What is gynecomastia?
When a man’s mammary gland enlarges to such an extent that it looks like a female breast, this is known as gynecomastia. It usually affects both breasts, more rarely just one side. The causes of the enlargement are varied and often lead to psychological problems for those affected. However, before an operation, the reasons for the disease should be clarified in detail (e.g. by analysing the hormone levels in the blood) and alternative solutions such as weight reduction or limiting alcohol consumption should be discussed. Often it is also a case of “pseudogynaecomastia”, a pure accumulation of fat without enlargement of the mammary land, which can be removed by liposuction.
Plastic surgeon uses the special liposuction method to remove excess fat from the breast area. This technique is gentle on the surrounding nerves and blood vessels. If your mammary glands are also enlarged, the excess breast tissue is removed using a small incision on the nipple. As a rule, the small scar heals very well and is almost invisible.
Gynecomastia is clearly visible when the upper body is uncovered. Minor manifestations of gynecomastia are clearly visible when viewed in half profile, i.e. with the upper body turned away at forty-five degrees. The turned breast forms the silhouette of the body and the bulging nipple stands out. When palpating the breast, the size of the mammary gland below the nipple can be estimated. An ultrasound examination allows for a more precise medical examination. If there are any doubts, an X-ray examination of the breast can also be carried out.
Gynecomastia development
Female breast growth in men is called gynaecomastia. Gynaecomastia can occur either unilaterally or bilaterally in the breast area. It is caused by an altered balance between female sex hormones (oestrogens) and the male sex hormone (testosterone). The proportion of the female messenger substance, which is always present in small amounts in the male body, increases. The causes of gynaecomastia are usually hormonal and can only be diagnosed by a doctor.
Who diagnoses gynecomastia?
Men who notice increased breast growth should consult the following doctors, depending on their age and the cause: General practitioner, paediatrician, specialist in urology, andrology (men’s health) or endocrinology (hormonology). Only specialists can determine whether the condition is genuine or merely pseudogynaecomastia. In pseudogynaecomastia, only fat is stored in the breast, usually caused by obesity, while true gynecomastia often has hormonal causes.
Suitable candidates for gynecomastia treatment
• Men who suffer from breast formation
• Men who have a female breast formation despite exercise and diet
• Patients who are of legal age
• Men who experience a feeling of tightness in the breast area or on the nipples
• If medication for breast formation does not work
Reasons
Gynecomastia is apparently mainly genetic. However, various substances can also trigger the condition, including
• Anabolic steroids
• Medications with oestrogen
• Alcohol and drugs
There are also some medical causes, such as cancer or impaired liver function. However, the majority of gynecomastia patients are thought to have unknown causes. The “female” breast contour is caused by excess fatty or glandular tissue. It mainly accumulates along the lower breast. A healthy diet and exercise can help to reduce excess fat. However, there is no way to specifically reduce breast fat. Nor is there a diet or special exercises that help to reduce excess glandular tissue. On the contrary, increased training of the chest muscles pushes the overlying fat and glandular tissue further forwards. As a result, gynecomastia is visually enhanced.
During puberty, many boys are affected by gynecomastia, which is found in almost 50 percent of adolescents. It can even occur in newborns due to the transfer of maternal hormones. In both cases, the breasts usually disappear on their own. In old age, many men tend to develop gynecomastia due to the higher oestrogen content.
In many cases, severe obesity, chronic kidney and liver disease, oestrogen-containing medication and excessive consumption of alcohol or marijuana are the triggers for the disease. A breast cancer tumour is rarely responsible for gynecomastia, but hormone treatment after prostate cancer is often the cause. In this case, it makes sense to remove the mammary gland at an early stage – overstretching and subsequent removal of excess skin can often be prevented in this way. However, before surgery, the reasons for the disease should be clarified in detail (e.g. by analysing the hormone levels in the blood) and alternative solutions such as weight reduction or limiting alcohol consumption should be discussed. Often it is also a case of “pseudogynaecomastia”, a pure accumulation of fat without enlargement of the mammary gland, which can be eliminated by liposuction.
A breast correction usually removes gynecomastia successfully, aesthetically pleasing and permanently. The feminine curves are removed and the breasts look masculine and natural again.
Tips for choosing a doctor
When choosing the right doctor, the specialisation in the field of gynecomastia and the specialist title are important factors. In addition to the specialist title, which only provides an initial orientation, the surgeon’s practical experience and surgical technique based on international standards should also be taken into account. Anyone who has already performed many operations on enlarged breasts in men according to all the rules of the surgical art knows what to look out for and how to react in the event of an unforeseen course of the operation. At the same time, he can determine the most suitable procedure for the individual patient. The risk of complications is lowest with experienced, meticulous surgeons. In addition, hygiene in the clinic or practice and the human factor should also play a role in the choice of a suitable doctor.
You should take enough time to choose a suitable doctor. Be clear about what bothers you about your appearance and what you expect from the operation. The choice of an appropriately trained specialist is a prerequisite for a satisfactory surgical result. We strongly advise you to choose a specialist in plastic and aesthetic surgery who has many years of further training. Together with you, they will select the appropriate surgical method in advance and clarify the possibilities, limitations and alternatives of the planned procedure.
The plastic surgeon is a recognised specialist who has completed six years of further training after graduating from medical school. During this time, they must perform numerous operations under supervision. After this practical experience and theoretical training, the doctor must pass the specialist examination at the respective state medical association. Only then is he officially awarded the title “Specialist in Plastic and Aesthetic Surgery” (currently the expiring title “Specialist in Plastic Surgery” is also used, whose further training was comparable) and thus for you, the patient, clear proof of a comprehensive qualification.
The consultation with the specialist
A prerequisite for a successful operation is a detailed discussion about the details of the operation and possible complications. Take the opportunity to clarify all important questions. Write down what you want to know. If necessary, take a companion with you. If you still have questions after the consultation, make another appointment or call your doctor. There should be enough time between the preliminary consultation and the operation to think things over.
Before the operation, the plastic surgeon will discuss a declaration of consent with you. This contains your personal details, an explanation of the type of treatment and the possible complications discussed. By signing the consent form, you agree to the procedure and confirm that you have been informed about the risks.
Can gynecomastia be operated on?
Gynecomastia surgery is considered a male breast reduction. The procedure is suitable for healthy men of all ages. Teenagers should only have the operation at the age of 17. This allows the body and also the psyche to mature and the gynecomastia often disappears on its own. However, if the gynecomastia has not disappeared by then, surgery is advisable. Waiting longer than the age of 18 or 19 often causes great emotional problems for young people.
A free consultation with a plastic and aesthetic surgeon can provide both the patient and their parents with the help they need to make the right decision. Gynecomastia surgery shows the best results in men with firm contours and elastic skin.
How does male breast reduction work?
Depending on the type and extent of gynecomastia, liposuction may be sufficient for breast reduction. This is the case if the excess fatty tissue has not stretched the skin excessively. In some cases, it is also necessary to excise excess glandular tissue with or without skin.
The procedure takes an average of two hours. It is usually performed on an outpatient basis under general or local anaesthetic. In pure liposuction, the surgeon makes very small incisions near the nipple. The fat is sucked out through these incisions using very narrow cannulas. In such cases, the scars are very small and barely visible. The results are permanent. If excess glandular tissue also needs to be removed, an incision is made along the areola (areola). The excess glandular tissue can then be removed through this incision.
In very pronounced cases, excess skin can also be removed through this incision. This results in a breast lift at the same time. Possible complications and risks of gynecomastia surgery Some patients may experience temporary numbness in the breast area. This discomfort can last up to a year. Rare complications associated with this procedure, as with many surgical procedures, include;
• The possibility of infection
• Water retention
• Bleeding
• Wide scars
• Pigmentary changes or
• Postoperative asymmetry
In rare cases, a second operation may be necessary to achieve a better tightening of the tissue.
Before gynecomastia
You should not take any painkillers containing acetylsalicylic acid (e.g. aspirin) for 14 days before the operation. The blood-thinning effect delays blood clotting and can cause secondary bleeding. Minimise the consumption of nicotine and alcohol before the procedure. If possible, stop smoking three to four weeks before the operation. If you are very overweight, you should reduce your weight by exercising and changing your diet before the operation.
If you regularly take medication or suffer from allergies (e.g. to medication, disinfectants or plasters), be sure to inform the doctor. It is also essential that you inform the doctor of any known illnesses. If you are prone to bruising or persistent bleeding after minor injuries, the plastic surgeon should rule out a coagulation disorder before the operation.
The procedure is performed either on an outpatient or inpatient basis – in a plastic surgeon’s practice or in a clinic or day clinic. Depending on the procedure, a hospital stay of a few days is to be expected, during which the patient will be monitored and cared for.
For minor corrections, a local anaesthetic with an additional sedative may be sufficient. General anaesthesia is required for major procedures. It is best to discuss with your plastic surgeon which preliminary examinations are necessary and when they will be carried out. You will also have the opportunity to discuss the anaesthetic with the anaesthetist.
The operation
The incision during the operation can vary. An incision is made at the edge of the nipples, under the armpit or along the underbust crease. The plastic surgeon removes the excess breast tissue through this incision. If liposuction is also necessary, a cannula may be inserted through additional small incisions to remove and suction out the fatty tissue with constant movement. Additional incisions may be necessary under the armpit or on the side of the abdomen.
In particularly severe cases of gynecomastia, the skin may be too stretched out after the correction to adapt to the new breast. Removing the excess skin and tightening the remaining skin can restore a natural shape. At the end of the procedure, a drain is usually placed to facilitate the drainage of wound secretions and blood. A compression bandage helps to support the new breast. The entire operation usually takes one to one and a half hours, or longer depending on the complexity.
After gynecomastia
Immediately after the operation, the breast will be tight and painful for a few days. Painkillers are usually administered to relieve this. The drains are usually removed on the first or second day after the operation. If self-dissolving stitches were not used, the stitches can be removed eight to ten days after the operation. Initially, the scar will still be red, but will fade within a few months and blend in with the surrounding skin. During the following six months, UV radiation of the scar should be avoided (e.g. sunbathing). To ensure that the severe bruising and swelling heal as quickly as possible, it is usual to wear an elastic bandage. This should be worn continuously for one to two weeks, later only at night. However, the swelling will only subside after a few weeks, so that the final result can only be assessed after around three months.
Your ability to work will be restored after a few days. You should avoid sporting activities and household chores (e.g. ironing and window cleaning) for three weeks. In the event that gynecomastia recurs after the operation, a repeat breast correction is possible. Even after the operation, the breasts should be checked regularly by a plastic surgeon.
If gynecomastia has only been achieved by liposuction, outpatient treatment is also possible. However, if an andromastectomy (male breast reduction) has been performed, hospitalisation is unavoidable. Patients diagnosed with severe to moderate disease are operated on under general anaesthetic. Immediately after the gynecomastia operation, the patient is given a bandage and compression. After a local anaesthetic, the patient can leave the doctor’s surgery on the day of the operation after an appropriate recovery period with an accompanying person. As circulatory problems may occur under certain circumstances, the patient should never drive home at the wheel of a car. Showering is generally permitted after the drain has been removed, but the patient should take it easy physically for the following four weeks. It is advisable to wear a compression waistcoat for the following six weeks. Light sporting activities can be resumed after approx. four weeks. Very strenuous physical activity should be avoided for a total of four to six weeks. As a rule, there is no suture removal after gynecomastia surgery as the sutures dissolve on their own.
Reasons to choose Turkey for gynecomastia operations
Today, successful aesthetic operations in the realm of plastic surgery cater not only to women but also to men, aiming for a healthy and self-assured appearance. Over recent years, Turkey has emerged as a prominent destination for medical tourism, steadily gaining recognition in this sector. Plastic surgery in Turkey includes aesthetic operations such as breast reduction, tummy tuck, breast augmentation, liposuction for women as well as operations such as six pack or gynecomastia for men. Choosing Turkey, especially Istanbul, one of its most developed and populous cities, offers numerous compelling advantages that make it an appealing choice for individuals seeking aesthetic improvements.
Primarily, Turkey and Istanbul have gained acclaim as premier hubs for medical tourism due to their modern healthcare facilities, experienced surgeons, and competitive pricing compared to many other countries. This amalgamation ensures access to cutting-edge medical infrastructure while providing cost-effective options for patients considering cosmetic surgeries. Among its many advantages, gynecomastia cost in Turkey stands out for its affordability compared to other nations.
Gynecomastia in Istanbul offers patients the opportunity to benefit from the expertise of numerous board-certified plastic surgeons specialising in aesthetic procedures, including advanced techniques for gynecomastia correction. These professionals are renowned for their proficiency in utilizing innovative surgical methods and state-of-the-art technologies to achieve precise and natural-looking results. Istanbul also boasts numerous quality healthcare facilities adhering to international standards, ensuring a comfortable and safe environment for patients throughout their medical journey. Personalized care and attention are notable advantages of undergoing cosmetic surgeries, including gynecomastia procedures, in Istanbul. Surgeons prioritize patient safety and satisfaction, tailoring treatment plans to individual needs and ensuring a comprehensive and supportive experience. The city also offers excellent recovery and aftercare facilities, contributing significantly to patients’ well-being and promoting a smooth recovery process.
Beyond medical benefits, choosing Istanbul for gynecomastia surgery allows patients to immerse themselves in the city’s rich cultural heritage and vibrant atmosphere. Exploring cultural landmarks, culinary delights, and diverse communities can enrich the overall experience during their stay. Additionally, language accessibility is a notable convenience, as many healthcare providers in Istanbul have English-speaking staff, facilitating clear communication and ensuring a seamless experience for patients from diverse linguistic backgrounds.
Turkey’s reputation for successful cosmetic surgeries, coupled with numerous satisfied patients sharing positive experiences, further solidifies Istanbul’s standing as a preferred destination for aesthetic enhancements. In conclusion, individuals considering cosmetic surgeries should conduct thorough research, consult with qualified surgeons, and gain a comprehensive understanding of the procedure’s risks, benefits, and expected outcomes. Opting for gynecomastia in Turkey offers a blend of medical expertise, quality healthcare infrastructure, personalized care, cultural enrichment, and cost-effectiveness, making it an attractive choice for individuals seeking aesthetic improvements.