Gynecomastia can occur in several forms. In some cases known as glandular gynecomastia there may actually be growth of the breast tissue. In other cases there may be diffuse fatty tissue and in some cases there may be a combination of both types of tissue.
The differentiation of glandular gynecomastia from diffuse fatty gynecomastia is extremely important for several reasons. Not only is the cause of these conditions different, but they require different treatments as well.
In the majority of patients physical examination by a plastic surgeon can differentiate these conditions. When glandular tissue is present, there is firmness which is not present with fatty tissue. In rare cases, radiographic studies, ultrasound or MRI studies may be necessary for this differentiation. This is important because treatment may vary depending upon the specific type of gynecomastia which is present.
When glandular tissue is present surgical excision is usually necessary. This is usually accomplished through a peri-areolar incision. The breast tissue is first separated from the skin and subcutaneous tissue. Once this is accomplished the breast tissue is separated from the underlying muscles and removed as a single unit.
When the breast tissue is predominately made of fat, liposuction can be utilized. This technique involves passing a canula through the breast tissue repeatedly while suction is applied to the canula. Cores of fat are removed and the area is effectively sculpted.
In some cases glandular and fatty components are present and combination procedures are necessary. Following surgery patients wear a compression garment for four to six weeks. This helps remodel the tissue and minimizes complications.
It’s important to realize that no two patients are alike and treatment should be individualized. If you’re concerned about gynecomastia, consultation with a board certified plastic surgeon would be appropriate.