What is Gynaecomastia?

Gynecomastia is a condition of overdeveloped or enlarged breasts in men that can occur at any age. Gynecomastia can cause emotional discomfort and impair your self-confidence. Some men may even avoid certain physical activities and intimacy simply to hide their condition.

The condition can be the result of hormonal changes, heredity, obesity or the use of certain drugs.

Gynecomastia is characterized by:

• Excess localized fat
• Excess glandular tissue development
• Sometimes excess breast skin
• Presence unilaterally (one breast) or bilaterally (both breasts)

What are the signs of gynaecomastia?

Signs vary from a small amount of extra tissue around the nipples to more prominent breasts. It can affect one or both breasts.

Sometimes, the breast tissue can be tender or painful, but this isn’t always the case.

What causes gynaecomastia?

Gynaecomastia can have several causes.

Hormone imbalance

Gynaecomastia can be caused by an imbalance between the sex hormones testosterone and oestrogen. Oestrogen causes breast tissue to grow. While all men produce some oestrogen, they usually have much higher levels of testosterone, which stops the oestrogen from causing breast tissue to grow.

If the balance of hormones in the body changes, this can cause a man’s breasts to grow. Sometimes, the cause of this imbalance is unknown.

1. Obesity

Some growth in breast tissue is not due to extra body fat from being overweight, so losing weight or doing more exercise may not improve the condition. However, a common reason for gynaecomastia is that being very overweight (obese) can increase levels of oestrogen, which can cause breast tissue to grow.

2. Newborn baby boys

Gynaecomastia can affect newborn baby boys, because oestrogen passes through theplacenta from the mother to the baby. This is temporary and will disappear a few weeks after the baby is born.

3. Puberty

During puberty, boys’ hormone levels vary. If the level of testosterone drops, oestrogen can cause breast tissue to grow. Many teenage boys have some degree of breast enlargement. Gynaecomastia at puberty usually clears up as boys get older and their hormone levels become more stable.

4. Older age

As men get older, they produce less testosterone. Older men also tend to have more body fat, and this can cause more oestrogen to be produced. These changes in hormone levels can lead to excess breast tissue growth.

5. Other causes

In rare cases, gynaecomastia can be caused by:

• side effects of medication – such as anti-ulcer drugs or medication for heart disease
• drinking too much alcohol
• a health abnormality – such as kidney failure or liver disease
• Klinefelter’s syndrome (a rare genetic disorder)
• lumps or infection in the testicles

Management of Gynaecomastia

Generally, no treatment is required for physiologic gynecomastia.

Pubertal gynecomastia resolves spontaneously within several weeks to 3 years in approximately 90% of patients. Breasts greater than 4 cm in diameter may not completely regress.

A major factor that should influence the initial choice of therapy for gynecomastia is the condition’s duration. It is unlikely that any medical therapy will result in significant regression in the late fibrotic stage (a duration of 12mo or longer) of gynecomastia.

Immediate and Long Term Effects of Gynecomastia Surgery

Instantaneous Breast Reduction

Since surgery is as direct of an approach to removing enlarged male breasts as anyone can hope for, the results can be seen right after the procedure. Granted the chest area will remain bandaged in order to prevent any post-operative infection (this is quite a common occurrence), but the effects are immediately apparent.

Reduced Likelihood of Recurrence

Those who choose to undergo man boob surgery do so in the hopes of avoiding recurrence of the condition. While it is true that surgery will lessen the likelihood of developing man breasts again, there is no 100% guarantee for this.

Recovery from gynaecomastia surgery

During your gynecomastia surgery recovery period, You will have to wear pressure garments for a period of 3 weeks to help your chest heal well and reduce swelling Your sutures will be absorbable sutures. Scars will be minimal and you will have minimal visible scars We do not use any drains, so don’t expect any tubes in the post operative period Medications to take orally to aid healing and reduce the potential for infection. Be sure to ask us your questions about what you can expect during your individual recovery period.

• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery? When will they be removed?
• Are stitches removed? When?
• When can I resume normal activity and exercise?
• When do I return for follow-up care?

It's very important to follow your plastic surgeon's instructions and attend follow-up visits as scheduled. The final results of gynecomastia surgery are permanent in many cases. However, if gynecomastia resulted from the use of certain prescription medications, drugs (including steroids) or weight gain you must be fully free from these substances and remain at a stable weight in order to maintain your results. It's important that the surgical incisions are not subjected to excessive force, swelling, abrasion or motion during the time of healing.

What is gynecomastia surgery?

Gynecomastia surgery is a procedure that reduces breast size in men by flattening the enlarged breast and enhancing the male chest contours.

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). In these cases the position and size of the areola can be surgically improved and excess skin may be reduced.

The procedure is done with a combination of liposuction and glandular excision. We do it through trans nipple approach which leaves very minimal or invisible scars, so no one will know that you ever had a surgery.

Plastic surgery to correct gynecomastia is technically called reduction mammaplasty.

Who is a good candidate for gynecomastia surgery?

Gynecomastia surgery candidates include:

• Men whose condition cannot be corrected through alternative medical treatments
• Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
• Nonsmokers and non-drug users
• Men with a positive outlook and specific goals in mind for improving the physical symptoms of gynecomastia
• Men who are physically healthy and of relatively normal weight
• Men who have realistic expectations
• Men whose breast development has stabilized
• Men who are bothered by the feeling that their breasts are too large

Adolescents may benefit from surgery, although secondary procedures may be needed in the future should breast development continue.

What should I expect during a consultation for gynecomastia surgery?

During your gynecomastia surgery consultation you should be prepared to discuss:

• Your surgical goals
• Medical conditions, drug allergies and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco and recreational drug use (including steroids)
• Previous surgeries

We will evaluate

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Perform diagnostic testing to determine the underlying cause of gynecomastia; this may include testing of your endocrine function
• Examine your breasts and may take detailed measurements of their size and shape, skin quality and placement of your nipples and areolas
• Take photographs for your medical records
• Discuss your options
• Recommend a course of treatment
• Discuss likely outcomes of gynecomastia correction and any risks or potential complications
• Discuss the use of anesthesia during your procedure

The consultation is the time to ask us your questions.

It's very important to understand all aspects of your surgical procedure.

It's natural to feel some anxiety, whether it's excitement for your anticipated new look or a bit of preoperative stress.

Don't be shy about discussing these feelings with us

What results should I expect after gynecomastia surgery?

Gynecomastia surgery results are immediately visible. Over time, post-surgical swelling will resolve and incision lines will fade. Satisfaction with your new image should continue to grow as you recover from surgery.

The final results of your gynecomastia surgery may take 3-6 months to achieve. Incision lines are permanent, but will continue to fade over time.

Gynecomastia surgery scars

Any surgical treatment to correct gynecomastia will require incisions. While most incision lines are concealed within natural contours, some may be visible and are a necessary result of male breast reduction surgery.

All gynecomastia surgery scars are permanent, even though some scars may be concealed in the natural contours of the breast. Your improved upper body will likely enhance your self-image and confidence, whether in a shirt and tie, a t-shirt or baring your chest at the beach.

The practices of surgery is not an exact science. Although good results are expected from your procedure, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure to treat gynecomastia.

Another surgery may be necessary:

•  To perform additional tightening or repositioning of the breasts
• To treat any complications that may occur

How should I prepare for gynecomastia surgery?

In preparing for gynecomastia surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Take certain medications or adjust your current medications
• Stop smoking
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

The success and safety of your gynecomastia procedure depends very much on your complete candidness during your consultation. You'll be asked a number of questions about your health, desires and lifestyle.

Male breast reduction surgery may be performed in an accredited, office-based surgical facility, licensed ambulatory surgical center or a hospital. Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.