This is an interesting case of gynecomastia surgery from which much can be learned. He is fit and trim. He has large, full breasts on both sides. He says he had gynecomastia since puberty but admits to taking supplements (hormones / prohormones) about 7 years prior to this treatment.
Hormones / prohormones often result in gynecomastia that is firm and glandular. It’s usually painful initially and this subsides in a few months. Nothing is going to make this go away other than surgical removal.
He is seen here 1 day after gynecomastia treatment (he is from out of town). You can appreciate the very large glandular masses that were removed from both sides. It was stuck and a challenge to get it out for this experienced surgeon. I was NOT ABLE to use my internal flap technique to pull in normal tissue in the area where this mass was removed because the gap between the flaps was over 3 centimeters. I feel he is going to do well even without these flaps because I didn’t want to leave mass behind so he doesn’t have a contour depression and I feel his contour is going to be fine without the flap because of his anatomy / body habitus with surrounding fat.
As always, the dilemma in this case is the goal of treatment and how to end up with the best result under the circumstances. As you can see from the photos his contour is quite good and the change in the appearance of his chest and body is a dramatic improvement on what he had.
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