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Gynaecomastia (Male Breast Reduction) Surgery

Gynaecomastia surgery, also known as male breast reduction surgery is performed to address the enlargement of male breasts, a condition called gynaecomastia. 

Reasons for Gynaecomastia Surgery

Gynaecomastia can occur due to various factors such as hormonal imbalances, genetic predisposition, obesity, certain medications, or underlying medical conditions. Men with gynaecomastia often experience self-consciousness, emotional distress, and a negative impact on their body image. Gynaecomastia surgery is recommended for individuals who have not achieved satisfactory results through other treatment non-invasive options, such as lifestyle modifications or hormonal therapy.

Preparing for Your Consultation

  1. Research: Take some time to research gynaecomastia surgery, its benefits, risks, and potential outcomes. Understanding the procedure and having basic knowledge will help you ask informed questions during your consultation.

  2. Choose a Qualified Surgeon: Look for a board-certified plastic surgeon with experience in gynaecomastia surgery. Verify their credentials, read patient reviews, and view before-and-after photos of previous patients to assess their expertise and results.

  3. Medical History: Compile your complete medical history, including any past surgeries, medical conditions, allergies, and medications you are currently taking. This information is crucial for your surgeon to assess your candidacy for surgery and plan the procedure accordingly.

  4. List of Questions: Write down a list of questions and concerns you want to discuss with your surgeon during the consultation. This ensures that you address all your doubts and gain a comprehensive understanding of the procedure.

  5. Goals and Expectations: Reflect on your goals and expectations for gynaecomastia surgery. Be realistic about the outcomes you desire and communicate them clearly to your surgeon. This will help them determine the most suitable approach to meet your expectations.

  6. Lifestyle Factors: Consider any lifestyle factors that may contribute to your gynaecomastia, such as medications you are taking, alcohol or drug use, or changes in weight. Discuss these factors with your surgeon as they may affect the treatment plan or recovery process.

  7. Bring Support: It can be helpful to bring a trusted friend or family member to the consultation. They can provide support, ask questions, and help you remember important details discussed during the appointment.

  8. Paperwork and Documentation: Bring any relevant medical records, test results, or imaging studies related to your gynaecomastia or overall health. These documents can provide valuable information to your surgeon and aid in developing an appropriate treatment plan.

  9. Consent and Financial Matters: Familiarize yourself with the consent process and potential financial obligations associated with the surgery. Understand the details of insurance coverage, if applicable.

  10. Open Communication: During the consultation, be open and honest with your surgeon about your concerns, expectations, and any anxieties you may have. Clear communication ensures that your surgeon fully understands your goals and can provide you with the best possible care.

Before your consultation for gynaecomastia surgery, your surgeon may request specific tests or evaluations to assess your overall health and determine your candidacy for the procedure. The exact tests may vary based on your individual medical history and the preferences of your surgeon. However, here are some common tests that may be requested:

  1. Blood Tests: Your surgeon may order routine blood tests to assess your general health, check for any underlying medical conditions, and evaluate your blood cell counts, liver function, kidney function, and overall metabolic profile. These tests help ensure that you are healthy enough to undergo surgery and identify any potential risks or contraindications.

  2. Hormone Level Testing: In some cases, hormone level testing may be requested to evaluate your hormonal balance. Gynaecomastia can sometimes be caused by hormonal imbalances, so assessing hormone levels can help guide treatment decisions.

  3. Imaging Studies: Your surgeon may request imaging studies, such as mammography or ultrasound, to evaluate the breast tissue in more detail. These tests can help determine the composition of the breast tissue, identify any underlying masses or abnormalities, and guide the surgical approach.

  4. Psychological Evaluation: In certain cases, a psychological evaluation may be recommended, especially if gynaecomastia has had a significant impact on your emotional well-being. This evaluation helps ensure that you have realistic expectations, understand the potential outcomes of the surgery, and are mentally prepared for the procedure.

It is important to follow your surgeon's instructions regarding any pre-operative tests or evaluations. These tests provide essential information to help your surgeon develop a personalized treatment plan and ensure your safety during the surgery.

What happens during the consultation with your surgeon?

  1. Medical History Review: Your surgeon will thoroughly review your medical history, including any past surgeries, medical conditions, allergies, and medications you are currently taking. Be prepared to provide detailed information about these aspects during your consultation.

  2. Physical Examination: A comprehensive physical examination will be conducted to assess the extent of your gynaecomastia, evaluate the breast tissue, and determine the most appropriate surgical approach. Your surgeon will examine the size, shape, and firmness of your breasts and assess the elasticity of your skin.

  3. Photos of your chest may be taken during this appointment to guide treatment planning
  4. You may be asked to undertake further testing
It is important to have a thorough consultation with your surgeon to discuss the specific details of your gynaecomastia procedure. Your specialist plastic surgeon will evaluate your unique situation, explain the surgical plan, and address any concerns or questions you may have.

Remember, the consultation is an opportunity to gather information, address your concerns, and establish a rapport with your surgeon. Take the time to make an informed decision before proceeding with gynaecomastia surgery.

Gynaecomastia Procedure Details:

  1. Anaesthesia: Gynaecomastia surgery is typically performed under general anaesthesia. This means you will be completely asleep and feel no pain during the procedure. Your anaesthesiologist will administer the anaesthesia and monitor you throughout the surgery to ensure your safety and comfort.

  2. Incision Placement: The specific incision pattern used during gynaecomastia surgery depends on the severity of your condition and the surgical technique chosen by your surgeon. Common incision options include:

    a. Periareolar Incision: A circular incision is made around the edge of the areola (the darker skin surrounding the nipple). This incision is well-camouflaged and allows direct access for removing excess glandular tissue and fatty deposits.

    b. Chest Wall Incision: In more severe cases of gynaecomastia, additional incisions may be required along the natural creases of the chest to access and remove excess tissue. This technique is often combined with liposuction for optimal results.

  3. Tissue Removal and Contouring:

    a. Liposuction: If the main component of your gynaecomastia is excess fatty tissue, liposuction may be employed. Small, thin tubes called cannulas are inserted through the incisions to loosen and suction out the excess fat. The cannulas are moved in a controlled manner to sculpt the chest and create a more defined contour.

    b. Excision: In cases where excess glandular tissue or sagging skin is present, surgical excision is necessary. Your surgeon will remove the excess tissue through the incisions, carefully sculpting the chest for a flatter, more masculine appearance. If needed, the areola and nipple may also be repositioned to achieve optimal symmetry and aesthetics.

  4. Nipple Repositioning: If the size or position of your nipples needs adjustment, your surgeon may reposition them for a more natural appearance. This is often done in conjunction with tissue removal and contouring.

  5. Closure and Dressings: Once the necessary modifications are made, your surgeon will close the incisions using sutures. In some cases, dissolvable sutures may be used, while in others, non-dissolvable sutures will be removed during a follow-up appointment. Dressings or compression garments may be applied to support the healing process and minimize swelling.

  6. Duration of Surgery: The duration of gynaecomastia surgery varies depending on the complexity of your case and the techniques used. On average, the procedure can take approximately one to three hours.

General Risks of Surgery

Like any surgical procedure, gynaecomastia surgery carries some general risks. These risks may include:

  1. Bleeding: Excessive bleeding during or after surgery may require further medical intervention.
  2. Infection: There is a small risk of developing an infection at the surgical site.
  3. Scarring: Although efforts are made to minimize scarring, some scarring may occur.
  4. Anesthesia-related risks: Anesthesia carries its own set of risks, which will be discussed further below.
  5. Blood clots: In rare cases, blood clots may form in the legs or lungs (deep vein thrombosis or pulmonary embolism).
  6. Numbness or changes in nipple sensation: Temporary or permanent changes in nipple sensation may occur.
  7. Skin irregularities: In some cases, the skin may appear uneven or have contour irregularities.
  8. Allergic reactions: There is a risk of experiencing an allergic reaction to medications or materials used during surgery.
  9. Unsatisfactory results: While gynaecomastia surgery aims to improve the appearance of the breasts, individual results may vary.

Specific Risks of Gynaecomastia Surgery

In addition to the general risks mentioned above, there are some specific risks associated with gynaecomastia surgery. These risks include:

  1. Asymmetry: The final outcome may result in uneven breast appearance or nipple position.
  2. Fluid accumulation: Fluid may accumulate beneath the skin (seroma) or around the lungs (pleural effusion).
  3. Skin necrosis: In rare cases, the blood supply to the skin may be compromised, resulting in skin tissue death.
  4. Changes in breast or nipple shape: There is a possibility of changes in breast shape or nipple projection.
  5. Deep tissue damage: Injury to underlying structures such as nerves, blood vessels, or muscles is possible but rare.

Surgical Options

Gynaecomastia surgery may involve different techniques to address the specific needs of each patient. The surgeon will determine the most suitable option based on the extent of gynaecomastia, the patient's overall health, and individual preferences. The two main surgical options are:

  1. Liposuction: This technique involves the removal of excess fat through small incisions. It is suitable for patients with predominantly fatty tissue and minimal glandular enlargement.
  2. Excision: In cases where glandular tissue or excess skin needs to be removed, excision techniques are employed. This approach may involve incisions around the areola or in more severe cases, additional incisions may be required to remove excessive loose skin.

Recovery and Post Operative Care 

  1. After the surgery, you will be taken to a recovery area, where you will be monitored closely. You may have dressings or compression garments applied to support the healing process and minimize swelling.

  2. Discomfort and Medication: Some discomfort, swelling, and bruising are normal after gynaecomastia surgery. Your surgeon may prescribe pain medication to manage any discomfort during the initial recovery period.

  3. Rest and Activity: It is important to get plenty of rest during the initial recovery phase. Strenuous activities, heavy lifting, and vigorous exercise should be avoided for  6 weeks to allow proper healing. Your surgeon will provide specific guidelines regarding activity restrictions and when you can resume normal activities.

  4. Follow-Up Appointments: You will be scheduled for follow-up appointments with your surgeon to monitor your healing progress. It is essential to attend these appointments to ensure optimal recovery and address any concerns or questions you may have.

  5. Swelling and Bruising: Swelling and bruising are common after gynaecomastia surgery and typically subside over several weeks. Wearing compression garments as instructed by your surgeon can help reduce swelling and support the healing process.

  6. Scarring: Incision scars will fade over time, but their appearance varies from person to person. Your surgeon may provide instructions on scar care, such as keeping the incisions clean and using topical treatments to minimize their visibility.

  7. Results: The final results of gynaecomastia surgery may take several months to fully manifest as the swelling subsides and the tissues settle. Most patients experience a significant improvement in the appearance of their chest, with a flatter and more masculine contour.

Aftercare Instructions

  1. Follow your surgeon's post-operative instructions regarding wound care, medication, and activity restrictions.
  2. Wear compression garments as recommended to minimize swelling and support the healing process.
  3. Avoid exposing the surgical site to excessive sun exposure or tanning beds during the healing phase to prevent pigmentation changes.
  4. Maintain a healthy lifestyle, including regular exercise and a balanced diet, to help maintain the results of your surgery.
  5. Attend all follow-up appointments with your surgeon to monitor your progress


Key Questions about Gynaecomastia

Before Procedure

Is a Male Breast Reduction right for me?

A good candidate for male breast reduction surgery is any man who feels uncomfortable with his large breast size. The procedure can be performed on men of all ages who are in good health, both physically and emotionally. The best candidates for male breast reduction surgery have firm, elastic skin that will reshape well to their body's new contours.

What is the recovery like for male breast reduction surgery?

The procedure is usually performed as day surgery where you are able to return home after recovery from anaesthetic with surgical drains. You can expect to return to Dr Cheng's rooms the next day for removal of surgical drains. Following male breast reduction surgery, patients will experience some bruising, swelling, and discomfort. This discomfort usually dissipates after a few days and can be reduced with prescribed medication. To help reduce swelling, a surgical pressure garment should be worn for about 3 weeks day and night and for 6 weeks at night.

You will be encouraged to walk around on the day of your breast reduction surgery. Depending on the type of work you do, you may be able to return to office work after one week. You may also begin light aerobic exercise after a week, but you should avoid strenuous activities for about three to four weeks following the surgery. Upper body gym exercises should be avoided for 6 weeks after surgery.

During Procedure

After Procedure

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Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Are you a candidate for surgery?

Are you a candidate for surgery?