Gynaecomastia is a term meaning male breast enlargement. It is quite a common condition and can cause embarrassment and self-consciousness. It may be on one side only or present on both sides.
Gynaecomastia surgery is surgery to reduce the male breast. Before going ahead with any treatment or surgery it is important to run through a basic health check, as gynaecomastia can be due to problems with weight, hormone disorders or imbalance, some medications or tumours such as a testicular tumour. In most men there is no medical reason, but these potential causes of gynaecomastia must be out ruled before going ahead with surgical treatment. Pre and post surgery clinical photographs of your chest will be taken.
Indications for Gynaecomastia Surgery:
Limitations of Gynaecomastia Surgery:
Types of Gynaecomastia Surgery:
Gynaecomastia or male breast reduction is usually done under general anaesthesia although milder cases may be suitable for local anaesthesia. The surgery takes between 1 and 3 hours depending on the extent and type of surgery required.
Liposuction may be suitable for milder cases of gynaecomastia or for forms of gynaecomastia where the excess breast tissue is predominantly fatty.
Liposuction is carried out through very small incisions where fluid is infiltrated and then a suction cannula is used to remove the fat. A narrow metal tube (suction cannula) attached to a suction pump is inserted through the very small skin incisions and used to remove the unwanted fat by moving it through the area to be treated under the skin. Most surgeons inject a local anaesthetic and adrenaline solution beforehand to help reduce pain and bleeding.
Liposuction has the advantage of using very small scars and of being very effective in removing subcutaneous tissue. It does rely somewhat on the ability of the skin to snap back and this is something that varies from individual to individual and lessens with age. Mostly power or suction assisted liposuction is used. Variations of liposuction utilise ultrasound or laser to assist in breaking down and removing the fat.
Open Gynaecomastia Reduction Surgery:
When the breast tissue is more solid and fibrous or there is a significant amount of extra skin, open surgery is necessary. Liposuction alone will not sufficiently remove this tissue. An incision is placed just underneath the nipple or towards the side under the armpit and the excess tissue is removed. This will leave a scar in the area, which will be red at first and will slowly fade. In severe cases a more extensive scar may be needed to remove sufficient skin and tighten the area. If necessary, the size of the areola (pigmented area of skin around the nipple) is reduced as well. In severe cases, the nipple may need to be moved and repositioned in to a better location on the chest.
Sometimes both techniques are combined for optimal effect. Liposuction effectively removes the fatty tissue present, while the more fibrous tissue is removed via an incision under the nipple. This can reduce the amount of open surgery needed and contour the rest of the chest nicely.
You will have bruising and swelling in the treated area afterwards which will peak at day 2 to 3 and slowly resolve over the weeks following this. Most of this will go in the next 4 to 6 weeks but swelling can persist for up to 6 months. You will have small scars in the areas the suction cannulae have been inserted if liposuction was used and you often have some temporary numbness of the overlying skin. Some fluid may ooze from these areas in the beginning. Surgical tapes will be placed over any incisions for open surgery and these will usually have been placed along the underside of the nipple. If having open surgery, a surgical drain will have been placed on each side of the chest and will remain in place for 24 to 48 hours. You may shower over the tapes but they need to dry or be dried (with a hairdryer on a cool setting) before dressing again.
You will need to wear a compression garment (vest-type garment) for 4 to 6 weeks postoperatively. This helps to provide support to the skin and to keep swelling controlled. It can be removed to shower but should be worn at all other times.
Liposuction alone is often done as a day case procedure. If open reduction with or without liposuction is performed, then you will normally stay 1 night or occasionally 2 nights in hospital.
Most people return to work after about 2 weeks depending the extent of the surgery and the nature of their work. Light activities can be resumed within 2 weeks and normal activities are usually unrestricted after 4 to 6 weeks.
While most gynaecomastia correction surgeries go very smoothly and patients are delighted with the results, as with any procedure there are some risks associated with gynaecomastia surgery.
Longevity of Procedure:
Gynaecomastia surgery has a high success rate and is considered an excellent procedure for reducing and reshaping the male breast.
It is important to be aware that small revisions or adjustments are often needed after the main procedure to get the optimum result.