Gynecomastia is the presence of a mammary gland in men at the level of the chest wall behind the nipple. Pseudo-gynecomastia is the presence of excess of fat in the chest wall giving the shape of a breast as in women. The diagnosis of gynecomastia is made by a clinical examination by our surgeon. He will complete the assessment with an ultrasound which highlights the presence of the gland.
A blood prolactin level can rule out the presence of a prolactin-secreting hormonal tumor that is responsible for gynecomastia. This last pathology is exceptional.
The treatment of gynecomastia is always surgical. An algorithm allows the most adopted technique to be chosen according to the defect. The most used techniques are glandular excision by an incision below the areola. This technique can be supplemented by a liposuction to extract the fatty excess that accompanies certain gynecomastia and to improve the esthetic result.
In the case of pseudo-gynecomastia, liposuction alone is generally sufficient because there is no mammary gland.
In some severe cases of gynecomastia and pseudo-gynecomstia, there is not only an excess fat and or gland but also a cutaneous excess with a ptoseis of the tissues. In cases where the excess skin is moderate and the skin is elastic, liposuction allows the skin to shrink. Sometimes, due to a larger skin excess, we have to make a skin excision which leaves a scar around the areola or in some cases a vertical scar descending from the areola to the pectoral groove.
The following video, in English, gives some explanations on gynecomastia and its treatment: