Procedure

Male Chest Reduction

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A male chest enlargement could be a major embarrassment to many youngsters and young adults – especially when they go to the swimming pool or temples where they are supposed to remove their shirts. They may also find it difficult to wear appropriately sized shirts or T-shirts. Many of them also find it difficult to share hotel rooms and removing their shirts at home.

Most of them will not have a proper reason why they have that problem but others may have a history of weight gain in adolescence. Some may have lost fat in other areas and retained the chest fat. Gynaecomastia can occur because of other reasons like use of certain drugs for long times, liver diseases, old age and hormonal imbalances. In most of the clients it’s idiopathic (without a proven cause). A gynaecomastia mainly have two components, the gland (firm component) and the fat (soft component).

Treatments

Even though there are medical managements for gynaecomastia, the most effective and commonly used treatment is a surgery. Medical management will sometimes be effective in some young clients who have had a gynaecomastia problem for less than two years. If medical management is ineffective after a year, or if the client has had this problem for more than 2 years or have thick glands, then the better option is to proceed with a surgery that involves a liposuction (key hole method to remove fat) and the Webster Procedure (surgery to remove the glands).

Surgery

It’s a day care surgery in which the patient gets discharged on the same day. The surgery could be performed under general anaesthesia or a local anaesthesia.

  1. Liposuction to remove the excess fat in the chest, below arm pits and upper abdomen
  2. Webster procedure to remove the glands through an incision in the areola

Liposuction

The surgery usually starts with a liposuction of the chest and the areas below the arm pits. There are different types of liposuction methods. We use VASER and MICROAIRE PALwhen performing a liposuction, which gives a good uniform sculpted look.

Webster procedure

After liposuction, the surgeon goes back to see whether there is remnant glandular tissue on the chest. If there is, it will be followed by a Webster procedure in which the surgeon will be making a small incision on the areolar boarder to remove the glands directly.

The surgeon makes the liposuction ports in the arm pits so there won’t be any visible scars. The areolar incision is also made on the lateral aspect of the areola and not in the inferior aspect,which also has a cosmetic advantage of no folding or depression after all the scars heal. We don’t use any drains nowadays.

Post operative care

There won’t be any visible stitches after the surgery and the client needs to consult the doctor 5 days after the surgery to do the first dressing. For one month after the surgery, the client needs to use a special type of customized garments (Pressure Garments),which will be given to him after the surgery. The recovery is faster for liposuction alone and for smaller grades of Gynaecomastia. In that case, the client can usually return to work within 3-4 days.

Methods of liposuction we have

Suction Assisted Liposuction

Here we use different sized metal suction cannulas along with a suction machine attached to the other end to remove fat while moving the cannulas mechanically in the desired region. This method is mainly used for small volume aspirations.

PAL / Power Assisted Liposuction

We do Power Assisted Liposuction using the Microaire machine, which is the best machine for this procedure. It’s good for large volume aspiration. Using PAL we can aspirate more fat with less physical effort from the surgeon. The same procedure can be performed using smaller cannulas and the damage caused to the nearby structures could be minimized. The amount of bruises and swelling will be less when PAL is used instead of SAL. The same applies to the downtime.

VASER / Ultrasound assisted liposuction

For this method ultrasound energy is used to break the fat cells from surrounding adhesions. Then the loose fat is just aspirated. It is good for treating thinner patients and removing fat from areas like chest and back. It causes less damage to the surrounding vessels and nerves.

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