Gynecomastia-pseudogynecomastia after weight loss

γυναικομαστία μετά από απώλεια βάρουςMen represent 15-20% of all patients undergoing bariatric surgery for weight loss purposes. The number is constantly increasing and, in theory, the number of men seeking for plastic restoration after weight loss shows constantly increasing trends.

The number of gynecomastia cases increased by 22%, from 2005 to 2006. The most common deformity occurs in men with excessive loose breast skin as a result of weight loss. Glandular gynecomastia is observed in older men while pseudogynecomastia is characterized by increase of subcutaneous fat in the breast, and enlarged gland may be absent.

 The differential diagnosis is based on that on palpation glandular gynecomastia appears as a round area below the areola vs the second one where diffuse fat deposits are evident.

There are several treatment methods in gynecomastia after weight loss.

Grading and treatment algorithm of pseudogynecomastia after weight loss.

Grade Description Treatment
Ι Mildly loose skin and fat; the areola is not involved  Liposuction or Webster removal
Ia
Ιb
without side skin
with side skin
Liposuction or Webster removal
II The areola is below the submammary line; side skin;mildly loose skin on the upper abdominal area Internal skin removal and Webster excision. Suturing on the areola outline
ΙΙΙ The areola is quite below the submammary line; side loose skin  Skin removal and re-placing of the areola as free graft

Cases:


Class Ia without side skin


Class Ib with side skin


Class II with the areola below the submammary crease

γυναικομαστία μετά από απώλεια βάρους
Class III with significant skin looseness

A recent interview of Dr. N Kapositas on gynecomastia and the true story of Dimitris

 

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