Personal concept

Since the term gynecomastia means an excessive growth, beyond normal limits, of the dimensions of the mammary gland, it is good to know that, most of the time, it is also accompanied by an excess of fat. Almost every man has a more or less obvious layer of fat on the chest, except for those who are extremely thin, even cachectic, or performance bodybuilders. It is also good to know that this fat, once increased in volume, is quite difficult to reduce through diet and exercise.

Another significant thing is that oftentimes within palpation you would think there is a giant gland behind the areola because it feels like extremely hard tissue, which would not always imply that we have a gland that big there . In fact, what we feel on palpation in these cases would be a mammary gland associated with the fat around it, extremely hard fat. This fat that surrounds the mammary gland is the hardest in the whole body, and the variants and techniques by which we remove it require a certain strategy, in order to obtain the best possible result. Since by palpation techniques it is almost impossible to tell how much of that tissue is gland and how much is fat, soft tissue ultrasound performed by an experienced radiologist is the procedure that helps both me as a doctor and the patient . With the help of the ultrasound, I will know what size of the gland to expect and, at the same time, how to perform liposuction in the area of ​​the mammary gland, and the patient will understand the relationship between the gland and the fat and will know what result to expect. This is an extremely important aspect, because the intraoperative techniques to remove fat, remove the mammary glands and protect the appearance of the areolas will be directly dependent on the postoperative result.

In order not to be too long, I tried to give you a summary, in short, about the idea that gynecomastia is not solved only by removing the mammary glands and that’s it. It should be seen as a body contouring procedure, in which the aim is to restore the shape of an aesthetic male chest.

A male chest from an aesthetic point of view, unlike a female one, has several criteria that make it unique:

1. The groove between the deltoid and pectoral region should be as visible as possible, as deep as possible.
2. The upper thoracic portion, the one immediately below the clavicle, should be as convex as possible or at least not under-elevated.
3. The central region, the one behind the areola-nipple complex, should be flattened, but not depressed.
4. The areola-nipple complex must be flat, as small as possible, at a maximum distance of 3-4 cm from the infrapectoral groove, not protruding and not showing visible scars, as possible.
5. The region of skin and subcutaneous tissue below the areola should begin to retract, providing as smooth a transition as possible to the infrapectoral groove.
6. The lateral edge of the pectoral muscle should be seen as best as possible, thus providing the shape, outline and volume of the muscle, as clearly as possible.
7. The region on the side of the chest and the one under the armpit should be as indented as possible, as sunken as possible, to highlight the pectoral muscle as well as possible.
8. Depending on the appearance of the fat layer immediately below the infrapectoral groove, a smooth transition between the pectoral, lower chest and abdomen regions will be needed, with the infrapectoral groove well defined .

So, from the above, you can tell that we are actually talking about a chest sculpt, that is, you have to understand that I will remove more from certain areas and less from others, and sometimes I can add fat to other areas. areas. What interests us the most is to highlight the pectoral muscle, over which we have a layer of fat and a mammary gland that spoils the appearance of our chest. For that, we have to remove them, but not anyway, but to sculpt them so that we get that individuation aspect. Thus, the chest, like any other region of the body, must be divided into several aesthetic units, and at the same time, it is crucial to understand the connection between the chest and the abdomen. You have to understand that often patients have gynecomastia but also significant lipomatosis in the abdomen or lower chest (last costal ridges), which can have an impact on the future outcome.

I always sit with each patient in front of the mirror and explain the particular situation of the chest and also the relationship of the future chest to the abdomen, because it is quite possible that, compared to the abdomen, the future chest appears much flatter and thus the appearance is not very attractive. In this case, the patient may also want to sculpt the abdomen in the future.

Aesthetic surgery is about shapes and contours, shadows and volumes. Any famous painting or sculpture had a whole strategy behind it. Don’t think that Michelangelo, as brilliant as he was, went into the Sistine Chapel, took a brush and colors and started painting. No way! At first he sketched and designed the size of each character so that everything would fit and fit perfectly. I think the same with any cosmetic surgery operation that I will perform, whether it is about the face, breast, body contour or intimate area. Each patient is a different story and each person has some particularities that make them unique. That’s why I want to study each chest separately and, at the same time, how to make that patient look good when undressing at the beach or in any other conditions, so that everything looks symmetrical and proportional. I gave the example of the Sistine Chapel because, from my point of view, it is a work of God, impossible to equal in the history of mankind.

The bottom line would be that I would like you to understand that not only the appearance of the chest matters when treating gynecomastia, but also the shape and contour of the arms, lower chest and abdomen. These regions must merge in the most aesthetic way possible, be proportional to each other and thus provide and restore the confidence that patients lose or want, confidence that made them avoid going to the beach , at the pool, or any other circumstance where a man ditches his shirt.
So gynecomastia treatment is a complex body contouring one that combines liposuction, liposculpture, mastectomy techniques and sometimes even fat injection to completely change the lives of men who want to either regain or achieve a male chest.