Dr. Jayanta Bain

Introduction 

The common male problem in an Aesthetic clinic, Gyanecomastia, is truly Pseudogynaecomastia with only fatty tissue and minimal glandular tissue. The condition is a part of the co existing Obesity disorder and is rarely, a standalone entity. The treatment options shall include an approach to answer the issue of obesity as a whole, not rest contented with surgical removal of the enlarged breasts alone. What is seen and what is treated is just a tip of the iceberg. 

Gynaecomastia, an innocuous condition, that affects 35-70% of male population immediately after birth, during adolescence and old age is rarely brought to notice as the sufferer makes all attempts to hide it as the condition brings with it a sense of shame and pain in public places and mental suffering. Herein starts the search for the treatment. Medical and multifaceted surgical options evolved over centuries with the current opinion being fat removal by anyone form of liposuction and the gland removal by direct excision. Gynaecomastia, is increased breast tissue in males composed of glandular and fatty tissue. 

Physiological gynaecomastia of puberty that normally regresses with age tend to stay back being sustained by the modern lifestyle changes. Processed foods and environmental pollution of air and water, the cosmetics used on the body like deo odorants, perfumes and toiletries, synthetics and chemicals have contributed to explosions of generalised obesity. With this generalised obesity, the tendency to hold back excess fat in the breast developed. This clearly shows the reason for higher incidence of (pseudo) Gynaecomastia of late. Hormonal imbalance due to reasons stated above, aggravate the situation. Gynaecomastia is part of the generalised obesity and it is more fat and little gland. 

However, this condition does not have any harmful effect on the body, but it can cause distress emotionally. Men may lose their self-confidence and they can be psychologically affected by this.

What Causes Gynaecomastia?

It is a type of hormonal imbalance that results in the growth of the male breast tissues. The ratio of oestrogen v/s androgens gets altered and causes the enlargement of the breasts. For this condition to occur, the amount of oestrogen increase in the body, or the amount of testosterone drops. Sometimes it can be the combination of both.

There are certain diseases that may contribute to gynaecomastia and they are as follows:

1. 351882 Kidney diseases

2. Liver disease

3. Drop in testosterone levels

4. Certain medications such as methadone, medications for HIV or treating prostate cancer

5. Certain tumours caused in male sex organs such as cancer of the Leydig cells or the Sertoli cells resulting in deprivation of androgen levels

Conclusion: 
True Gynaecomastia that requires surgical treatment is not so uncommon. What is commonly believed to be gynaecomastia is truly Pseudo gynaecomastia with a co exiting clinical picture of obesity, high BMI, sedentary life and wrong lifestyle. Surgical treatment by liposuction under Tumescent Anaesthesia gives very good results with high patient satisfaction and negligible post operative complications. Gland fragmented with laser can be extricated thro’ same entry point without sub areolar incision. In case you have a concern or query you can always consult an expert & get answers to your questions!

Many men and women suffer from baldness these days and in order to conceal it, look for options available in the market. Though there are many temporary solutions, the most permanent solution is hair transplantation. 

What is Hair Transplantation?
Hair transplantation is broadly achieved by removing grafts/follicles from the donor area which are more resistant to hormonal changes and placing them in areas of scanty growth or baldness. There are two methods to remove the grafts – Follicular Unit Transplantation (FUT) and Follicular Unit Extraction (FUE).

In FUT method, a strip of scalp is cut out from the donor area and is dissected into individual grafts.

FUE method of hair transplantation involves taking the individual follicular units/grafts from the donor area one by one by cutting around it through a tiny specialised machine and removing them. The process is tedious and takes a few hours but is painless after a few numbing injections are given.

The rest of the procedure remains the same in both techniques. Tiny sites are created using very fine blades and needles in the balding areas after numbing them again with local anaesthetic injections. These grafts are then inserted in the sites on the front of the head or wherever there is hair loss. 

Advantages of FUT method

1. Larger areas of baldness can be covered in fewer sittings.
2. The recovery time is much quicker with the patient often returning to work the next day itself.
3. The resection rate (the grafts that get cut whilst removing) may be lesser providing superior results. However, the resection rate depends on the skill of the surgeon and his/her staff.

Advantages of FUE method

1. As this method of hair transplantation does not involve taking an entire strip of scalp from the donor area like in strip surgery, there are no cuts or stitches.
2. There is no linear scar.

Both methods involve surgery hence a proper consultation with the surgeon is required who can explain the procedure and its advantages and disadvantages. It takes several hours to perform the surgery and implant hence it is important to block the day out completely and be mentally prepared for it. Most surgeons will want to shave the entire head before embarking on the procedure so make sure that you factor that in.

Post surgery care
It is important to follow post surgery instructions and take good care of the grafts. Swelling of the scalp, face is common for a few days. You will be on antibiotics, painkillers for a few days and will be asked to use Finasteride.

The grafts are wetted with saline repeatedly for a few days after the transplant. Hair is washed with a diluted shampoo the next day in a specific manner without disturbing the grafts. They will eventually fall out after two weeks and the new growth will be seen anywhere between three to six months. In FUT method, post-op wound care of the scar is important and the sutures are removed after a week. 

Who should opt for FUT method?

1. People who have larger areas of baldness. 
2. People who would like to get the procedure done in a single sitting.

Who should go in for FUE method?

1. Suitable for people who have smaller areas of baldness.
2. People who want to wear shorter hair styles.
3. People with active lifestyles like sportsmen, etc.
4. Women with smaller areas of baldness.
5. People who prefer less invasive procedures and don’t want cuts, stitches on the scalp.
6. Those who want faster recovery.

As per MCI guidelines Hair Transplant surgery should performed by Plastic and Cosmetic surgeon. In case you have a concern or query you can always consult an expert & get answers to your questions!

To look good is one of the best ways to help yourself feel good. With the help of the latest technology, we now have cosmetic solutions to our appearance related problems and these are available at numerous salon or in jars that can sit on our nightstand, ready for regular use. Yet, there are more long-term solutions with greater efficacy that one can get from a cosmetic surgeon. Facial implants are one such solution which can help us in many ways.

Here are the various benefits of facial implants.

1. Augmentation: One of the main benefits of getting facial implants is that these will help in significantly augmenting your facial features, especially your cheeks. If you have a weak chin which seems slightly receding or too chubby cheeks, then this is a good cosmetic option which can help in giving better shape so that the features are well augmented with better definition and fullness. This will render a fine balance to your overall appearance and make your face that much more attractive as well.
2. Reconstruction: Sometimes, we lose the shape and definition of our features to age and weight as well as other factors like a stressful lifestyle where eating and sleeping patterns are less than ideal. In such a scenario, we can reconstruct the facial features, restoring the contours and bringing back the original proportions of the face. This will make the features look like they really fit in with your face which gives a good appearance in the long run.
3. Rejuvenate: These implants can also help in rejuvenating and adding a more fresh feel to your overall appearance. With the help of these implants, you can actually bring back the distinction between areas like the jaw and the chin, as well as the cheeks so that your face looks more well proportioned, well defined, and even younger.
4. Correct deficiencies: If you have any facial deficiencies in terms of the contours as well as the definition of your features and the blend of the same, then you can turn to facial implants. These implants will help in better contouring in a way that will fix these imperfections in your jaw, chin and cheeks. This will give you a more polished look.
5. Facial symmetry: One of the best benefits of facial implants is the fact that it renders greater symmetry to your face. After this procedure, your face will actually have features set in a proportionate line which creates a pleasing and perfect look. If you feel you cheeks are too large or your chin and jaw are literally merging in with each other, then a facial implant will help in bringing in greater symmetry for your face. These procedures are also quite quick to perform.

In case you have a concern or query you can always consult an expert & get answers to your questions!