> Gynecomastia

 

Gynecomastia

 

 

 


The surgical correction of over-developed or enlarged breasts in men.


Gynecomastia is the clinical term applied to excess development of breast tissue in men. Many adolescent males develop breasts due to certain hormonal changes. This is called physiological gynaecomastia. A majority of these subside on their own, but in a small minority, they persist. The cause is not generally known and can cause significant anxiety, social inhibition and self-consciousness for men who suffer from this condition.

Male breast reduction, or gynecomastia surgery, removes tissue from the breasts, and in extreme cases excess skin, and can improve the appearance of the chest in cases where diet and exercise have failed. The results of the procedure are significant and permanent.


It is important that you should get a proper consultation with an endocrinologist who can rule out any cause for the condition. You no longer need to suffer this condition as scientific advances in Aesthetic Surgery allow us to get rid of male breasts without leaving a mark. Unfortunately, there is presently no non-surgical way to get rid of male breasts.      
    
Who does Gynecomastia typically affect?

Most teenage boys experience some degree of breast enlargement which affects one or both breasts. However, by early adulthood less than 10% have a residual problem. This incidence rises with age, reaching approximately 30% (1 in 3) in older men. Although the cause of gynecomastia is largely unknown some possible causes include: medicines (for high blood pressure, heart disease prostate and testicular cancer), drugs (such as marijuana anabolic steroids, digitalis and cimetidine), some diseases (such as liver failure and some cancers) and some very rare congenital abnormalities.

It is possible to remove the gland and excess skin leaving an almost normal looking chest. The scars are not visible if only liposuction is used. In other techniques, the scar is barely visible. This procedure is likely to give a feeling of normalcy and improve the quality of your life. It is not likely to change your life or the way people treat you.

Who is an Ideal candidate?
In general, the most suitable candidates for male breast reduction surgery are:

  • In good physical and psychological health

  • Mature enough to fully understand the procedure

  • Experiencing embarrassment and/or social inhibition due to breast enlargement

  • Have good skin elasticity

  • Realistic in their expectations of the surgical outcomes

  • Willing to initially try dieting and exercising as first options prior to resorting to surgery

  • Non-smokers or able to stop smoking during the healing process

  • Not using drugs or anabolic steroids


The Primary Consultation
Aconsultation with your Plastic Surgeon will educate you as to how gynecomastia surgery can improve the appearance of your chest.  This consultation will fully educate you regarding the procedure and will include a discussion of your goals, options available for Gynecomastia correction, their likely outcomes, potential risks and complications.

It is important for you to provide complete information about your past medical history, any medical illness, drug allergies, previous surgeries, and medications that you currently take.

General Guidelines prior to surgery to follow prior to their Gynaecomastia surgery.:

  • Detailed Chest examination and measurements

  • Pre-Operative Photographs for medical record keeping

  • Obtain laboratory testing or a medical evaluation

  • Pre-operative Anaesthetic assessment for fitness for surgery

  • Sign an informed  Consent Form

  • Take certain medications or adjust your current medications

  • Stop smoking well in advance of surgery

  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they increase risk of  bleeding.

  • Maintain a stable weight for 3 months prior to the date of surgery


The Operative Procedure
Your gynaecomastia removal surgery will be performed in a major hospital under general anaesthetic for your comfort. The attending Anaesthetist will explain the type and risks of the particular form of anaesthesia for your operation.

The options include surgical removal of the tissue under the breast, or liposuction of the chest wall. In both instances, a small elliptical incision is made on the lower half of the nipple area (areola). For those men with tissue that is more glandular in nature, all breast tissue directly under the nipple is removed. If the breasts are fatty, it is possible to get rid of the breast gland by liposuction alone.

In some people, ultrasonic assisted liposuction is an excellent approach. During liposuction, a small suction cannula is inserted into the incision to remove fat and other tissue. It is possible to remove all the fat and leave an even chest. The excess skin contracts and remodels over the chest wall in the next six weeks.

In rare cases, a repeat procedure maybe necessary. In a few cases, if there is a very large amount of extra skin, it may be necessary to remove this tissue. The surgery normally lasts 1 ½ to 3 hours.

Post Operative Period

You usually have to stay a minimum of one night in the hospital after your operation. It usually takes 1-2 days to recover from the surgery. Initially pain at the surgical site is controlled by adequate pain medication. You will have a soft dressing around chest for firm support. You will also have a tube draining fluids from each side, if excision is done. The dressing and tubes will be removed simultaneously once the drainage stops. All wounds are well healed within 7 days of the procedure. Stitches are usually absorbable and do not need to be removed.

After the operation the chest is usually temporarily swollen and bruised. This will settle down over the next 2 weeks. You may also experience numbness or a burning sensation. It is important to remember that the final appearance after the surgery may take approximately 3-6 months.

Patients can get back to work within 3-7 days of the procedure. It is however advisable to avoid straining, stretching and lifting weights for the initial three weeks. You can get back to a normal exercise programme 6 weeks after the surgery. You will be instructed to wear a elastic vest for 6-8  weeks. This allows all empty spaces to collapse, allowing the skin to retract and settle on the chest wall. Sun exposure is to be avoided for at least six months to prevent permanently altering the skin pigmentation.

Risks and Potential Complications
Although there are very few risks associated with this procedure, a possible general risk includes collection of blood under the skin (hematoma). Bleeding is rare but may have to be stopped. Any surgery carries risks associated with anaesthesia. There are very few risks if the procedure is done under local anaesthesia. These risks will be fully discussed with you prior to your consent for surgery. General risks like delayed wound healing and infections are common to many other operations and can be treated satisfactorily. Specific risks, which are likely to happen after open or excision technique are contour defects, rippling of the skin, excessive scarring and pigmentation changes. In a few cases there maybe persistent altered sensation.

What are the Long term Results ?
The improvement from this procedure is permanent, but weight gain or use of certain drugs could result in recurrence of the enlarged breasts.

Please note:
that with all procedures there is a possibility dissatisfaction with the outcome.