Gynecomastia or male breast reduction surgery is one of the top three procedures for men and was up 13% last year according to British Association of Aesthetic Plastic Surgeons.
Mr Alex Karidis has developed specialist expertise in the area of gynecomastia. Now one of the UK’s leading surgeons for the treatment of enlarged male breast tissue, his two part procedure is relied on as one of the best and most effective ways to treat gynecomastia. Here he shares his essential know-how about the condition and how his combination of liposuction and gland removal is the best treatment to consider.
“Gynecomastia is a condition affecting men that concerns not just breast fat but glands too. If you take a cross section of area you’ll see fat glands have little cushions of fat surrounding them. So even if you shrink or remove the fat cells the gland is still going to be there, protruding visibly on the outside.”
“For the vast majority of individuals who have gynecomastia the condition is idiopathic, which means there’s no particular reason, it’s just genetic. A tiny proportion of cases are due to hormonal changes but very few.”
“An indication of a hormonal problem would be if the issue developed fairly recently out of the blue and accompanied with symptoms such as pain and secretion. That would suggest there might be a hormonal cause.”
“Most guys have had the problem for years and for most patients the problem developed during puberty so it’s a genetic and evolutionary hormonal problem.”
“Unfortunately there’s no pill, potion or cream that will get rid of it. Not exercise either – as you get leaner with exercise, it might look worse as the gland will stand out.”
“The fat gland doesn’t actually produce anything, it’s dormant. Body builders who take steroids often develop gynecomastia as steroids are hormones and they can stimulate the gland. Occasionally some patients taking medication for baldness may develop it too.”
“Liposuction is carried out in the theatre under general anaesthetic and is an effective procedure to clear the fat cells in the area. Once this is done, I know what is left is gland.”
“Next, I carry out a procedure called gland removal, which compliments the liposuction. This two part procedure is the best way of treating gynecomastia. In my professional opinion and experience, it’s the only way to combat the issue of protruding fat glands left visible after fat removal.”
“To remove the gland I make a little nick underneath the nipple and we just take out the gland. I generally remove around 99.9% of the gland. The tiniest amount is left. Men have glands as well as women do but we have different hormones so has no function.”
“I would say all my patients have a combination of gland and fat in the male breast area. So nearly all would be suitable for this two-part procedure of fat removal followed by gland removal.”
DOES COOLSCULPTING WORK FOR GYNECOMASTIA?
“A lot of guys who have gynecomastia will say when they put weight on the problem is not as prominent – because the surrounding fat in effect masks the problem of the protruding gland. When they lose weight the issue looks worse because the fat has started to shrink and the gland is more visible so looks worse.”
“This is the reason we don’t carry out CoolSculpting for gynecomastia because if we did it’s very likely we’d make the problem look worse. Once the fat is reduced through fat freezing, the gland will be more visible leaving the patient disappointed and still facing the same problem. This is why CoolSculpting is simply not appropriate for gynecomastia.”
“There is only a tiny fraction of patients who have what we call pseudo-gynecomastia which is not actually true gyna as it’s only fat. But that’s so rare – in fact, in the last 20 years I’ve been treating gynecomastia I’ve yet to see someone who’s got only fat. So it’s a fallacy and wrong that CoolSculpting can be used to treat male breast – it should not be offered in my opinion.”
“So the winning combo is lipo and gland removal. It’s very important we never do lipo by itself – it should always accompanied by gland removal.”
“It’s worth adding gynecomastia as a condition does not cause any medical problems. A man can easily live with it without any issue. It’s purely a cosmetic issue. Obviously it can affect men’s psyche and confidence and might affect what they can and can’t wear and will be visible naked. But these are all psychological reasons. If you do have a degree of protrusion in the chest and it bothers you, then liposuction and gland removal will do the trick.”