Gynécomastia

For whom?

For men full of complexes about the image of their virility because of developed feminine breasts.

Aims

Gynecomastia is therefore destined to correct this physical anomaly very often at the root of great psychological suffering.

Before the operation

Your medical examinations

Between one week and a month prior to the operation, you must make an appointment with a medical test laboratory in order to go through a full pre-surgical check-up. For a gynecomastia operation, in addition to the usual medical check-up, a pre-surgical mammography is mandatory, together with an endocrinal check-up and a testicular scan.

Taking medication

You should in no circumstances take a medication containing aspirin at least 10 days before the operation. You should also advise on any medication you may have taken. It is essential that you refrain from eating, drinking or smoking 8 hours before the operation.

Your luggage

As far as your luggage is concerned, you must remember to bring clothing for the upper part with a buttoned covering at the front (you can easily roll that up more easily the first few days after the operation.)

Getting ready for the operation

You will be taken to your clinic the night of the operation, the time to get settled in your room, to take a shower if needed and to meet with the medical team: your surgeon, the anesthetist doctor, and all the health care staff. The operation takes place the following morning. Very often, the night before the operation, the nurses will give you a kind of pre-medication in the form of a light tranquilizer to make sure that slightly anxious patients to face the operation with more fortitude.

Type of anesthesia

Full anesthesia is the rule to correct a glandular gynecomastia.

If it is just a fatty gynecomastia, partial anesthesia may be sufficient.

The type of anesthesia may be assessed by the surgeon according to the age and the tolerance of the patient

Duration of your hospital stay

2 nights.

Duration of your total stay in Tunisia

6 nights/7days

Operation

• The glandular gynecomastia :

When the gynecomastia is caused by abnormal hormonal development, we refer to it as glandular. The operation consists in a cut to bring to surface the hypertrophied gland. Situated around the lower half of each areola, the incision is a small half a circle. The stitches will leave a scar that can hardly be visible. When there is an important skin amount in excess and that it isn’t elastic, the incisions are then horizontal, more or less long, and around the areolas.

• The fatty gynecomastia :

When the gynecomastia is caused by an excessive quantity of fat (adipomasty), we carry out a liposuction. The surgeon will inject a mix into the breast; that mix reduces at the same time bleeding but also allows the suction of fat substances. The surgeon inserts a thin tube by way of small incisions and sucks thus the fat substance. The incisions will be stitched afterwards. The excess skin will retract in a natural fashion. Two small scars of less than 1cm long remain on the thorax.

In case of mixed gynecomastia, fatty and glandular at the same time, we combine liposuction to ablation of the gland in order to secure the best result.

Duration of the operation

The operation aiming at treating gynecomastia lasts 1 hour.

After the operation

A sucking drainage (redons) together with a compressed bandage are put in place at the end of the operation. In case of a liposuction no drainage is needed.

The bandage will be removed the following day. The pain felt after the operation is usually minimal. In all cases, it can easily be brought under control through the administration of usual pain killers. A compressive clothing (bolero) should be worn permanently for one or two months.

Surgical aftereffects

A slight pain may be felt; it will be eased through the use of pain killers. Some ecchymoses (blue in color)will be seen for many days; an odema (swelling) may also appear. The uneven and tumor like aspect of the thorax following the ablation of the bandage will disappear after a few weeks. The healing process of a gynecomastia is not painful. An insensitivity of a short duration is felt at the level of the nipples, as well as the crests.

Sports activities, violent movements, carrying heavy loads are to be avoided the first one or two months.

Results

The final result can only be seen after 6 months to 1 year, namely because of the gradual skin retraction. One must wait at least one year to be able to see the final state of the scars.

Complications

Complications caused by gynecomastia surgery are fortunately very rare. Most patients arefully satisfied with the results that have been achieved. Yet, complications are unpredictable, and may occur even when the surgeon has all the skills and competencies required for the exercise of cosmetic, plastic, and reconstructive surgery.

Complications of a general nature:

These are risks related to full anesthesia, thrombi-embolic accidents (phlebitis, pulmonary embolic), hematoma, and exceptional infections.

Complications specific to gynecomastia surgery :

The necrosis of the areola is quite rare.

Scar healing problems: as it is the case for most scars over the body, the healing process may last a minimum of 6 to 12 months, going through a phase of redness and initial induration of the scar for 2 to 3 months.

Esthetic results:

• Insufficient correction, with an excessive residual of fat under the skin and / or skin.
• Concave (“hollow”) aspect of the breast, linked to the thickness of the residual layer of fat substance around the breast. A complementary liposuction may be administered to reduce this anomaly.
• Areola looking too dug through cuts at this level: an injection of fatty substance may remedy this problem (lipofilling).
• Wrinkled appearance of the breast when the skin is not sufficiently or correctly retracted. This aspect may be improved at a price of a horizontal scar that is more or less important over the breast in order to remove the excess of skin at that level.

Work interruption

There is no need for interrupting the work: the recovery stay spent in Tunisia following the operation is very beneficial and enables most of our patients to resume their professional activities as soon as they return home.

Fees

The fees of a gynecomastia are : 1600 euros.