What to expect on preliminary consultation?
- Diagnosis can be done through a various test that includes blood sample, physical test, and another medical history, it is carried out by Gynecomastia surgery in Delhi through years of experience in same. The treatment of the gynecomastia depends upon the grades of gynecomastia and knowing them can help you grade them yourself:
Grade 1 – Small enlargement without skin excess.
Grade 2 – Moderate enlargement without skin excess.
Grade 3- Moderate enlargement with minor skin excess.
Grade 4 – Marked enlargement with excess skin, mimicking Female Breast.
- The secondary sexual characteristics like pubic hair, and axillary hair, penis and testes would be examined thoroughly for changes in patterns, tumors, masses and abnormalities of development respectively. The axilla is also checked for enlargement of lymph nodes.
- Surgical procedure is thoroughly explained to the patient, its preoperative and postoperative care instructions given to the patient.
Differentiating between true gynecomastia and false gynecomastia.
On examination of the breast it is checked if the swelling is fatty tissue (not truly Gynecomastia) or breast tissue.
In case of former, the feeling between the palpating thumb and forefinger is soft and meets no resistance of an intervening mass until the nipple is reached.
In case of a true gynecomastia there is a feeling of a mass between the fingers.
- You would be given a list of mandatory blood investigations, COVID testing and ultrasound chest , if required.
- In case you are on blood thinners, you would be asked to stop it at least 3 days prior to surgery.
- It is wiser to quit smoking at least 2 weeks prior to surgery.
Treatment of Gynecomastia
The Treatment of Gynecomastia is surgery and only surgery. There is no medical treatment for Gynecomastia. The treatment involves liposuction of the chest along with vaser which helps in suction of the fat giving a better contour and shape to the chest along with a small periareolar approach for removal of glands.
What to expect on the day of surgery.
- Patient is allowed to come only with one attendant to avoid overcrowding.
- Patient can have light meals and come if the surgery is decided for local anaesthesia, however if the patient has opted for general anaesthesia, patient should be nil by mouth for at least eight hours prior to surgery.
- There should not be any upper respiratory tract infection or any fever at the day of surgery or any other major contraindication.
- Patient is asked to fill the consent form which also briefs about the possible complications.
- Patient is asked to trim his hairs, a day prior to surgery.
- Preoperative photographs are taken.
- Local Anaesthesia sensitivity is done.
- Patient is asked to empty the Bladder before going for the procedure.
- Patient is advised to lay supine with legs apart
- Anaesthesia is given as opted by the patient. If local, we proceed in following steps.
- About 1.5 mm incision is given over the axillary crease or the side of imf, infiltrating canula is inserted and the local anaesthetic medication infiltrated in the various planes.
- We usually wait 20 minutes post infiltration, so the whole area gets anaesthetised.
- Infiltration is followed by VASER, which emulsifies the fat so that it is easy to suction without any bleeding. If the glands are very fragile, it can be melted with VASER as well and no separate incision is required for the glandular excision.
- This is followed by liposuction and if required separate incision for glandular excision.
- We leave a small incision used for infiltration patent for drainage of the fluid
- Pressure dressing is done, and glands excised are sent for histopathological examination.
- Patient can be discharged thirty minutes to one hour post procedure.
Post Operative Instructions
- Patient may take rest for at least 2 days. a course of antibiotics and a pain killer, with antiinflammatory medication is advised
- First dressing is open after 48 hours after surgery.
- Pressure garments are advised to wear for at least three to four weeks. This will help ensure that the treated areas retain the aesthetically desired contour appearance.
- Local hygiene and good hydration of the skin should be maintained
Complications are usually rare, may include pain, edema, bruising and Infection.