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Male breast tissue Gynaecomasty

Treatment

Male breast tissue is constituted by one or both following elements

Incisions

A small incision on the edge of the areola in case of lipo only. In case of resection of breast tissue, a semi-circular incision on the edge of the areola. Those incisions heal very well and are not a problem on the long term.

Resection breast tissue

Most of the breast tissue is removed, leaving only a small portion under the nipple and areola to ensure their survival and for aesthetic reasons.

Liposuction of fat

Fat can be liposuctioned under local or general anesthesia, depending on the area and the wish of the patient.

Possible complications short and long term

A.Short term

Bruising of the skin (Ecchymosis)

http://en.wikipedia.org/wiki/Ecchymosis

When blood migrates into the skin, the skin first turns blue after a day or two. Over a period of 10 days it further turns into green and finally yellow before disappearing completely. No ointments should be used to speed up this resorption of blood. They could only add a rash.

Blood collections (Haematoma)

http://en.wikipedia.org/wiki/Hematoma

When even more blood accumulates in the virtual spaces between subcutaneous fat and muscle, this is called a haematoma. They also are quite common.

Their natural course is to convert to hard nodules -over a period of weeks-, which sometimes can be felt, and trouble the patient. They also disappear very slowly, over the course of months.

Large blood collections in a matter of hours after surgery points to a bleeding vessel. It is very rare, but needs to be addressed immediately. The incision is reopened and the bleeding vessel identified and coagulated. The breast is rinsed from blood clots. The incidence of this complication is less than 2%.

Seroma

http://en.wikipedia.org/wiki/Seroma

A seroma is an accumulation of blood plasma in a pocket between subcutaneous fat and muscle. It can be diagnosed by its fluctuating aspect ( think of water mattress) and by puncturing it, retrieving a clear yellowish and slightly viscous liquid.

Treatment is easy : either it can be evacuated in several sessions or -if painless- it will go away by itself . Seroma are not uncommon, they occur in about 5% of cases.

Death of Tissues

This occurs only in cases where the vascularization to the nipple is impaired, such as with too radical resections of the tissues underlying the nipple and areola.

Treatment of necrosis

It takes months to get rid of necrotic tissues and reconstructive surgery needs to be done to restore the appearance of the nipple. If the nipple is completely necrotic, a new one has to be reconstructed with grafts.

Infections

A primary infection of the breast due to contamination of the tissues during surgery is extremely rare. I never saw one case.

 

B.Long term problems:

Esthetical problems

Uneven resection can cause dimpling, irregularities. The treatment consists in revising the area surgically. Very rare

 

Hypertrophic scar

Development of a thicker and broader scar. Can also be revised.

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T20D5a
T20D6
T20D7

type 1: peri-areolar incision

type 2 : inframammary incision

type 3: infra-mammary + reduction of skin

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