Why Choose to Have a Breast Reduction (Gynaecomastia)?
Males also have breast tissue under the nipple that can enlarge along with fatty tissue to form a breast, in most cases there is no specific cause. Occasionally it can result from a hormonal imbalance or after taking certain medicines.
The breast swelling can be composed mostly of fat, breast tissue or a mixture. This can occur at any age, but is most common in teenage boys and although the breast can reduce, it frequently remains life long.
Procedure In Brief
Gynaecomastia can form from a mixture of breast and fat. It can be a small marble sized lump or a large fully formed breast. When it comprises of a small lump of breast tissue it is best removed via a small cut through the nipple. When the breast swelling is mostly fat then liposuction can be used. This involves the use of 3-4mm needles to suck fat out from the breast.
 Much larger cases frequently need removal of a large area of breast tissue. This effectively becomes a mastectomy (removal of breast). It is usually performed by making a cut around the nipple and removing some skin as well as breast tissue. In very rare cases the cuts need to be bigger and extend into the skin around the nipple.
Scars
The scars will depend on the technique used (as above). Scars across the nipple become almost invisible over time. Scars around the nipple tend to be quite red in the first 6 weeks, becoming purple over the next 3 months, and then fading to white. In general, most patients form very good quality scars over time, but others take longer or may form raised or stretched scars. How other wounds have healed may be an indication.
Medicines
A full medical history will be obtained before any surgery. As a precaution, do not take any over the counter medicines or herbal remedies prior to surgery or for 3 days following. Also avoid aspirin, ibuprofen and Nsaid based tablets. It would be useful to bring a list of any prescribed medications to your pre-op assessment.
Smoking
If you are a smoker, try and stop for a minimum of one week before and after surgery as it can reduce the chances of complications.
Recovering from Male Breast Reduction (Gynaecomastia)
Length Of Surgery
The operation takes 45 minutes – 2.30 hours depending on the type of technique used and size of the breast.
Length Of Stay In Hospital
A patient may be seen as a day case or may require an overnight stay in hospital.
Dressings
You will wake up with dressings on the wounds and elastoplast support tape on the chest. Please let Amir Tadros know if you are allergic to elastoplast before surgery. The dressings will stay on for three days, and must be kept dry. If needed, you will then return to have them replaced with lighter dressings.
Drains
It is common to insert a small surgical drain into the breast to remove any unwanted blood/fluid for 24-48 hours.
Time Off Work
People vary in recovery, but patients should allow at least 3 days – 2 weeks depending on the extent of surgery (full anaesthetic can take longer to recover from). Patients with highly active physical jobs may require longer.
Time To Exercise
Patients usually feel able to walk a distance at 5-7 days, swim by 10-14 days (if fully healed). Strenuous exercise (aerobics etc) should be avoided for 3-4 weeks.
Driving
Patients should avoid driving until they are completely free of pain and restriction, and be able to confidently perform an emergency stop. This is to ensure they will be covered by their insurance policy. It may take up to 3 weeks to recover sufficiently.
Follow Up
We will check your wound and change the dressing at day 3 and 7. You will then have an appointment with Amir Tadros at 3 months. You will not be charged for any follow up appointment relating to your surgery.
Recovery And Final Outcome
You should expect some bruising and swelling, which will last 1-2 weeks. It is common to experience some leaking from the wounds in the first few days as they begin to heal. You should immediately have a good flat shape, and it will continue to improve (especially following larger operations) over 4-6 weeks. By this time the skin and nipple will be much softer.
Potential Complications With Male Breast Reduction (Gynaecomastia)
This is a routine operation that is a great success for the vast majority of patients. However, as with any procedure, it is very important you understand what can go wrong as well as right. The potential complications are listed below.
- Nipple loss: This is very uncommon and occurs if the blood supply to the nipple is stopped. If this happens the nipple will be lost and be replaced by a scar. Although rare, the risk is increased in any patient by smoking, obesity and old age. There is also an increased risk if the reduction is for very large breasts. If you fit into any of these categories Amir Tadros will discuss potential alternative surgical techniques during the consultation to avoid this risk.
- Remaining asymmetry or irregularity: Most patients can expect a good flat result to both sides. However, there is a possibility of small differences between each side.
- Wound breakdown: This is very uncommon in this type of surgery.
- Bleeding: A blood clot can collect in the breast, which would result in going back to theatre for its removal. However, if a blood clot is to form it will be within the first 24 hours post surgery. Blood clotting results in approximately 3% of patients.
- Infection: Quite uncommon but if occurs you will need a course of antibiotics.
- General operation risks: Chest infections, Blood clots in the leg or lung (DVT or PE). Although rare it is important to avoid these by not smoking, being excessively overweight and moving about after surgery as soon as possible.
If you have any questions about this or experience any side-effects that you are concerned about please don’t hesitate to contact us.
What does Male Breast Reduction (Gynaecomastia) cost?
The surgical fee is based on the surgery. Minor bilateral $9,800, Major Bilateral $14,800.
Please note that there will also be a hospital and anaesthetic fee.
Frequently Asked Questions:
Will the correction be permanent?
Yes, providing your weight remains stable.
Is there an increased risk of breast cancer if I have gynaecomastia?
No, gynaecomastia does not increase the chances of a man developing breast cancer. It is important to obtain a proper diagnosis from a medical professional however, to ensure that the breasts are enlarged as a result of gynaecomastia and not breast cancer.
What causes gynaecomastia?
Gynaecomastia is caused by an imbalance of hormones, where an excess of oestrogens (female hormones) outnumber the androgens (male hormones) present in the body. It is common during puberty, and will generally settle down once puberty has passed. However, true gynaecomastia is a more permanent condition as is likely to require surgery.
There are a number of things that can trigger true gynaecomastia. In some cases, it can be a side effect of illegal drug consumption (anabolic steroids and marijuana in particular), alcohol abuse or a reaction to some forms of medication (especially, anti-ulcer drugs or medication for heart disease).
It is also associated with problems with the male sex organs, especially when the condition involves decreased testosterone production. Gynaecomastia is also linked to hyperthyroisism, chronic kidney failure, and cirrhosis of the liver.
How old does a patient have to be to get treatment for gynaecomastia?
As it is not unusual for teenage boys to experience changes in their breasts during puberty, therefore it is advisable to wait until development has stopped and a definite diagnosis of gynaecomastia can be made. This will generally be around the age of 18 or over.
I am 16 now and have had breast swelling for the last 3 years. Will it go away?
They may do but not all gynaecomastia from teenage years disappears. If still present a few years past puberty there is a strong chance of this being permanent. Gynaecomastia arising in puberty is common and is usually due to a sensitivity to female hormones and NOT excess levels of female hormones themselves.
The gynaecomastia is composed of breast tissue and some fat. Being a normal weight will help but if still present then you may need surgery to correct it if it bothers you enough.
Will I have any scars if my gynaecomastia is treated?
Sometimes liposuction alone can treat gynaecomastia. However, most patients need a mixture of liposuction and open surgery resulting in a scar around or partly around the nipple.
What has caused my gynaecomastia?
The most common type is pubertal and a sensitivity to hormones. Occasionally it is caused by true hormone imbalances and these can be tested for.
Some drugs like steroids or hormone treatments can cause gynaecomastia and in older patients it is important to ensure this is not a breast cancer especially if the lump is one sided.
How much scarring can I expect from a gynaecomastia procedure?
In the majority of cases, gynaecomastia will be treated using a combination of liposuction and open surgery. The incision will be made through the border of the areola, which will help obscure the visible scarring. In time, the scar is likely to fade which will further reduce its visibility.
How do I know if I need surgery for my gynaecomastia or if I can reduce it with weight loss?
A pure case of gynaecomastia cannot be reduced by losing weight, or exercising, as the breasts are enlarged by excess glandular breast tissue rather than simply by fat.
Aside from undergoing a thorough examination, the most obvious way to determine whether you have gynaecomastia is when you loose weight elsewhere on your body but the breasts remain enlarged.
What is pseudogynecomastia?
Pseudogynecomastia is when a man develops breasts as a result of being severely overweight or obese. In this case, the breasts are enlarged by excess fatty deposits, rather than by breast tissue.
Will the results from the surgery be permanent?
Yes, providing that weight stays stable, once all of the excess tissue is removed from the breast, the surgery will be permanent.
