In some boys during puberty and adolescence, breasts develop to a notable size. This can cause psychological problems and causes the boys to be embarrassed to remove their clothes in front of others, like in the locker rooms or in the swimming pools. But, the breasts become normal and almost flat in most of these boys, in two or three years from the time they had developed the breasts. In a few persons the enlarged breasts persist, requiring surgical correction. On rare occasions, breasts could develop in adult males also, sometimes it could be associated with hormonal problems.
In smaller Gynaecomastia the surgery could be performed under local anaestesia without any hospital stay. But most of the patients require general anaesthesia. To do both sides it takes 2-3 hours (longer if the breasts are to be tightened at the same time)
A small hole of 3 mm diameter is made on either side and through that hole the fatty & breast tissues are sucked out with help of a suction machine. An incision (cut) is made at the margin of the lower areola (the dark skin that surrounds the nipple). The skin and the areola are lifted up and the remaining breast tissue (breast glards) removed. A suction drain is placed before suturing the wounds. This will not produce any visible scar.
On patients with very large Gynaecomastia, the skin is also tightened at the same time of the above surgery to avoid sagging after the surgery.
Strenuous activities including sports and games are to be limited for about 8 weeks following the surgery.
Results and Complications
After abdominoplasty about 75% to 85% of the patients are very happy with their results, but the remainder is not totally happy, because of their high expectations, technical limitations, healing problems, and fluid collections and/or poor patient selection. If a transverse incision is used, the resulting scar is usually thin, acceptable and well hidden by the bikini. Some people are poor scar formers, and they could from thick, wide prominent scars than the usual patients.
Conventional abdominoplasty technique requires an extensive incision from one hip region to opposite hip region through whole of lower abdomen. But the endoscopic abdominoplasty enables us to be abdominoplasty through a small incision about 20 cm long only. The incision is deepened up to rectus muscle sheath. Once we reach the rectus sheath the abdomen skin and fat layer raised. Then introduce the endoscopic retractor to dissect up to umbilicus and then above the level of umbilicus up to xiphisternum by using the endoscope dissector. Then the rectus muscle is plicated using the endoscopic needle holder. The whole rectus sheath from xyphisterum upto umbilicus and again from umbilicus to public region is tightened. The excess lower abdomen skin and fat excised.