The first thing that the surgeon will do during your consultation is to determine your Gynecomastia Grade. This is important because the operation will depend on what Grade you have. At Evita Clinic, we Grade patients using the chart below:
Grade I – enlargement of the glands (small breast)
Grade II – enlargement of the glands and accumulation of fats around the chest (moderate breast)
Grade III – enlargement of the glands, accumulation of fats around the chest, moderate skin sag (large breast)
Grade IV – severe enlargement of the glands, accumulation of fats around the chest, severe skin sagging (similar to female breast)
Surgery for Gynecomastia Grade 3 is divided into three parts (1) Liposuction (2) Gland Removal and (3) Skin Resection (Circum-Areolar Type). Among the three, the part that is most crucial and concerning for the patients is the “skin resection”. This is because of the scar it will leave after the surgery.
The necessity to receive the Areolar skin resection depends on the patient. It does have its advantages. The purpose of this procedure is to remove the excess saggy skin which has been stretched and enlarged due to the glands and fats. Choosing to include this procedure, would give patients a flatter and more normal-looking chest.
Anyone with this Grade can have this surgery. But for our younger patients, specifically 40 years old and below and single, we advise them to proceed with the liposuction and gland removal first. This is because they still have the chance to improve the condition of their skin sagging by exercising really hard after the surgery and improving their overall health.
Grade 2 Gynecomastia cases: Both patients above are in their 20s. Looking at their “Fitness Score”, the one below, has a higher BMI. Their glands are almost of the same size. But you can clearly see the difference of their results 4 weeks after their surgery. The one with a good Fitness Score has a better-looking chest. If one neglects to exercise after their surgery, the result will be of that of a “crying chest”.
Whether one decides to have the skin resection or not, working out after the surgery is very important.