by Internet Medical Society
Gynecomastia can come in all shapes and sizes, from being barely noticeable to something painful and virtually impossible to hide. Most grading systems rate the severity of the condition from 1 to 4, with 4 being the most severe, while others use a more granular approach, adding 2 or even 3 extra levels of severity.
Type 1 gynecomastia produces puffy nipples, and is more common among men with a leaner build. Surgery is performed under local anesthesia.
Approximately 90% of excess glandular tissue in Type 2 patients can be removed through surgery. Liposuction may also be performed.
In Type 3 cases, the breasts protrude from the chest at a 45-60 degree angle. Surgery is required to remove the excess tissue.
Type 4 gynecomastia is characterized by sagging skin and breast tissue protruding from the chest at an angle of 60-90. Surgery is performed to remove the excess breast tissue, and also to excise the excess skin due to chest sag.
Sagging breast tissue that falls below the chest fold is tightened through a procedure known as the “anchor lift.” Excess skin requires surgical removal.
Type 6 is characterized by extreme sag of the breast tissue that falls below the chest fold, extending under the armpits and towards the patient’s back. Surgical removal and liposuction are required to flatten the breast and remove fatty deposits.
This is the most extreme stage of gynecomastia, with severe sagging and noticeable volume in the breast (up to DD cup size). Surgical removal of excess breast tissue is required.
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