Keyhole

[Brocklesnar]

I have severe gynecomastia and I contacted a surgeon through mail and he told me that it can be solved by keyhole surgery.... But i read a post by SR01 that gyne will come back after long time after doing keyhole surgery.... Is it true?

[Dr. Schuster]

I'm not exactly sure what a keyhole procedure is. If it results in a scar that extends downward from the lower part of the areola, I would get another opinion.

[Brocklesnar]

Doctor this is what it is..... Keyhole (small scar) surgery for gynecomastia is a modified chest liposuction technique, where the breast tissue is disrupted/ disintegrated first using special instruments and then removed along with the excess fat deposits. Tough gland tissue can be completely removed through the small cut in skin. Since the marks are only 4-5 mm long, they are hardly visible even in the Indian skin which is prone to having prominent scars. In keyhole gynecomastia surgery, the small scars are located in the lateral chest (under armpit) and under areola. These are locations having low visibility especially when the marks are so small. The traditional Gynecomastia incision under the areola is usually many times longer than the minimal access method.

[Dr. Elliot Jacobs]

In keyhole gynecomastia surgery, the small scars are located in the lateral chest (under armpit) and under areola.

Sorry, but the last sentence of the description actually describes what most gyne surgeons here in the US already do on a routine basis.

Dr Jacobs

[Dr. Schuster]

OK. I am still not 100% sure but it sounds reasonable. 

[DrPensler]

I am not sure exactly what you are describing. I use a 1 mm incision in the skin fold near the origin of the sternal head of the pec major and an incision at the inferior boarder of the areola.
I often see patients who are upset because they have an incision in the middle of the axilla and a second incision under the breast in the inframammary fold. These incisions are several centimeters long and are quite visible.  There is only minimal if any improvement I can achieve in these patients after the fact.

[George Pope, M.D.]

If your gynecomastia is severe, as you describe it, the chances of getting all of the breast or "gland" tissue out through small incisions just a couple of mm in length sounds doubtful to me.  The beauty of the periareolar incision that most of us use is that the resulting scar is usually invisible after it's healed, due to the color mismatch between areolar and chest wall skin.
If you haven't done so already, ask to see before and after photos.
Dr. Pope, MD