Gynecomastia, or the enlargement of breast tissue in the male breast, can be an embarrassing condition for a man since a flat, muscular chest is the standard for males in our society.
A recent article by Elliot Jacobs, M.D. of New York, states that 65% of all male breast disorders are gynecomastia. Teenage males are especially hard hit by this disorder which can often cause, not only physical, but psychological pain. Many young, healthy males who are attempting to look more muscular will go to the illegal use of male hormones like testosterone, or even the legal use of health store products such as DHEA. These and other hormone producing products can lead to the growth of breast tissue in males and have the unfortunate side effect of making one look worse when they were only trying to look better. Today, men can take back their lives through liposuction and gland excision of male breasts.
Two components, glands and fat, are the causes for gynecomastia. True gynecomastia refers to the growth of glandular or breast tissue and is usually due to hormonal fluctuations or imbalances. Pseudogynecomastia refers to fatty deposits in the breast area. Puffy nipples are many times a characteristic of both true or pseudo gynecomastia.
The techniques for removing gynecomastia are all surgical. In the process of male breast reduction, both the true and pseudo gynecomastia are removed in the same operation. When you reduce the gynecomastia and flatten the chest, you are also reducing the size and puffiness of the nipples. Normally, Dr. Schlesinger’s approach is liposuction through a very small incision in the armpit removing 100% of the fat and 60-100% of the gland. Since the incision is small and sutures are under the skin, there are no stitches to be removed and very minimal scarring. If you have a large gland component, a small incision is made at the bottom edge of the nipple. This is a very delicate operation. If too much is removed, the nipple will indent, a condition which can be as undesirable as protruding nipples.
Unfortunately, not all liposuction is the same. Traditional liposuction does an excellent job of removing fatty tissue and a reasonable job of removing some gland. The newer forms of liposuction such as Vaser, Laser, Smart, Slim, etc. can remove fat, but no better than traditional liposuction. However, when it comes to removing gland, they do a terrible job. They turn the gland tissue to concrete, fail to remove it, and make secondary attempts at removing it very difficult to almost impossible. As a side note, all claims that these “not so smart” lipos tighten skin has no scientific evidence to back it up. Therefore, Dr. Schlesinger only uses traditional liposuction for removal of all pseudogynecomastia and some true gynecomastia.
Dr. Schlesinger always sends the gland tissue to pathology because, unfortunately, male breast cancer is a reality. According to the American Cancer Society, breast cancer is 100 times less common among men than among women. In 2012, there will be about 2,119 new cases of invasive breast cancer diagnosed among men, and about 410 men will die from breast cancer. Any man in his 50’s or 60’s with a lump in one breast should seek medical advice as soon as possible.
Post surgery, we utilize ultrasound (the kind physical therapists use for sore muscles) to improve the outcome and speed the healing process. After surgery, we also use DMSO. This is a wood product used by athletes around the world to decrease bruising and swelling. Rumor has it that the participants in the Tour de France bath in this stuff. It is actually a horse linament, and Dr. Schlesinger adds a special ingredient to make it tolerable to human skin. Our patients start using this the night of surgery. It gets rid of bruising and swelling at an incredible rate, and that along with post operative ultrasound allows our patients to get back to work and to the beach with no shirt on very, very quickly.