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Liposuction of the male breast is one of the many areas on men most commonly treated by liposuction. The other areas are the abdomen, flanks, and chin/cheek/jowls. Male patients with excessive fat in their breasts can be successfully treated with tumescent liposuction.

Gynecomastia, which is an enlargement of the male breast(s), is of 2 types:

Pseudo-gynecomastia is defined as an enlargement of male breast(s) caused by an excessive amount of fat tissue, but a normal amount of glandular breast tissue. Most male breasts that appear unusually large are the result of excessive fat. A slight but cosmetically undesirable degree of pseudo-gynecomastia probably occurs in a majority of men as they become older.

True-gynecomastia is defined as enlargement of male breast(s) caused by excessive glandular breast tissue. There are a number of causes of gynecomastia including alcoholism, failure of the testicles to produce sufficient testosterone hormone, and many medications.

Bilateral gynecomastia can also be associated with human immunodeficiency virus (HIV) infection, renal failure treated with hemodialysis, certain cancers such as testicular cancer, and adrenal corticosteroid secreting tumors.

If a male has a single enlarged breast then one must consider the possibility of a true breast tumor. Any significant asymmetry of the male breasts, especially if there is a history of recent onset of asymmetric growth, should prompt the surgeon to consider a mammogram.

Drugs that can cause gynecomastia include amiloride (Moduretic), amiodarone (Cordarone), amphetamines, anabolic steroids, antiandrogens (cyproterone), anticancer (cytotoxic) drugs, androgens, busulfan (Myleran), captopril (Capoten), cimetidine (Tagamet), clomiphene (Clomid), diazepam (Valium), diethylpropion (Tenuate), digitalis, domperidone, estrogens, isoniazid, ketoconazole (Nizoral), marijuana, methyldopa, metoclopramide, nifedipine (Procardia), nitrosourea, penicillamine, phenothiazines, phenytoin (Dilantin), reserpine, spironolactone (Aldactone), tricyclic antidepressants, vincristine.

Procedure

Liposuction of the male breast is a well-recognized procedure. At ENHANCE usage of smaller cannulas give consistently outstanding results.

Tumescent liposuction of the male breast can be easily done under local anesthesia. After gently injecting local anesthesia into selected areas of the skin overlying the breasts, multiple 1.5 mm adits (punch biopsy holes) are made. Then a large volume of tumescent local anesthesia is injected into the breasts. The resistance of glandular breast tissue to penetration by a microcannula can be reduced by infiltrating a large volume of tumescent local anesthesia. The smaller the cannula diameter, the easier it can penetrate the dense tissues. Short 5 cm long 16 gauge cannulas are ideal of initiating liposuction within the dense portion of the male breast.

Postoperative Care

After liposuction is completed, the adits allowed to remain open (they are not closed with sutures) in order to maximize drainage of blood-tinged tumescent anesthetic solution. This drainage is absorbed by HK Pads held in place by a spandex HK Breast-Torso Garment.

Realistic Expectations

Most patients should expect a significant improvement. It is a good idea for patients to assume that they will only achieve a 50% improvement. In fact, most men will achieve more than a 50% improvement. In some men, there is not much room for improvement.

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