Gynecomastia is an excessive development of the male mammary gland. It may be present in one breast or both, and may be symmetrical or not. It is not usually painful, but it can sometimes be accompanied by a sensitivity of the chest.
Gynecomastia can have hormonal origins. Often temporary in adolescents, it may be permanent for adults.
Theoretically, true gynecomastia is the excessive development of mammary glands, and false gynecomastia is only caused by fat (also called adipomastia). Practically, glandular development and fat excess are often associated.
Gynecomastia is a physical defect often causing psychological distress. The presence of female-like breasts can significantly affect men’s self-image.
The cause of the abnormal growth of mammary glands remains mostly unknown, it is called essential or idiopathic gynecomastia.
Some diseases can cause gynecomastia. It is necessary to conduct a comprehensive assessment (clinical examination, imaging and biological examination) to exclude a genetic, endocrinal, cancer, drug-related or chronic cause.
When the cause is identified, it is treated as a priority.
In cases of essential gynecomastia or failure of medical treatment, a surgery is needed. The surgeon performs, to varying degrees, liposuction with or without glandular excision.
In the case of a pure adipomastia, liposuction is sufficient and the scars are minimal.
Depending on the extent of fatty and glandular hypertrophy, the procedure leaves a scar around the lower half of the areola, around the entire perimeter of the areola (periareolar) or both a periareolar and vertical/or horizontal scar, in the submammary fold. A graft of the nipple-areolar complex is sometimes needed.
The operation is performed on an outpatient basis under general anesthesia, and last 1 to 2 hours.
