Articles of Plastic Surgery

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Fat deposit on men’s chest is a fairly common, but for some it can become a problem, mostly if there is an exaggerated accumulation of fat and mammary gland.

When we focus on this subject, we must acknowledge that this condition can disappear with an adequate medical treatment.

Gynecomasty is a Greek term, which means feminine breast, for this condition to appear there must be an unbalance between the estrogen and androgen blood hormones. The primary growth of the breast depends on a balance between these two hormones; this pathology could be the consequence of the concentration of estrogen in the blood, a decrease in the concentration of androgen, or the increase of sensibility of the tissue to the estrogen, and even unknown causes in some cases. 

The increase of concentration of the estrogen hormone in men, can be caused by any of the following reasons: testicular tumors, a tumor in the pituitary gland, hermaphroditism, an hepatic illness (alcoholism), hyperthyroidism, obesity, Phytoestrogen found in poultry and beef, the use of marihuana, some hair or body creams, some medicines as Cimetidine, Digoxine, Isoniazide, Ketoconazol, growing hormones, and others.   

The decrease of the concentration of androgen can be the product of: aging, or due to hypogonadism, a problem with androgen receptors, a deficiency of 11 B-17-hydroxilasa, or due to medicines such as espirilactone and ketoconazol.

As soon as this pathology appears, the patient should go to an internist, so the possible causes can be investigated and treated, to have an endocrinologist’s opinion, is also important. 

If after a year the gynecomasty persists, it’s very possible it won’t disappear, since some microscopic changes occur that cause the glandular stroma to hyaline.

This is when plastic surgery could offer definite physical changes.

In my office I perform medical exams and study the patient’s medical history to be able to determine the type of gynecomasty and choose which is the most appropriate surgical technique to be used. Previous to surgery blood tests, an ultrasound, and a mammogram to make sure there is no breast cancer must be done, also an examination done by my anesthesiologist, is obligatory.

The surgery is performed under sedation, and local anesthesia, leaving the smallest amount of scars as possible. The procedure could go from a simple liposuction of the fat, up to an apartial resection of the mammary gland; if there is excess skin, or aureole it’s necessary to dry them out. It is important that the objective of the procedure should be the restoration of a masculine shape chest, concealing the scars in strategic places causing the least possible side effects.  

You can go back to work or school three days after the operation, wearing a thoracic girdle. After a month you can start exercising again.

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