Gynecomastia: The 4Dx technique

In surgery for gynecomastia, it is not sufficient to just remove the gland or do a liposuction that addresses the front of the chest only as it is not aesthetically pleasing for the patient and the surgeon alike. Most patients expect to achieve a sculpted look, which includes not only the breast area but also the surrounding areas such as the sides, the axillae, and the infraclavicular region. To tackle these areas and achieve a well-sculpted and aesthetic look, we describe the 4Dx (4 Directions) technique of liposuction for gynecomastia. It also makes the procedure more objective for plastic surgeons while allowing for individualization of the procedure.