Gynaecomastia

Removal of excessive breast tissue in men

Gynaecomastia Dr Ayad Harb

What is Gyanecomastia?

Excessive breast tissue occurs in about 20% of males and can be completely normal, especially at certain stages of life, such as childhood, puberty and old age, when hormone imbalances can occur. Gynaecomastia can also occur as a side effect to certain medication or recreational drugs. It is also always important to check other conditions in the body that may manifest with Gynaecomastia, such as liver, thyroid or testicular problems.

What are the effects of Gynaecomastia?

Gynaecomastia is generally a cosmetic concern, however it can also have physical symptoms of pain and heaviness. Alongside this, Gynaecomastia can cause significant physical and psychological morbidity for the patient and may effect confidence, self-esteem and social development.

What are the treatment options for Gynaecomastia?

The treatments for gynaecomastia include liposuction, skin tightening with BODYtite and reduction surgery to remove the breast tissue. 

Types of Gynaecomastia surgery?

Gynaecomastia or male breast reduction can be done under local or general anaesthesia. The surgery takes between 1 and 3 hours depending on the extent and type of surgery required.

Liposuction
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 through which a suction cannula is used to remove the fat. Local anaesthetic and adrenaline solution beforehand to help reduce pain and bleeding. Alongside this, 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.

BODYtite
BODYtite is a minimally invasive surgical radiofrequency treatment which will reduce fat and tighten the skin. This is especially useful when the gynaecomastia is associated with a minor skin excess. BODYtite is often combined with liposuction to reduce the fat and skin excess found in gynaecomastia.

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 to a better location on the chest.

Combination Surgery
Sometimes combinations of different 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.

What to expect after Gynaecomastia surgery

Immediately after surgery, you will experience some swelling and heaviness in the treated areas. You may experience bruising and swelling which will peak at day 2 to 3 and slowly resolve over the following 7-14 days. You will notice 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.

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.

How long is the downtime following Gynaecomastia surgery?

Most people return to work after about 2 weeks depending on 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.

How long will the results last?

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.

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