Gynecomastia is defined as the presence of mammary glands in males. It is further classified as true if the breasts are composed predominantly or exclusively of glandular tissue, false (or pseudogynecomastia) if the increase in size is due predominantly or exclusively to adipose tissue, and combined when both types of tissue are present. Under general anaesthetic or local anaesthetic with medical sedation, the excess tissue can be removed by liposuction (false gynecomastia), through a periareolar or hemiperiareolar incision and surgical excision of the excess glandular tissue (true gynecomastia), or by a combination of both techniques. The use of a liposuction cannula with a carefully designed cutting tip allows removal of both glandular tissue and adipose tissue, so combined gynecomastia can be corrected with incisions of just a few millimetres in length. When necessary, excess skin can be surgically removed after the volume of adipose or glandular tissue has been reduced (usually in the case of severe gynecomastia). In all cases, the procedure is preceded by ultrasonography and hormonal tests in order to clarify the nature and cause of the problem.
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