Gynecomastia and Male Breast Correction

Intervention Timing: Adolescents vs Adults

Age significantly influences therapeutic approach. In adolescents (12-18 years), pubertal gynecomastia has a 75% probability of spontaneous resolution within 2 years. We recommend observation and psychological support, intervening surgically only in severe cases with grave psychosocial impact. After 18 years, spontaneous regression becomes improbable (less than 5% of cases), making surgery the only definitive solution. For adults, there's no age limit: seventy-year-old patients can benefit as much as thirty-year-olds, provided they're in good general health.

Differential Diagnosis: True Gynecomastia vs Pseudogynecomastia

This distinction is crucial for choosing appropriate treatment. True gynecomastia: presence of mammary glandular tissue, felt as firm nodule behind areola, often tender to pressure. Pseudogynecomastia: only fatty accumulation, soft tissue, non-tender. Mixed form (most common): combination of both. Diagnosis is based on clinical examination, breast ultrasound and, if necessary, hormonal tests. Each type requires specific surgical technique: pseudogynecomastia responds to liposuction, true gynecomastia requires glandular excision, mixed form needs combined approach.

Specific Surgical Techniques by Type

Liposuction: for pseudogynecomastia or fatty component. 3-4mm incisions, optimal results in elastic tissues. Periareolar excision: for true gynecomastia. Incision along lower areolar border, practically invisible. Combined technique: most frequent, combines liposuction for fat and excision for gland. Skin reduction: in severe cases with skin excess, may require additional incisions. Choice depends on volume, skin quality, and patient expectations.

Complication Management and Prevention

Complications are rare but possible: hematoma (2-3%), infection (1%), temporary asymmetry (5-10%), sensitivity alterations (transient in 15% of cases). Prevention begins with accurate pre-operative evaluation, identifying risk factors like coagulation disorders or specific medication use. Post-operative drainage reduces hematoma risk, while prophylactic antibiotics prevent infections. Adherence to post-operative instructions (compression garment, activity limitation) is crucial for optimal results.

Understanding the Recovery Timeline

Recovery follows predictable phases that patients should understand. Week 1: Moderate discomfort managed with oral pain medication, compression garment worn continuously. Week 2-4: Gradual return to normal activities, light exercise permitted. Month 2-3: Swelling significantly reduces, results become apparent. Month 6: Final results visible with complete tissue settling. Most patients return to desk work within 3-5 days, gym activities after 4-6 weeks. The compression garment, while initially uncomfortable, is essential for optimal healing and should be worn as directed.

Realistic Expectations and Long-Term Results

Results are permanent provided stable weight is maintained and triggering causes avoided (steroids, specific medications). Improvement is immediately visible but final result is appreciated after 3-6 months when swelling and fibrosis completely resolve. Expect a natural masculine chest, not "sculpted": the goal is eliminating feminization, not creating a bodybuilder physique. Satisfaction is extremely high: over 95% of patients would repeat the procedure, with significant improvements in quality of life and self-esteem.

Hormone Evaluation: When Testing is Necessary

Not all gynecomastia requires extensive hormonal workup, but certain indicators warrant investigation. Testing recommended for: rapid onset, very large volume, associated symptoms (decreased libido, erectile dysfunction), young age (<14 or >25), or asymmetric presentation. Common findings: testosterone deficiency, elevated estrogen, thyroid disorders, or medication effects. Treatment implications: some hormonal causes can be corrected medically, potentially avoiding surgery or improving surgical outcomes.

Why Choose Image for Gynecomastia

Psychologically Aware Approach: Understanding of emotional impact and discrete support throughout the journey.

Precise Diagnosis: Accurate distinction between types to choose optimal surgical technique.

Multiple Techniques: From simple liposuction to combined approaches for every severity grade.

Natural Results: Goal of harmonic chest masculinization, not artificial appearance.

Privacy and Discretion: Reserved environment respecting male sensitivity regarding this topic.

Comprehensive Care: From initial evaluation through long-term follow-up with attention to both physical and psychological well-being.