Gynecomastia is a medical term used to describe an abnormally enlarged or overdeveloped male breast. The condition is usually idiopathic (i.e. meaning no specific cause) and is more common than people think. Gynecomastia can also be the result of hormonal changes, heredity, obesity or the use of certain drugs. Physiological gynaecomastia occurs in pre-pubertal boys but usually resolves once they reach early adulthood. In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola (the dark skin surrounding the nipple). Gynecomastia can cause emotional discomfort and impair your self-confidence. Some men may even avoid certain physical activities and intimacy to hide their condition.
Gynecomastia is characterised by:
- Excess localised fat
- Excess glandular tissue development
- Sometimes excess breast skin
- Presence unilaterally (one breast) or bilaterally (both breasts)
Gynecomastia surgery or technically called reduction mammaplasty can help to reduce the size of the male breast by removing tissue and in severe condition skin as well. It will improve the appearance of a sagging chest and help to enhance the chest contour. In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone may be sufficient. Excision techniques are recommended where glandular breast tissue or excess skin must be removed to correct gynecomastia. Excision also is necessary if the areola will be reduced or the nipple will be repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference. Sometimes gynecomastia is treated with both liposuction and excision.
Ideal Candidates for Male Breast Reduction Surgery:
- Men who are emotionally affected and embarrassed with their enlarged breasts
- Men whose breast development has stabilised
- Men with a positive outlook and specific goals in mind for improving the physical symptoms of gynecomastia
- Men who have realistic expectations
- Physically healthy men and of relatively normal weight
- Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
- Non-smokers and non-drug users
Adolescents may benefit from surgery; occasionally secondary procedures may be needed in the future should breast development continue.
Preoperative evaluation for Male Breast Reduction Surgery:
Communication is vital to achieving the patient’s goals. During the initial consultation, patients will have the opportunity to discuss their goals and desired results with the plastic surgeon. The plastic surgeon will work closely with the patients to reach an agreement about the expectations from the surgical procedures involved and their long term benefits. Every patient is different. Therefore a specific treatment regimen is planned to suit an individual’s need.
The preoperative evaluation for male breast reduction surgery includes:
- Discussion about patients’ expectations and desired outcome
- Medical conditions, drug allergies and previous medical or surgical treatment
- Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
- Discussion on anaesthesia and its risks
- Examine breasts and take detailed measurements of the size and shape, skin quality and placement of nipples and areolas
- Discuss your options
- Recommend a course of treatment
- Discuss likely outcomes of gynecomastia correction and any risks or potential complications
- Photography for preoperative and postoperative evaluation
Preparation for male breast reduction surgery
- Get laboratory testing or a medical evaluation
- Adjust medications for specific medical conditions
- Stop smoking and alcohol well in advance before the scheduled date for surgery
- Avoid taking aspirin, anti-inflammatory drugs and herbal supplements before surgery
- Special instructions will be given on the day before and after surgery
The risks and safety information on male breast reduction surgery
It is essential for patients to understand that every surgical procedure has its complications and downtime. However, if a patient is appropriately assessed before the surgery and postoperative care is given adequately, these risks can be eliminated or reduced.
Some of the risks of male breast reduction surgery:
- Bleeding (hematoma)
- Blood clots
- Breast asymmetry
- Breast contour and shape irregularities
- Changes in nipple or breast sensation may be temporary or permanent
- Damage to deeper structures such as nerves, blood vessels, muscles and lungs
- Fatty tissue found in the breast might die (fat necrosis)
- Fluid accumulation (seroma)
- Persistent pain
- Poor wound healing
- Possibility of revision surgery
- Unfavourable scarring
- Reactions to tape, suture materials, glues, topical preparations or injected agents
- Anaesthesia risks
Postoperative expectations and care
During the recovery period of gynecomastia surgery, dressings or bandages will be applied to at incision sites. An elastic bandage or support garment is usually used to minimise swelling and support the new chest contour as it heals after surgery. A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. This drainage tube is removed after 1-2 days after the surgery. During the first 2-3 days, there may be discomfort, swelling and bruises around the chest wall.
Specific postoperative instructions are given to care for the surgical sites, medications to apply or take orally to aid healing and reduce the potential for infection. Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively. It is advisable to avoid strenuous activities such as heavy weight lifting or vigorous exercise for the first 7-10 days after the surgery. Light physical and social activities can be resumed from the 4th day after the surgery. Stitches will be removed 7-10 days after the surgery. The symptoms of discomfort, swelling, bruises and tightness around the chest wall may disappear completely about 2-3 weeks after the surgery, but the chest contour may gradually take several months or a year to soften and feel more natural.
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How much will a male breast reduction surgery cost?
Cost is always a consideration in elective surgery. The cost of male breast reduction surgery can vary widely.
The cost of male breast reduction surgery may include:
- Surgeon’s fee
- Hospital or surgical facility costs
- Anaesthesia fees
- Medical tests and x-rays
- Special support garment
- Prescriptions for medication
Male breast reduction surgery is a cosmetic surgical procedure. Most of the health insurance companies do not cover cosmetic surgeries or their complications.