Gynaecomastia is often a very normal occurrence in young boys, and commonly disappears after the pubertal growth spurt. If it persists, it can be a source of embarrassment and discomfort. It is successfully treated by male breast reduction surgery.
There are a number of causes of gynaecomastia, most commonly in young male teenagers due to normal hormonal imbalances during puberty. Other causes include obesity, liver disease, abnormal hormonal problems, and the use of certain medications or anabolic steroids. These causes need to be excluded before undergoing surgery.
|In/Outpatient:||Outpatient in Private Hospital|
|Length of surgery:||1-2hrs|
|Recovery:||Most patients are back to work in approximately 7 days. They can resume light exercise at 4 weeks.|
|Results:||Final results are seen within 3 – 6 months, and the duration of those results vary from one person to another.|
What is Gynecomastia?
All mammals have breast tissue, even males. Under the influence of hormones, the breast gland usually enlarges. This is why women develop breasts as they mature. Men, still have a small amount of oestrogen which can simulate breast gland enlargement.
- Gynecomastia Causes Men who take hormone supplements or anabolic steroids in the course of a bodybuilding, often develop gynecomastia. This is because those steroids, which chemically resembles oestrogen, can overstimulate the normal breast to enlarge. When the steroids are stopped, the enlargement often does not subside, leaving the patient with gynecomastia.Many young boys grow up being overweight and chubby. They develop a thick layer of subcutaneous fat and an element of gynecomastia in their childhood. When puberty approaches, and the growth spurt occurs, the puppy fat dissolves away. However, the enlarged breast may remain and gynecomastia becomes evident.Idiopathic gynecomastia is a condition for which no obvious cause can be determined is the most common cause of gynaecomastia in men. It is assumed that the patient has normal amounts of oestrogen, but that the breast gland is unusually sensitive and enlarges as a result of this stimulation.Pseudogynecomastia is a condition of an apparent breast enlargement due almost exclusively to an excess deposition of fatty tissue. If it does not respond to exercise and diet, then surgical relief by liposuction alone is very likely to be successful.There are certain rarer causes of gynaecomastia that may need to be evaluated to exclude hormone imbalances or cancers which have been known to cause gynaecomastia. In these cases you may need to be referred to a medical specialist for further investigations.
Your male breast reduction procedure is performed in a fully accredited hospital. Your anaesthetist will give you a general anaesthetic and you can expect the operation to take between 1 – 2 hours. Most patients are able to go home the same day of surgery with no drains required.
The type of procedure you will have depends on the underlying cause of the gynaecomastia. If the enlargement is due to excess fatty tissue alone, then liposuction will be used to remove the fat through very small incisions. If the enlargement is due to excess breast tissue then a small incision around the edge of the areola (periareolar scar) will be used and the tissue cut out. If the enlargement is due to a combination of excess fatty tissue and glandular tissue then it is likely you will need both liposuction and a surgical excision using a periareolar incision. In a very small number of cases, where the degree of breast enlargement is extreme, then a larger procedure may be required necessitating longer scars to remove excess skin as well as the fatty and glandular tissue.
At the end of the operation the incisions are closed with absorbable sutures, a dressing is applied over the incisions and you will leave the hospital wearing a comfortable and supportive chest binder garment.
Preparing for Gynaecomastia Surgery
Once you have decided to have male breast reduction surgery, Dr. Turner and his staff will guide you in your preparation. You will be given instructions to help make your surgery and recovery go smoothly. And you may be given various tests so that your medical records are as up to date as possible before proceeding to an operation.
- Pre-op Evaluation As with other types of surgery, a chest x-ray and blood tests may be necessary to assess your general health. Dr Turner may want photographs of your breasts in your medical record to document your problem and to compare results.
- Pre-op Instruction Dr. Turner will ask that you to stop taking aspirin-containing products two weeks before surgery to minimize bleeding. You will also be asked to stop smoking before surgery because it restricts the blood flow and may affect healing, resulting in wound breakdown and less than optimal results.
- Wearing a Garment You will be measured for a surgical garment to wear in the recovery period. This is to be worn day and night for six weeks after surgery to give the best possible result.
After Gynaecomastia Surgery
After your surgery, you wake up in a recovery room. Dr Turner and the nursing staff monitor you, checking your blood pressure, temperature and pulse. Once you are alert, you may be discharged. You may be given prescriptions to relieve pain and prophylactic antibiotics are commonly prescribed. Have someone fill the prescription, drive you home and take care of you as you recover. Follow any post-op instructions given to you.
- Your First Postoperative Visit At 1 week after your gynaecomastia surgery you return to Dr Turner’s office and your wounds are reviewed. Here, you begin to see the results of your surgery despite some initial swelling. Dr Turner will tell you how to care for your wound and dressing.
- Gynaecomastia Follow-up During your gynaecomastia follow-up visits Dr Turner will monitor the shape of your chest and watch for infection. Healing takes several weeks or longer, depending on how long swelling lasts. Swelling normally takes up to six weeks to settle. The regime for wearing a garments and resumption of normal activities and exercise will be discussed at these visits.
When can I resume normal work / social activities
It is uncommon for significant restriction in normal daily activities following gynecomastia surgery. Exercises, sport and gym activities are gradually reintroduced, with unrestricted enjoyment of all exercise within 4-6 weeks.
Understanding the Risks and Complications
As with any surgery, gynaecomastia involves risks and potential complications. You need to understand and accept these in order to make an informed consent to the operation. Some risks are more likely to occur than others. Please ask Dr Turner for as much detail as you need to fully understand the procedure, its benefits and its risks.
Some risks are more likely to occur than others:
- Visible scars
- Irregular chest contour
- Persistent tissue
- Nipple sensation changes
- Recurrent gynaecomastia