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Gynecomastia is a benign enlargement of male breast glandular tissue, the most common breast condition in males. It is caused by an increased ratio of estrogen to androgen production, which increases the size of the male breast. The causes are unknown in 25% of cases, and 10% to 25% are associated with drugs. Symptoms include breast pain or tenderness, and psychological effects include anxiety, reduced self-esteem, embarrassment, and depression. Surgical options include liposuction, limited access excision, skin sparing mastectomy, and breast amputation with free nipple transfer.

A retrospective analysis of 448 patients who underwent gynecomastia surgery from January 2020 to December 2021 was conducted. The study followed ethical principles and patient consent. Patients were thoroughly examined during consultations, with blood tests and hormone tests only performed if necessary. A questionnaire was created to assess patient satisfaction after surgery, as no standard outcome assessment questionnaire exists for gynecomastia treatment.

The study aimed to create a sculpted chest by using liposuction to improve skin redraping. The procedure involved a 4mm stab incision, injected with tumescent solution, and focused on the glandular area for better tissue retraction. The endpoint of liposuction was determined by the desired chest shape. The gland excision was done using a periareolar incision, and the pectoralis fascia was preserved to prevent skin adhesion. If skin redundancy was present, NAC lifting plaster was applied, followed by compression garment for a month. Patients were advised to wear compression garments 24/7.

This study found that most patients had Grade II gynecomastia, followed by Grade III, Grade IV, and Grade I. The average BMI was 27.31 kg/m2, with Grades III and IV having higher BMIs. The study found that 25.9% of patients experienced some form of complication, with seroma and superficial skin necrosis being the most common.

Gynecomastia surgery is a safe, rewarding procedure involving various technologies and methods, with common complications but easily manageable for better patient satisfaction.