For moderate to severe gynecomastia, it may be recommended for the patient to have a 2 stage procedure. This is due to excessive skin. This could be due to considerable weight changes or a severe case of gynecomastia as in the above picture. The goal is to reduce the skin, fat and gland content without a large mastectomy scar across the chest. A scar of this nature can be as devastating as the gynecomastia and disfiguring.
Patient on the O.R. table after gland excision, liposuction, superior crescent lift and external lift sutures. He is seen 6 month later.
The first stage gynecomastia surgery is aggressive gland excision and liposuction. A superior crescent breast lift is often done to advance the nipple-areolar complex upward and reduce the breast fold. This was done in this case. Sometimes this superior crescent lift can avoid the second stage altogether. After six months the blood flow will reestablish itself to the nipple areolar complex and the second stage lift also known as a peri-areolar lift can be performed. The procedure consists of an incision around the nipple-areolar complex where the skin is excised with a purse string closure.
He is seen two weeks later