Breast fat transfer is getting popular due to its efficacy and long-term safety. But what happens to the breasts after 5 years post-breast fat transfer?
April 24, 2024
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What type of scar will I get after my gynecomastia surgery?
Can you make the gynecomastia surgery scars less obvious?
Dr Ivan Puah has more than 17 years of liposuction and body sculpting experience, including performing gynecomastia and corrective surgery in male patients from all walks of life in Singapore and the Asia Pacific. He often hears the above questions from patients during their gynecomastia surgery consultation.
But lately, a question often asked, which begets a scratch on the head, was…
I read about scarless gynecomastia surgery online; can you do that? Can you guarantee that there will not be any scars after the surgery?
Scarless gynecomastia surgery
We see Google ads and articles from some medical providers marketing "Scarless Gynecomastia Surgery." Scarless, by definition, is no scar, so how does one do surgery without scarring… because a cut is a cut, right?
After all, the objective of gynecomastia surgery is to excise the enlarged male breast tissue, and depending on the patient's clinical condition and gynecomastia grading score, the tissue can be quite a size!
Anatomy of the Gynecomastia Tissue
If you are unaware of the anatomy of the gynecomastia gland, here is a picture of two glandular tissues removed by Dr Puah.
The average breast glandular tissue size is less than 2 cm in width. The glandular tissue in a gynecomastia patient is usually larger than 2cm [1]. The enlarged male breast tissue consists of a head, body and tail. The head's shape is semicircular and located towards the body's centre, while the tail tapers off the body to the side and towards the pecs and humerus area. The size of the glandular tissue and the amount of chest fat in a gynecomastia patient make every surgery unique [2].
FACT: IT IS IMPOSSIBLE to remove enlarged male breasts with radiofrequency heat or non-invasive treatments. Glandular tissues CANNOT BE MELTED, FROZEN, BLASTED, ETC. It has been proven that, as of now, the only successful intervention is to SURGICALLY REMOVE the tissue from the chest.
So, how can removing these sizable tissues not cause any scarring? First, let's understand how a typical gynecomastia surgery is done.
What happens during a traditional gynecomastia surgery?
Typically, traditional gynecomastia surgery involves creating large linear incisions under the breast to allow the removal of enlarged breast tissue and chest fat. This tends to result in prominent, linear, thick scar formation under the breast post-surgery.
After the procedure, the doctor must also make other incisions for fluid drainage. Drainage tubes actually increase the risk of wound infection and additional surgical scars.
Since incision is necessary, how is scarless gynecomastia surgery possible? Is it possible to not have scars after surgery?
According to Dr Ivan Puah, the answer is yes and no. This will depend on the individual's gynecomastia severity and grade, age, degree of skin droopiness and laxity, and how well the patient takes care of the wound post-op.
Scarless gynecomastia surgery is possible if the patient has Grade I gynecomastia, which is typically characterised by a minor glandular tissue enlargement without skin excess.
Patients diagnosed with Grade II gynecomastia, where the glandular tissue enlargement is moderate in size and without skin excess, may also achieve a scarless gyno result post-op.
However, scarless gynecomastia surgery may not be achievable for those suffering from Grade III and above, as these are the most acute forms of gynecomastia, characterised by severely enlarged glands, excess fat tissues, and significant excess skin sagginess. Additional incisions or longer cuts are necessary to produce satisfactory results in patients with more severe gynecomastia.
However, this doesn't mean that those with Grade III and above will be left with unsightly scars after their gynecomastia surgery.
What the gyno doctor can do on his part to minimise scarring are how and where the incision was made and closed
The wounds will be closed using a special suturing technique to minimise wound tension. While the gynecomastia doctor will do his or her best to reduce the chance of scarring, it is essential for the gyno patient to have realistic expectations. Other factors will affect the extent of the surgical scar formation.
Understanding scar formation post surgery and the treatment options
Did you know that a whopping "100 million patients develop scars in the developed world alone each year due to 55 million elective operations?" [3]
According to a study on the relationship between immunological mechanisms of scarring and their psychological impact on patients, dark-skinned individuals are more prone to forming scars than light-skinned individuals, with genetic factors playing a significant role.
Common scar issues such as hyperpigmentation and thickening require different care and treatment approaches.
Scarless gynecomastia surgery is possible, but it will very much depend on the patient's healing process and the following factors:
- Incisions size
- Location of the incisions
- Genetics
- Post-surgery wound care
- Lifestyle
In general, scars tend to lighten and improve with proper care, though some patients may develop bumpy, reddish keloids due to excessive collagen in the skin. This condition affects an estimated 11 million people [4].
It's important to understand that scars can still form even with the best care. How a scar looks in the end depends a lot on genetics. Some people naturally produce more collagen, which can lead to keloid scars that are harder to avoid. For patients with a risk of keloid formation, steroidal injections or scar revision may be required. Everyone's healing process is different, so it may be tough to prevent scarring completely.
Modernised Gynecomastia Surgery: Dr Ivan Puah's 360° GTD® technique - Step by Step
Wanting to explore the option of gynecomastia surgery is a highly personal decision, and we understand its importance. Dr Ivan Puah takes a modernised and customised approach to meet the needs of each unique gyno patient to achieve optimal results for each individual. Our doctor and team prioritise your comfort, safety and results throughout your journey with us.
Twilight Sedation for Gynecomastia Surgery: Optimal Comfort and Peace of Mind
Undergo your gynecomastia surgery at our advanced MOH-approved Day Surgery Centre, furnished with up-to-date surgical equipment and a monitoring system. Our team of anaesthesiologists offers twilight sedation, ensuring a smooth and comfortable procedure without the need for general anaesthesia.
Customised Glandular Tissue Removal & Chest Contouring
During the procedure, small incisions will be made strategically. Following the infiltration of the numbing solution to the targeted area, Dr Ivan Puah will carry out glandular tissue excision with his proprietary surgical approach—360° GTD® technique. This allows a thorough and clean excision of the affected tissues and minimises the risks of scarring and haematoma formation.
Additionally, his approach does not necessitate the need for postoperative drainage, thus reducing the need for additional incisions and eliminating the risks of infection. For those who require chest fat removal and contouring, Dr Puah's patented MDC-Sculpt® Lipo Technique, a multi-dimensional fat removal and sculpting approach, offers customised results tailored to individual fat distribution, muscular curvature and skin laxity.
Close incisions with fine stitching
A typical gynecomastia surgery takes between 1.5 and 2.5 hours. After the surgery, the incisions are carefully closed with stitches. Sterile dressings and a compression garment are then applied. Our experienced post-surgical team will care for you while you rest at the recovery bay.
Seamless Recovery: Same-Day Discharge with Comprehensive Aftercare Support
Once you've come to and are ready to head home, you will be discharged on the same day with a post-op care kit and a detailed aftercare advisory.
Benefits of Dr Ivan Puah's Unique Gynecomastia Surgery with 360° GTD® technique
The benefits of Dr Ivan Puah's proprietary gynecomastia surgical technique include:
- Involves minimal and strategically placed incisions less than 4mm
- Permanent and thorough glandular tissue reduction
- Reduces the risks of haematoma formation
- Tightens skin for a smoother chest contour
- Methodological sculpting techniques for a natural-looking chest
- No post-surgery drainage tube, thus reducing scarring and risk of infection
- Minimal disruption to daily activity and work
What you can do to prevent scar formation after gyno surgery
General lifestyle choices
When you are healing, adopt HEALTH - Hydrate, Eat well, Avoid drinking, Leave smoking, Think positive and Have plenty of rest. As a matter of fact, adopt HEALTH even when you are not sick to be in the pink of health, inside and out.
Sun protection
Sun exposure can darken the scar colour. Avoid outdoor activities that require you to remove your shirt for at least 6 months. If unavoidable, apply sunscreen SPF 30+ and double up with scar reduction gel/cream.
Silicone sheets/gel, vitamins & natural treatments
Silicone has been used for decades to hasten scar discolouration. It can come in gel form and self-adhesive sheets. Vitamin E and Aloe can also help with scar healing.
Anti-scar massage with MLD Therapy
MLD Therapy encourages blood flow to avoid the build-up of lymph fluid in the body, stimulates the healing process, improves skin texture, and minimises scar formation. This service is also available at Amaris B. Clinic.
If you have any questions regarding Scarless Gynecomastia Surgery, we welcome you to contact us at customer@amaris-b.com or WhatsApp +65 9152 4140.
