GYNECOMASTIA – MALE CHEST CORRECTIONWHAT IS GYNECOMASTIA?Gynecomastia is a condition in which there is abnormal enlargement ofthe male breasts. This is a very common condition in young males and usuallyasymptomatic. Commonly seen during puberty.WHAT ARE THE CAUSES?Gynecomastia commonly occurs due to hormonal imbalance. Estrogen is thehormone which causes breast tissue to grow. Though men produce smallquantities of estrogen , they have higher levels of testosterone . when there is animbalance between these two hormones, the male breast tends to grow.Obesity can also cause this condition as it can increase the levels of estrogen.New born babies can also have due to estrogen from mother. During pubertyhormone levels may vary and produce enlarged breasts. But it usually clears uponce the hormones stabilise. It is also common during old age as the testosteronelevels drop.Other rare causes includeLiver disorder, certain medications, anabolic steroids, klinefilter syndrome etc.WHAT ARE THE SYMPTOMS?Gynecomastia most commonly presents as a painless swelling. It is usuallybilateral. Need for treatment is mainly for cosmetic reasons. Inability to undressin front of others, wear t-shirts, go for swimming are the common complaints.Sometimes they present with low self esteem, decreased confidence and insevere cases depression.WHAT IS THE TREATMENT?Gynecomastia is a benign condition and the only reason for correction is forcosmetic purpose. It can be easily corrected by a simple day care procedurewhich involves liposuction of the chest along with gland excision. It is usuallydone under general anesthesia. Patients are advised to wear a compressiongarment for a period of six to eight weeks to achieve the desired results. Patientsare advised to avoid lifting heavy weights for a period of two months.

Breast augmentationBreasts are a symbol of feminity in women. They add not only beauty butalso a sense of pride and confidence in them. Women like to have a good shapeand wear clothes which fit them perfectly.Those with hypomastia have not only problems in wearing fitting clothes italso affects their confidence and self esteem . In some cases it can affect theperformance at work or cause marital disputes in personal life.BREAST IMPLANT:Breast implants have been a popular method of breast augmentation allover the world. Implants give the desired shape and projection of choice. Theycome in two choice of filler substance, saline or silicone. The implants can beplaced above the muscle(sub glandular), or below the muscle(sub muscular).PREOPERATIVE WORKUPA detailed discussion of expectations and examination can help to decide thesize of the implants. The choice of placement as well as the site can be decided.All the patients are expected to do a routine blood examination and any specialinvestigations if required for anesthesia. Smoking to be stopped atleast threeweeks prior to the surgery. A routine ultrasound / mammogram to be done forall patients prior to the procedure.PROCEDUREIt is usually done as a day care surgery. The incision is made (inframammary),the plane is developed(sub glandular or submuscular), and the implants areplaced through aseptic precautions. Wound is closed in layers.ANASTHESIAIt is done under general ansthesia and takes about 60 minutes.POSTOPERATIVE CARETight plasters are applied to keep the implants in their place. The patients areadvised a support bra to be worn from the second postoperative day upto atleasta period of two months. All strenuous activities, lifting of heavy weights to beavoided for a period of two months.

WHAT ARE THE TYPES OF BREAST AUGMENTATION?Breast augmentation or enlargement can be done by implants or using ones ownfat. Though most of us familiar with implants, breast fat fill is a newer procedurewhich is slowly gaining popularity.WHAT IS BREAST FAT FILL?Breast fat fill is a procedure in which the patient is aspirated from onearea(tummy, thighs, arms) and is used to augment or enlarge their breasts.ARE YOU AN IDEAL CANDIDATE FOR BREAST FAT FILL?In general women who have small breasts, who have lost volume post lactation,weight loss can opt for breast fat fill.You are an ideal candidateIf you have small volume breasts with minimal or no saggingGood physical and mental healthIdeal body weightRealistic expectationsPROCEDURE DETAILS:Breast fat fill is done as a day care procedure under general anesthesia. Preoperative markings and the areas from which fat is going to be aspirated isdecided. Liposuction of the donor areas is done (tummy, thighs, back,arms)andthe aspirated fat is injected into the breasts through a minimal incison(5mm) inthe armpit/axilla. Post operatively a compression garment to the area ofliposuction and support bra is advised for a period of 6-8 weeks. Strenuousactivities to be avoided for a period of two months.DIFFERENCE IN RESULTS COMPARED TO BREAST IMPLANT.Breast fat fill has a few advantages over breast implant, such as using onesown fat ,removing fat from undesired area to augment a desired area. There areno scars over the breasts, only small scars in the armpit . however one has toremember that upto 20-30% of the injected fat may get absorbed and the patientmay need another sitting to get the optimal results.