Keyhole surgery is the best option for treating gynecomastia. Keyhole (small scar) surgery for gynecomastia is a combination of chest liposuction and gland excision through tiny cuts.The excess fat in the chest is removed by fine definition liposuction. The tough gland tissue can be completely removed through another small cut in skin under the areola. Since the marks are only 4-5 mm long, they are hardly visible even in the Indian skin which is prone to having prominent scars. In keyhole gynecomastia surgery, the small scars are located in the outer chest (under armpit) and under areola. These are locations having low visibility especially when the marks are so small. The traditional Gynecomastia incision under the areola is usually many times longer than the minimal access method. Minimal access gynecomastia surgery or MAGS is now the best gynecomastia surgery method.
The surgery is usually done under General anesthesia. Tumuscent fluid is injected onto the chest fat first. Chest liposuction is performed for removal of excess chest fat. Part of the breast tissue also comes out by Liposuction. Even in cases where the breast tissue is tough and does not come out completely, the residual tissue can be removed through the small access point under the areolaby a method called "anterior light pull through". This results in complete removal of the offending gland tissue using small incicsions. Traditional half circle incision under areola is not needed to remove the gland/ breast tissue. Small scars are very well accepted by all men who have undergone the surgery.
Dr. Hari Menon performs keyhole method in most cases of Gynecomastia removal. The access points are about 3-4 mm long and placed on the lower, outer chest. This makes the mark almost invisible on the front view. The mark is tiny and fades over many weeks.
Keyhole gynecomastia reduction is often performed as a day care surgery. Normal activities can be resumed from next day.
Keyhole surgery for male breasts can be performed in most cases of Gynecomastia in India, from grade 1 to grade 2b in young men. When there is lot of loose skin or when the male breasts are sagging beyond a certain limit, open removal of the excess skin is required. Such situations are fortunately not very common. Since scars tend to remain prominent in Indian skin, most men prefer small scar surgery. Even in cases with sagging skin, minimal access surgery is done and skin is allowed to heal for 6 months to one year. An elastic vest is worn during this time and supports the skin during healing. The need for skin tightening is reassesed after 6-12 months. In most cases, the skin tightens up to an acceptable level and secondary skin tightening procedures(which leaves big scars) are not required.
Click to see photos of Keyhole Gynecomastia surgery in India
Chest liposuction alone will be sufficient in cases of psuedo gynecomastia(fatty chest), which is purely excess fat deposition without gland formation. Chest liposuction is also useful in correcting previous gynecomastia surgery- in cases where 1.only gland has been removed thereby leaving a crater deformity and 2. in cases where there is lot of fat deposition on chest after surgery due to weight gain.
Liposuction of the chest in gynecomastia correction gives the advantage of complete correction of chest shape and more stable results. Male chest liposuction is no different in technique from liposuction of other areas. Tumescent Suction Assissted Lipectomy is the best method. Combining liposuction with gland removal results in a more sculpted look for the male chest. Hi definition liposuction is often employed to produce the desired chest contour. Liposuction of the entire chest also aids in better skin contraction in larger gynecomastias.
Chest being a limited area, the recovery after chest liposuction is relatively quick. Hospital stay is not needed and you can resume normal day to day activities the morning after surgery. Swelling takes 3-4 weeks to subside. Even when there is swelling, overall chest shape will be better than pre surgery shape.
Tiny 3-4 mm scar on the sides of chest and under areola, low scar visibility
Gynecomastia surgery is an ideal procedure to be done as 'nip tuck vacation' or medical tourism. The surgery does not need hospital stay, recovery is fast and routine activities can be started from next day. Only one post surgery check up is needed usually. In keyhole method, there are no drains to cause discomfort. The all inclusive cost of minimal access gynecomastia surgery (MAGS) in India can be between USD 1100- USD 2500.
Cochin is well connected to Indian cities and also has an international airport. Kerala is one of the best travel destinations in India.
Planning-
Initial planning for gyno vacation in India can be done through emails. To know if you have gynecomastia and for approximate cost, send an email (drharimenon@gmail.com) with photos of chest in front and side views with details like age and medical history. The date for pre op evaluation and surgery can then be booked online or by phone. Pre op assessments, surgery and post op check up can be completed in 5 days if well planned.
Pre surgery preparation-
Your Gynecomastia surgery can be scheduled 3-4 days after the first consultation. Pre op preparations include blood tests, anesthesia doctor's evaluation and getting measured for custom made elastic vest. It is possible to reduce the interval between consultation and gyno surgery to 1 day if the measurements for vest are provided by e mail well in advance. Heavy smokers should stop smoking 2 weeks before surgery.
On day of surgery-
Keyhole gynecomastia surgery is a day care procedure. You can return home/ hotel in the evening. Pain medications will be prescribed. Normal diet, driving and routine activities can be resumed from next morning.
2-3 days of sightseeing in 'God's own country'-
You may proceed to a resort or some sight seeing after 24 hours. Nearby places to visit- Munnar (High range), Alleppey backwaters and house boat ride, Kumarakom back water resorts, Cherai beach, Marari beach, Athirapally water falls, Thekkady widlife reserve.
Post op visit-
First post op visit is 3-4 days after surgery. Frequent check ups are not normally required. Second assessment is done one month after surgery if you are available in Cochin. Otherwise you may keep in touch with Dr. Menon by phone or e mail.
