on the body like deo-odorants, perfumes and toiletries, synthetics and chemicals have contributed to explosions of generalised obesity. With this generalised obesity, the tendency to hold back excess fat in the breast developed. This clearly shows the reason for higher incidence of (pseudo) gynaecomastia of late. Hormonal imbalance due to reasons stated above, aggravate the situation.

Post operatively, the need to reduce weight by increasing Basal Metabolic Rate and lifestyle changes, to prevent recurrence or weight gain is reinforced. This includes a change in dietary composition that avoids all processed foods of any kind and a change in exercise types of High Intensity Interval Training(HIIT) and 3Dimensional exercise that could be performed over few seconds to minutes with long lasting effects and hormonal balance restoration.

True Gynaecomastia that requires surgical treatment is not so uncommon. What is commonly believed to be gynaecomastia is truly Pseudo gynaecomastia with a co exiting clinical picture of obesity, high BMI, sedentary life and wrong lifestyle.

Gynaecomastia may be physisological or non physiological.

Physiological gynaecomastia occurs in 3 phases of life:

1. New borne – Self limiting
2. During puberty- Often asymmetric, tender and spontaneously regresses. Always due to hormonal imbalance
3. Senile- in elderly, it is often sagging rather than the actual gland enlargement.

Non- physiological gynaecomastia

Hypogonadism           

 Tumours- Testis, Pituitary, adrenals; if it is one sided, may be primary breast tumour.                       

Drug effects- H2 blockers, PPI, TCA, metronidazole, ketoconazole, calcium channel blockers, hormone therapy, chemotherapy, anabolic steroids, clomiphene, diazepam, phenytoin, digitalis, isoniazid, marijuana abuse.

Hormones:

• Deficiency in testosterone can cause Gynaecomastia.
• Increased estrogen production can cause Gynaecomastia.
• Increased conversion of androgens to estrogens in peripheral tissues ( congenital adrenal hyperplasia, feminising adrenal tumors) can cause Gynaecomastia.

Gynaecomatia management at Silkee is unique and different. 

               As against the standard method of liposuction for the fat and incision for the gland, we at Silkee achieve comparable results by an innovative method, standardised at Silkee.            

• The method employed is by Laser liposuction. The method avoids general anaesthesia and everything that goes along with.
• A specialised form of local anaesthesia called Tumescent Anaesthesia is used.
• No sedation is given and the individual is fully awake, watchful and alert.
• The procedure does not involve long surgical incision and the suturing.
• Thro’ a 3 mm incision (just small enough to pass the laser fiber) below the nipple, the laser fibre melts the fat which is sucked out, the gland is fragmented and removed.
• The wound closes in 24-48 hrs after the laser liposuction without the need for suturing.
• Surgical treatment by laser liposuction under Tumescent Anaesthesia gives very good results with high patient satisfaction and negligible post-operative complications.
• Safety profile and efficacy of this method by laser liposuction at Silkee is an established fact over more than a decade.