For those who worry about Gynecomastia and having the operation.

Hello.

I am Yoon Sang-yeop, Director of Silhouette Plastic Surgery, who runs a gynecomastia hospital in Korea. This article is intended for those who worry about gynecomastia surgery or who wish to have gynecomastia reoperationin Asia to inform that appropriate gynecomastia surgery is available in Korea.

I am a doctor who has carried out the most gynecomastia surgery in Korea.

In 2003, I started performing gynecomastia surgery as a plastic surgeon.

In 2007, I opened a branded silhouette gynecomastia center. .

Since then, I have carried out about 6000 cases until the current January, 2016.  

I am proud that Korean plastic surgeons have recognized me as the best in gynecomastia surgery and that I have published lotst of papers related to gynecomastia.

In addition, I have created the gynecomastia chapters of a textbook (cosmetic surgery) for doctors specializing in plastic surgeon or plastic surgeons.

I think it was meaningful to have a change to know about the gynecomastia forum.

I am writing this article not simply for publicity.

I am writing to let you know that there is a good gynecomastia center for your operation in Korea and Asia.

I also have introduced ingenious surgical procedures.

I would like to explain about the differences from the traditional surgery. 

1.     Reoperation for gynecomastia

2.     Areola increased due to gynecomastia collapsed simultaneous

3.     Gynecomastia surgeries developed by generation and comparison of scars

4.     Our most recent updated papers on gynecomastia and the procedures

      5.   Our papers on gynecomastia, published in medical journals

Historically, Gynecomastia surgery has a very long history.  

There is a record of the operation before Christ.

However, it is after the 1990s when the modern and contemporary significance of proper operation was carried out.  

Especially with liposuction developed, the full-fledged gynecomastia surgery has developed.  

It is after 2000 when gynecomastia surgery has been well-known and publicized in Korea. 

Especially as Director Yoon Sang-yeop has opened the website www.gynecomastia.co.kr for the first time in Korea in 2004, when full-scale operation started. 

Silhouette Gynecomastia Center is a gynecomastia center where the most gynecomastia surgeries have been carried out in Korea, more than 6,000 surgeries.

Gynecomastia reoperation has its main 4 types:

Gynecomastia surgeon has been carried out in non-specialized hospital so the reoperation is needed.

First, Bleeding

It is the case to take out the blood pooling after the bleeding side effects occur immediately after surgery. 
Most of gynecomastia surgical procedures are liposuction, where the glandular tissue made in the last stage is cut and removed. Conceptually, if you undergo mastectomy, a lot of nerves and blood vessels are cut together. This causes bleeding side effects. Thus, the blood needs to be drained.

       

Those who have had gynecomastia surgery do not complain about bleeding- less than other hospitals. There is no need to worry about drain; hemostasis is perfect. It is because the surgical procedure is different. Ggynecomastia is mostly gynecomastia with mush more fat. Thus, if liposuction is done thoroughly and the glandular tissue is incised for the minimum-required amount, the blood side effects do not occur. 

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Second, Depression
If the surgeon has a lack of aesthetic sense for the overall chest and carries out tumor excision focused on removing the glandular tissue, depression occurs just like the picture below.

If conducts the surgery aimed for the complete incision in a concept of breast cancer surgery, Then, a plate deformed concept (saucer deformity) occurs.

Only the papillary region has been hollowed; the patient has had the operation in other hospitals 

The reoperation to correct depression (dish-shaped deformation) needs autologus fat injection as well to restore the tissue such as fascia around the areola and to compensate for the deficiencies.

And the chest full contour is created to be flat by inhaling the area across the chest. Silhouette Gynecomastia Center makes this type of reoperation available.

Third, Remained Prominence
This is the case when the prominence has been still remained after the surgery as the glandular has not been removed. .

It is a principle to remove the minimum glandular line; however, the prominence and sharpness needs to be solved completely.

Otherwise, there is no difference before and after the surgery.  

If only liposuction had done or the glandular line has not been removed, it may be a problem, as shown in the picture below.

Even through a large scar has been left in the areola, the prominence still remains in the profile. The patient re-visited Silhouette Gynecomastia Center after the operation in other hospitals. 

Liposuction has been done leaving the large scar in the underarms and on the side flanks, the chest is still prominent. The patient had the surgery in other hospitals and revisited the . Silhouette Gynecomastia Center .

For the reoperation, liposuction and removal of the glandular line need to be properly carried out again during the plastic surgery of the existing scar.

It is important to choose the right hospital and surgeon to prevent reoperation.  

It is required to allow the experienced plastic surgery specialists to carry out the surgery

Fourth, Skin Redundancy
Even for a very large breast, if he skin is properly stretched using an ultrasonic wave in the gynecomastia surgery procedure, the skin not leave any boundary area. .

However, when there was a sudden change in weight or the skin elasticity significantly deteriorates, there may be an area around the skin.

Around 3-6 months after the surgery, the second skin resection surgery may be needed.

In Silhouette Gynecomastia Center, the first surgery procedures proceeds to shrink the skin, to properly lift up the sagging chest skin, and to attach it to the chest wall, which is aimed to prevent the skin from sagging or not being left.

If a part of the glandular line is removed without the treatment of the sagging skin, the skin  sags and overlaps, making a not good image..

Silhouette Gynecomastia Center solves skin sagging and gynecomastia through the reoperation.

In Silhouette Gynecomastia Center, the sagging skin was contracted and the left fat and glandular line have been properly, removed.    

Areola increased due to gynecomastia reduced at the same time 

The areola diameter increased up to by 34mm, caused by gynecomastia, was reduced up to 25mm.  

The right picture shows the areola reduced in 3 months after the surgery.

For the patient under much stress with 36 mm diameter, the diameter was reduced up to 27mm through reducing the areole without a scar.  

The right pictures shows that the areole is well-maintained in a shape in 6 months. 


Procedure of areola reduction 

This approach is an innovative method to reduce the areloa by stlmulating its back side using a ultrasonic

In the procedure, a small hole was made in the areola or nipple and the areola diameter was reduced by applying thermal energy on the rear side of the areola. 

It is the case when gynecomastia causes the widened areola. If the fat and glandular line are properly removed through gynecomastia surgery, the areola is reduced much. In particular, stimulating the rear side of the areola with an ultrasonic or high-frequency instrument makes it reduced more. It can reduce it more than 25% on average. This procedure is a Silhouette Plastic Surgery’s own unique surgery.    

Gynecomstia Surgery developed by Generation

The most desirable for gynecomastia surgery is not to leave a scar at all.  

However, the reality is that a small hole is needed to insert an instrument for liposuction and for the removal of the glandular line.

In Silhouette Plastic Surgery, 2-3mm of a small hole is made for the surgery . Thus, scars are not left.

1. Big scar of areola applied to breast cancer surgery – scar exceeding the areola diameter or the areola

The incision is out of the areola after by making a scar after incised at 180 degrees and the scar was extended in a 3 o’clock and 9 o’clock.  

In a plastic surgery concept, it is out of sense to carry out gynecomastia surgery leaving such a serious scar. It is not recommendable.

2. The entire areola (360 degrees) or border scar above

In this procedure, the areola is allowed to turn around or a scar is left on the top.

 

As the existing serious scar is left, it is not desirable to make a scar not in a state of needing plastic surgery or cutting the skin unnecessarily.

3.Abnormal scar below the areola

Although not beyond the areola, it is the past approach of using the border 180 degrees below the areola or of incising the border more than 1.5cm   

If a scar is left only in 6 o’clock by making the minimum incision, it is not seen well. 

However, the smaller the scar is, the more difficult the surgery. Thus, the same approach is used in the unreferenced hospitals.     

For the plastic surgeons dealing with scars, it is unacceptable to leave a scar more than 1.5츠.  

In my opinion, it is undesirable.  

In addition, most patients has high expectancy. Thus, making a scar more than 1.5cm, they feel unsatisfactory. This may cause stress.

If the surgeon has better skills and experienced more, it is possible to reduce the scar not to be seen.   

4. Incision hole made on the abdomen for liposuction of a scars far away the abdomen

A scar is not left on the chest, such as the nipple or areola. However, the

scar is made on the ares far way the abdomen, the scar is visible and clear.  Thus, it is not recommended. 



5. Scar in inframammary fold or on the flank side

In this procedure, a scar is made on the imaginary line on the flank side or inframammary fold

Unlike a woman, a man has no clear inframammary fold, making a scar on the imaginary line is not helpful because that line does not hide the scar.

Rather, a noticeable trace is left so it is not desirable.

In the past, a few papers that had dealt with this procedures were published. Recently, many plastic surgeons criticize the method of a making incision on the flank side, as well as the papers do that.  Thus, this approach is not applied any more.

6. Minimal Incision Scar

A scar is made by making the 6-7mm of minimal incision in 6 o’clock direction. It is a procedure using the scissors for gynecomastia and a high frequency machine.

This approach was published by Director Yoon Sng-yeop of Silhouette Plastic Surgery in Korean Society of Plastic Reconstrctive Surgeon in 2007. .

Since then, many plastic surgeons have heard the announcement , learned the method, and followed it.

Using the special utensils and scissors as shown in the picture can reduce the areola scars.  

Since then, Silhouette Plastic Surgery has developed this method more to carry out the surgery making a 2-3mm small hale (stab incision)

Recently, a developed method guarantying no scar is used. 

7. 2mm small hole(stab incision, small hole) scar

The surgery is available only by making a small hole, not making the incision or scar.

A 2-3mm hole is made on the areola or in the armpit for liposuction or glandular removal.        

A scar is not left after the surgery.  

An electric knife (tissue shave) is used. .

In 2009, Silhouette Plastic Surgery used an electric knife (tissue shave) for gynecomastia surgery.

It was announced as a new surgical method in the Korean Society of Plast Reconstrctive Surgeon.

In the front side of the tissue shaver, there is a metal blade to cut the glandular tissue. It is cut as the shaver rotates.    

The rear side of the electric knife is connected to the machine to absorbing the tissue, inhaling the cut glandular tissue.  

In the procedure, fat is melted using an ultrasonic wave to be inhaled. The grandular line is cut step by step and removed gradually.

Silhouette Plastic Surgery is the only hospital that can carry out the surgery with a 2mm-small hole. It is explained by Silhouette Plastic Surgery’s career with the surgical cases of 6,000 or more .
Accumulated experiences and know-how make it possible to damage the surrounding tissue and to minimize scars.

However, the only surgical method one way does not solve all gynecomastias. Do not stick to  the method only.   

Gynecomastia surgery has developed continuously.

The ultimate goals of gynecomastia surgery are

1.     Not to leave surgical traces,

2.     Not to damage the surrounding tissue

3.     To effectively remove fat and the grandular line

4.     To make a male chest into a normal, flat shape.

5.     And to quickly restore to the life without side effects. 

Surgical Methods by Generation by Silhouette Plastic Surgery and Comparison of Scars

(Left) 1^st generation gynecomastia surgery; prior to 2008(scar length 2 - 3cm)

(Middle ) 2^nd generation gynecomastia surgery; prior to 2010 (scar length 6 – 7 mm)

(Right) 3^rd generation gynecomastia surgery; after 2010 (scar length 2 – 3 mm, invisible after the surgery)

Silhouette Plastic Surgery has increasingly developed the surgical procedure developed on its own. 

It can be distinguished into the above 3 generations.

Ultimately, it is evolving in the direction of the invisible scars while liposuction and grandular removal are effectively carried put.

The most recent updated gynecomastia surgical methods by Silhouette Plastic Surgery

Benefits from Gynecomastia Surgery by Silhouette Plastic Surgery

1.No scars after the  surgery. 2-3 mm small holes scars are difficult to find. .
2. The operative time is short as about 1 hour.
3. Everyday life available after the surgery. Faster recovery. Most of the surgical procedures are liposuction. No damage occurs to the surrounding tissue as mastectomy is not applied, like breast cancer surgery,
4. Not uncomfortable because there is no need to wear a drain.
5. As a human bond is used to stitch the skin, no process is required to apply disinfection or undo a seam. It is possible to take a shower the following day. 

Procedure by Gynecomastia Surgery by Silhouette Plastic Surgery

The surgery is available by making a small hole in the areola or in the armpit.

A hole is not made into the two sites at the same time. One of the two sites is selected for

the surgery. 

Hereunder the procedure of the surgery, such as making a hole.

1. Topical anesthetic or sedation is applied. After the patient is anesthetized, a hole (2-3mm)  is drilled in the areola boundaries using a surgical knife.  

2. Tumescent solution (topical anesthetic and hemostatic agent) is applied evenly across the chest..

3. The fat across the chest is evenly inhaled using an ultrasonic liposuction instrument. .

The black border seen in the picture is the overall scope of the liposuction.

The greenish inner circle is a portion where the breast tissue (granular tissue + fat tissue) are present. It is inhaled by applying an ultrasound wave on a lot of the area.

Applying the fat intake process fully and properly reduces the first touched breast tissue (green boundary and the areola size level (3-4cm) even much.

4. The fat left after uultrasonic liposuction is inhaled using a general fat inhaling instrument..

5. If fat and the granular line are separated, the touching area is reduced Less than one-fifth.

6. The minimal necessary portion of the left grandular tissue is gradually cut using a  (tissue shaver to be removed.  

Cautious work proceeds to protect the chest from depression and to enable the chest to look flat. 

7. The small hole made in the areola or in the armpit is inner-stitched and the outer skin is attached by applying a human bond. 

6. A sponge is used to protect the skin and the are is covered with elastic bandage for24 hours.  

7. After the surgery, the sponge and the elastic bandage are released; only the siimle compressive band is worn  for 2-4 weeks.

For 2 – 4 weeks after the surgery, weight training is available.

The surgical method does not damage the surrounding tissues. Thus, the patient can recover quickly and take exercises soon.

Some papers on gynecomastia surgery, published in mdecial journals

1.    2005

2.    2007

3. 

4. 2009

5. 2014 in English journal

In addition to that, Director of Silhouette Gynecomastia Center has provided lectures on

gynecomastia to doctors majoring in surgery against the specialists, more than 30 times.