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Dr. Beldholm Answers The Most Commonly Asked Questions About Gynaecomastia

In this article I will go through the most common questions that I get from my patients when it comes to Gynaecomastia surgery. I will also share with you some of the many cases of man boobs that I do and how this has affected these patients.

Most Commonly Asked Questions on Gynaecomastia (Man Boobs) Removal

Transcript of Dr Beldholm talking about the most common questions that he gets regarding man boob surgery

Check out this article to get more information about the top 10 most common questions!

Getting a smooth result from your gynaecomastia operation

When we do the gynecomastia Operation, we obviously have to remove the breast tissue that’s been formed. The problem is, though, if you make the cut and you just remove the breast tissue, you are going to end up with a saucer deformity. This deformity is basically like a depression where you’ve removed the Gland. What we need to do is we need to do liposuction around everything to give you an even result. This gives you a really awesome result.

This video shows a crater deformity also called a saucer deformity. This video is from Dr Miguel Delgado’s who is a plastic surgeon in San Francisco. Once you get this deformity you will need revision plastic surgery that can be quite difficult as the nipple is then stuck down. It occurs when too much gland tissue has been removed and where the edges of the gland tissue have not been appropriately feathered in. I have seen quite a few men that have had gynaecomastia operations done by other plastic surgeons or cosmetic surgeons without using liposuction, which has caused this deformity. If you are seeing a plastic or cosmetic surgeon it is really important that you ask them about their technique and also for them to show you lots of before and after photos. In my opinion it is essential to use liposuction to avoid this problem. Ideally, the liposuction should be done with a VASER liposculpture machine. The Vaser liposculpture machine melts the fat and can also remove quite a bit of the breast gland so that when you make the incision to remove the gland it is nicely feathered in.

Trying to fix these deformities can be quite difficult and depend on a lot of factors. Sometimes there is a depression there but the gland is not stuck down or tethered. I find that in these situations it can be quite easy to just do additional Vaser Liposculpture around the gland and this will just complete the result. If the areola is really stuck down, then a small amount of fat injection in addition to releasing the areola and doing liposuction around the area would usually create a good result.

The other thing I tend to do, just to add on to give you an even better result is to do a lot of liposuction on the side of the chest, because that defines the muscle edge. Now, a lot of bodybuilders, they obviously have a lot of muscle already, very minimal fat, so we just have to do a tiny bit of lipo around the gland just to feather the gland in, make sure that there isn’t depressions, and then cut out the gland from there.


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A manly chest is best with something that shows the pec muscle, and that’s what bodybuilders try to do, they try to increase their pec muscles. That’s what we do if we do pec implants and things like that. What I need to do during surgery is to define the muscle edge. I do this by doing aggressive liposuction on the side of the chest wall and underneath the muscle. You really want to make sure that the muscle is nice and bulging in the middle, and then there’s no sort of puffy gland on the nipple areola complex. What you want to do is to show-off the pec muscle. The key thing is to understand how a male chest looks, it is not the same as doing surgery in women. I got a lot of patients that come in that obviously have a little bit of fat on top of the muscle. You don’t want to remove everything there, because that’s just going to make you look flat with no definition. It’s all about defining the pectoralis major muscle and making it look like you’ve really got the bodybuilding physique up top.

My story of a biker with gynaecomastia

Many years ago I had a female colleague that I worked with. She was a liposuction expert and did this as a full time occupation. One of her patients was a big bloke, a biker, that was very concerned about his gynaecomastia. She did the operation and thought that she had done a great job. However, after a few months he came back to the clinic extremely unhappy, and I was asked to come and see him. I talked to him for some time and noted that the result was not actually that bad, the gynaecomastia was gone and he had a much flatter chest. But what I discovered was that he was unhappy because he thought that the muscle had been removed!! The issue was more of a definition of a manly chest as opposed to doing a technically correct plastic surgical operation. He felt that his upper chest was now not in proportion to the rest of his body.

The key take-away lesson here is that cosmetic surgery is NOT about doing a technically correct operation, it is about knowing what result you want and achieving this. Any plastic surgeon or cosmetic surgeon can learn the steps of these operations, however to be truly great you need to be able to use these techniques like an artist uses his tools and sculpt a result that you will be amazed by.

Hi- definition VASER liposculpture of the chest wall

This video shows a patient that has had high definition VASER liposculpture of his chest. You may be wondering what the difference is between standard liposuction and gland removal and the high definition gland removal. My standard approach for all my man boob operations is to include liposuction. As mentioned above, this liposuction will give you definition and a superior result. However it will not give you a “chiseled” look.

The high definition approach takes around 1 hour extra to do and requires special VASER instruments. Initially, the fat is removed using the same approach as for the standard operation. Once this is done, the VASER probe is used to score the skin on the inside in the areas that require definition. Because we are doing aggressive VASER close to the skin, this operation is usually performed under a general anaesthetic as doing this is going to be painful with the standard sedation and local anaesthetic approach.

You can compare this case with the cases below and you will note the difference.

I see a lot of bodybuilders, and basically what they are concerned about is if the gland is going to come back? A lot of them have tried steroids and after steroids, they’ve tried reversing agents, and it hasn’t worked. They still got their breast gland there and it is embarrassing, because they want to show off their muscles and they can’t because they’ve got these nipples that stand out. A lot of them come to me and we remove the excess breast tissue. The question they have is if they did go back to steroids in the future, are they ever going to get the breast glandular tissue growing back? I guess the short answer is – very unlikely. However, we don’t actually remove the nipple and there’s still some remaining breast gland ducts in the nipple itself just underneath the areola and nipple, so there’s a potential for those to grow. However, the potential is really tiny. It’s very, very unlikely going to get that whole breast tissue growing back again.

The other thing I see quite a bit are guys that are really well-built, that have done the gym work, but for whatever reason, they’ve used steroids in the past or in the present, they get this little puffiness around the nipple-areola complex. What we do there is really a fairly straightforward operation. I do a little cut underneath the areola, and then we basically cut that area out and the gland out. It’s usually only a small grape-sized type gland that we cut out. That makes a big difference because it’s not puffy anymore, it’s flat. Everything else looks great because they’ve done their physical work at the gym. It’s usually a very quick recovery and a straightforward operation for you.

Usually, when someone’s sent to me, they’re quite embarrassed about having  gynecomastia. I see a lot of the ones that have it from teenage years. I see a lot of body builders. I see some guys that have put a bit of extra weight on and it just made the gland grow. Usually, the key thing there is that it is embarrassing for a guy to have breast tissue on the chest. Most men that I see with man boobs are hiding it in shirts (never taking the shirt off), most of them they would not take their shirts off even on the beach. If you go to the gym, you never take your shirt off there or in the change room, so it is embarrassing.

The great news is that It’s a quick and simple fix, usually.

It’s an hour operation. We can fix the chest for you. We can get rid of the breast tissue. A lot of the guys that I’ve seen, especially the ones that have it from teenage years and have had it for 10, 20 years are amazed how they just waited so long to have it done. Obviously there are risks with any operation, but the risks are quite low compared with other major operations. You’re looking at an hour, an hour and a half operation and a fairly quick recovery of a week or two. The results are usually very predictable.

Gynaecomastia before and after cases

These next few cases demonstrate the typical results with our standard gynaecomastia operation. This can be done either in the private hospital or our sedation and local anaesthetic clinic in Broadmeadow. Find out more about our prices and approach.

Patient 3061: small gland gynaecomastia case done under local and sedation in our broadmeadow day procedure facility

I see quite a few men that are quite well built but have a small breast gland. You can see that this guy only has a small puffy gland. However, he was quite concerned about this and even though he was happy with his general physique, he never took his shirt off because the nipple and areola stood out. He had a grape sized gland. We did the operation in our day procedure clinic in Broadmeadow. Even though the result is quite subtle he was extremely happy. He was able to take his shirt off without being embarrassed.

Patient 3062: Revision surgery for gynaecomastia and a large areola case done under a full general sedation in Hunter Valley Private Hospital in Newcastle

I see a few patients that have been done by other plastic surgeons. This gentleman had a gynaecomastia operation done by a local plastic surgeon. It was done about one year prior to seeing me, he had had gynaecomastia as a teenager and wanted this fixed. The other issue he had was large areola which made him feel he looked like a female. As can be seen on the before photos, the results after having the operation was not ideal and he was not happy. Revision surgery can be quite difficult and unpredictable. We did further liposuction on him. I removed further gland tissue and I also did a reduction of his areola. He was extremely happy with this result.

Patient 3063: small gland gynaecomastia case for a bodybuilder that has taken bodybuilding steroids done under local and sedation in our broadmeadow day procedure facility

This is a very similar case to the case above. This gentleman had small gynaecomastia. He works out a lot and has at one stage tried anabolic steroid, which caused his gland to grow. He tried reversing agents and other “tricks of the trade”, however, he was unsuccessful in trying to get rid of his man boobs. We did a small operation for him in our day procedure clinic in Broadmeadow, NSW. Again even though to most people the difference is small, he was extremely happy with the results.

Conclusion from Dr. Beldholm about Gynaecomastia

Gynaecomastia is a common condition in men. There are 2 main groups that I see. Gynaecomastia that does not settle after teenage years and body builders that take steroids. The good news is that the operation to fix this is usually quite straight forward and usually quite affordable.

Time for a consult?

Keen to book an appointment ASAP? Using our Make An Appointment online booking system is simple and takes just a minute! You can also give us a call at (02) 4934 5700.

Send us an enquiry about gynaecomastia surgery

Send us your details and any questions that you may have and we will get back to you as soon as we can.

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The post Dr. Beldholm Answers The Most Commonly Asked Questions About Gynaecomastia appeared first on Specialist Cosmetic Surgery.

This post first appeared on Dr Beldholm's Plastic Surgery, please read the originial post: here

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Dr. Beldholm Answers The Most Commonly Asked Questions About Gynaecomastia


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