Gynaecomastia is male chest/breast enlargement. While usually no medical cause is identified, it can be due to high weight, hormonal problems, or as a side effect of some medications or substance misuse. You will be asked about these conditions during your consultation and advised if weight reduction or other treatment is needed before treating your gynaecomastia.
The enlargement can be due to excess fatty tissue, excess breast gland tissue or a combination of both. In significant cases, the skin may be stretched and/or sagging as well. Surgery aims to reduce the excess tissue to achieve a normal male chest contour.
Fatty tissue can be reduced by using liposuction to remove fat through very small incisions. For some men, this is enough to adequately treat their gynaecomastia. Others will need glandular tissue removed as well from behind the nipple. A small semi-circular incision is made on the lower half of the areola to access this glandular tissue and remove it. A small group of men needs this removal only and no liposuction.
In situations of extensive gynaecomastia or after significant weight loss, the skin may be stretched and sagging after fat and gland reduction. Skin removal is necessary in this case and will result in longer scars in the breast crease or around the nipple area. At times it is necessary to detach completely and reattach the nipple in a new higher position. Sometimes skin removal is better done at a second later stage.
Light dressings and a support garment will be needed afterward. Support garments are usually advised to be worn between one and three months after surgery. You will also be advised on care of your chest scars while they heal and fade.
Ensure you consider all aspects of a procedure. You can speak to your surgeon about these areas of the surgery in more detail during a consultation.
1.5 to 3 hours depending on the extent and type of gynaecomastia reduction
General anaesthesia (most common) or local anaesthesia and sedation
Day surgery unless combined with other procedures that require an overnight stay
Risks can include early risks of surgery such as bleeding, infection, seroma (fluid build-up), wound healing problems, clots in your leg veins, breast risks such as altered sensation of the nipple (usually numbness but can be oversensitivity, usually temporary but can be permanent), asymmetry, loose skin, loss of tissue including the nipple and areola, poor scarring, recurrence (more common if weight gain occurs) and over-reduction leaving a dip in chest contour.
Risks can be reduced by having your surgery at a healthy and steady weight, planning your surgery in relation to your lifestyle, avoiding nicotine in the run up to and recovery from your surgery, optimising any health conditions e.g. diabetes and following your surgeon’s after care advice.
Your chest area will be swollen, tight and tender particularly in the first two weeks, but usually up to six weeks. Your chest tissue will gradually soften as you heal and as the swelling goes down. You will need to wear a support garment and look after your scars as your surgeon advised. One to two weeks off work is usual. Return to exercise is after six to eight weeks.
Results are long-lasting but are affected by weight gain, weight loss and hormonal changes. Tissue ageing will continue as normal.