How is gynecomastia surgery performed?
Gynecomastia surgery is typically an outpatient procedure. There are three reduction methods for gynecomastia surgery that determine the incision locations and resulting scars. Reduction methods include liposuction, excision (cutting out excess glandular tissue), or a combination of liposuction and excision.
The steps for gynecomastia surgery will vary depending on the severity of your condition and the technique you and your aesthetic plastic surgeon decide on.
What are my gynecomastia surgery options?
Gynecomastia surgery incisions vary by patient. There are three common types of incisions. Your aesthetic plastic surgeon will select a technique based on your breast size and shape, areola size and position, skin elasticity and your desired results.
Liposuction
Your surgeon places small liposuction incisions in hard to see areas on and around the chest. If your condition is minimal, you may be able to get a minimally invasive gynecomastia surgical procedure. Using a "pull-through technique," your surgeon makes a very small incision (approximately 5 mm) at the areolar edge. Following liposuction, your surgeon pulls the glandular tissue from the overlying areola through the incision. The major advantage of this procedure is the smaller incision and reduced scarring.
With liposuction, there are fewer postoperative complications than open surgical excision; however, liposuction-assisted breast reduction does not correct glandular gynecomastia. Your surgeon must assess your breast’s fatty and glandular components before surgery to determine whether you are a good candidate for a liposuction only treatment.
IMAGE IMAGE CAPTION: Small liposuction incisions in hard to see areas under the chest
Excision
Most patients require excision. With surgical excision, your surgeon makes an incision under the areola. The most common approach is the intra-areolar incision, or Webster incision, which extends along the circumference of the bottom half of the areola in the pigmented portion. The length of your incision depends on your anatomy.
If you need to reduce the size of your areola, the surgeon makes an incision all the way around the areola.
IMAGE IMAGE CAPTION: The incision extends all the way around the areola.
Combination of Liposuction and Excision
To treat the puffy nipples associated with gynecomastia, you will probably need liposuction combined with excision. Your surgeon places small liposuction incisions in hard to see areas on and around the chest to conduct the liposuction and will make an incision around the areola to complete the excision.
IMAGE IMAGE CAPTION: Small liposuction incisions in hard to see areas under the chest plus an incision that extends along the circumference of the bottom half of the areola.
In severe gynecomastia, your surgeon may need to complete a skin resection (surgical removal of part of an organ or structure) and move the nipple (nipple transposition).
IMAGE IMAGE CAPTION: Small liposuction incisions in hard to see areas under the chest plus an incision that extends all the way around the areola.