Gynecomastia Surgery in an Overweight Patient
VASER Liposuction with Gland Excision for Grade 3 Gynecomastia
A 32-year-old businessman from Secunderabad had struggled with enlarged breasts for most of his adult life. His weight made it worse. Multiple doctors had told him to lose weight first, but the chest never improved even when he did. Dr. Harikiran Chekuri at Redefine Clinic used VASER-assisted liposuction combined with gland excision to remove over a liter of fat and achieve a dramatically improved chest contour. The results changed how he carried himself.
PATIENT PROFILE
THE PROBLEM
He had always been on the heavier side. But the chest was different. Even when he was at his lightest weight in college, the breasts were there. Now at 92 kg, they had become impossible to hide. He wore only dark colored, loose kurtas to work. Formal shirts were out of the question because the buttons would strain at the chest.
Every doctor he consulted said the same thing. Lose weight first. He did. Lost 12 kilos over two years through diet and walking. His face got thinner. His stomach reduced. But the chest stayed exactly the same. The breasts hung there, stubborn, making every shirt look wrong.
His wife finally convinced him to see a plastic surgeon instead of a general physician. He came across Redefine Clinic and booked an appointment with Dr. Harikiran Chekuri. For the first time, someone explained that his chest had actual gland tissue that would never go away with diet or exercise.
CONSULTATION & TREATMENT PLAN
WHAT WAS ASSESSED DURING THE CONSULTATION
A thorough evaluation was conducted:
- Physical examination revealed Grade 3 gynecomastia with significant fat and palpable gland
- Skin assessment: Mild skin laxity but good elasticity for age
- Chest circumference and breast mound measurements documented
- Ultrasound confirmed predominantly fatty tissue with central glandular component
- Hormonal panel: All values within normal limits
- Cardiac and anesthetic fitness assessed (ECG, basic blood work)
- Patient goals: Flat chest, ability to wear fitted shirts, no visible scarring
WHY VASER LIPOSUCTION WITH GLAND EXCISION WAS CHOSEN
- Large volume of fat required VASER for efficient and safe removal
- VASER ultrasound energy liquefies fat while preserving blood vessels and nerves
- Better skin retraction compared to traditional liposuction
- Gland excision necessary as glandular tissue cannot be removed by liposuction
- Combined approach addresses both fatty and glandular components
- Avoids the need for skin excision in most cases due to VASER’s skin tightening effect
PRE-OPERATIVE PHOTOS
Baseline photographs documented the extent of breast enlargement, chest contour, and skin quality. Multiple angles were captured to assess the degree of correction needed.
PROCEDURE DETAILS
- Surgery performed under general anesthesia
- Tumescent solution infiltrated into the chest and lateral chest wall
- VASER probe used to emulsify fat using ultrasound energy
- Liposuction performed through 3mm incisions in the axilla and periareolar area
- Approximately 600ml of fat aspirated from each side (1200ml total)
- Additional liposuction of lateral chest roll for better contour
- Periareolar incision made for direct gland excision
- Dense glandular disc removed from beneath both nipples
- Drains placed bilaterally to prevent fluid collection
- Compression garment applied immediately
PROCEDURE FACTS
POST-OPERATIVE RESULTS
The transformation was dramatic. Even with the post-operative swelling, the chest looked significantly flatter on day one. By week three, when most of the swelling had subsided, he could see the masculine chest contour he had never had. The lateral chest rolls were gone. The nipples lay flat. By week eight, he walked into a store and bought his first fitted formal shirt in over a decade.
OUTCOMES AT A GLANCE
PATIENT FEEDBACK
Feedback recorded at the 8-week follow-up visit at Redefine, Hyderabad.
Google Review
★ ★ ★ ★ ★ 5.0
Verified Patient (Name withheld for privacy)
“Every doctor told me to lose weight first. I did. Lost 12 kilos. The chest stayed the same. Finally Dr. Chekuri explained that it was gland tissue and fat together, and no amount of dieting would fix it. The surgery removed over a liter of fat. I could not believe how different I looked when the swelling went down. Last week I bought a fitted shirt for the first time in years. My wife cried when she saw me wear it. This has changed my life more than I can explain.”
Profile: Male · 32 years · Businessman · Secunderabad
Procedure: VASER Gynecomastia Surgery · Redefine, Gachibowli · March 2026
Doctor: Dr. Harikiran Chekuri · Redefine
POST-OPERATIVE CARE & RECOVERY
- Wear compression garment continuously for 6 weeks (due to larger volume removed)
- Keep drain sites clean, empty drains as instructed, record output
- Take prescribed antibiotics and pain medications
- Avoid raising arms above shoulders for 2 weeks
- No heavy lifting or strenuous activity for 6 weeks
- Sleep on back, use pillows for support
- Maintain stable weight to preserve results
- Attend all follow-up appointments
RECOVERY TIMELINE
DISCLAIMER: This case study is for informational purposes only and does not constitute medical advice. Individual results may vary based on the grade of gynecomastia, body weight, skin elasticity, and healing response. Patients with higher BMI may have different outcomes. Consult a qualified plastic surgeon before undergoing any procedure. Patient feedback published with written consent. Patient identity withheld per confidentiality guidelines.
Dr. Harikiran Chekuri
MBBS, MD, MCh (Plastic Surgery)
Redefine Hair Transplant & Plastic Surgery Centre, Hyderabad
redefineu.in | +91 92371 23456
