Gynecomastia – Patient 107
A man in his late 50’s with breast development since his early teens. He is troubled by the appearance of his chest at the beach, but also in some shirts. He has not used marijuana or anabolic steroids, two common caused of male breast development, and his cause is considered “idiopathic” – which means that doctors don’t know the cause. This is probably the most common scenario. Some medical studies suggest that 30% or more of males may have some female appearing breast development around the time of puberty but in most cases it goes away. If it is not gone by 18 months, then it is probably not going to resolve. He is shown before and again, 6 weeks after gynecomastia treatment with a SAFElipo. His small incisions are still red at this point but will fade as he heals over the next 6-12 months. He is already pleased with the improvement in his contour. Typically skin is felt to continue to shrink and contract over the next 6 months. The “S.A.F.E.” method described by Dr. Simeon Wall gives more effectiveness with fewer irregularities than thermal-based technologies such as laser-assisted liposuction or internal ultrasound-assisted liposuction. These thermal technologies can damage the fat cell and coagulate the tissues surrounding the fat, and can lead to more irregularities in the skin. With SAFElipo, a three step process is followed: S eparation, fat A spiration and F at E qualization. In the first step a special probe is used to mechanically separate the fat cells. This is often done with a power assisted device that vibrates back and forth. Then fat aspiration is performed but can be less aggressive than standard techniques because the fat cells have already been separated. After suctioning, the area may feel smooth, but can still have some irregular areas of fat that are thicker and thinner. The mechanical probe is then used for Fat Equalization, to help reposition the fat deposits and smooth them out. Using this technique can give a smoother result, and helps to preserve the fat cells that are left behind.
Gynecomastia – Patient 106
A very early followup in a college student with unilateral (one sided) gynecomastia. He is shown before and again, 5 1/2 weeks after a combination of external assisted, power assisted liposuction of the right chest/breast combined with direct excision. Scars typically thicken for 6 weeks and then start to soften and lighten over the next two years. He already has an excellent contour and correction, no longer having a “feminine” appearing breast. No skin excision was necessary.
Gynecomastia – Patient 105
An 18 yo college student with idiopathic gynecomastia (idiopathic means that the cause is unknown). He is shown 5 weeks after a combination of direct excision and mechanically assisted/ external ultrasound assisted liposuction. The imprint from the silicone pads that we have recommended that he wear to help with scarring is seen in the after photos. He already has an excellent contour, and the scars should continue to fade over the next 6 months.
Gynecomastia – Patient 104
A man in his late 20’s is troubled by prominent breasts (gynecomastia) as well as prominent nipple papules. This really bothered him at the beach, and also when wearing shirts. As in many of my cases here in Boston, he has had this since puberty. He denies significant marijuana use or anabolic steroids, which have both been known to cause gynecomastia (male breast development). In his case we would list the cause as “idiopathic”, which is a fancy word for “the cause is not known”. As much as 30% of young males can have some breast development at the time of puberty, but in the majority of these men, it resolves spontaneously. If it has not gone away by 18 months, however, it is probably not going to go away without surgery. At first glance, his gynecomastia and nipple prominence may not seem too noticeable, but an oblique (3/4) view and side view tell the story. He is shown before, and again, 6 weeks after a combination of a nipple papule reduction with a “top hat flap”, combined with external ultrasound assisted liposuction of his chest and a direct excision of a small button of breast tissue through an incision around his areola. The keloids in the middle of his chest are preexisting from acne scars, and were treated at the time of his surgery with the injection of Kenalog, a type of steroid that can soften and flatten scars. His tattoos are blurred for his privacy, the photos are otherwise unretouched.
Gynecomastia – Patient 103
A 27 yo man with gynecomastia (male breast development) secondary to marijuana use is shown before and again 6 months after bilateral gynecomastia correction with a combination of liposuction and direct excision. He is pleased with the correction of his gynecomastia, giving him back a normal male chest after his surgery. He now feels comfortable in a golf shirt or at the beach. His tattoos are blurred for his privacy, the photos are otherwise unretouched.
Gynecomastia – Patient 102
A 14 boy with gynecomastia (feminine breast development) of idiopathic (unknown) cause is shown before and 4 months after surgery with a combination of liposuction and direct excision. The small scars in the upper chest and at the lower edge of the areola are barely visible at 4 months, but will continue to diminish over the next 18 months. He already feels comfortable going without his shirt in gym class.