Male Breast surgery (Gynaecomastia)

Male Breast surgery (Gynaecomastia)

Overview

Gynecomastia is a condition in which boys or men present with enlarged breasts, affecting either one or both sides, sometimes unevenly. The main causes include an imbalance in the hormonal levels, being overweight or use of certain drugs. It usually isn’t a serious condition. However, it may impair one’s self-confidence and cause severe emotional discomfort. Male breast reduction surgery is an effective option that helps reduce the volume of the breast tissue in men and re-contours the male chest giving it a more masculine appearance.
It may be combined with a liposuction of certain regions of the chest, abdomen or the back to create a combined outcome

Who is a good candidate for Male Breast Reduction surgery?

The surgery for male breast reduction is normally not advisable for children or adolescents below 16-18 years of age. You are considered a good candidate for surgery if you fulfil the following criteria:

    • Physically healthy and fit without comorbidities that can impair the healing process.
    • Alternative medical treatments fail to correct the condition.
    • Men who are not overweight.
    • Condition has persisted over time and leads to embarrassment and self-esteem issues.
    • Non-smokers and non-drug users.
    • Gynecomastia not due to medical conditions like liver failure/cirrhosis, kidney failure, tumours, hyperthyroidism etc. These patients shall be referred to the appropriate specialist to address the underlying issue.
  • How to prepare for a Male Breast Reduction Surgery?

    Dr Aditya shall discuss your past medical history in detail to determine your candidacy for the procedure. The procedure shall be explained to you in detail.

    Doctor shall discuss the following:

    • Your concerns about your chest contour to plan the likely options based on the desired results.
    • Your exact goals from the procedure including removal of excess skin, repositioning of the nipples and reducing the size of the nipples and areolas.
    • Male Breast Reduction surgery options: this shall be based on your anatomy, the surgeon’s preferences and desired results:
    • Removal of the tissue under the breast and nipple.
    • Liposuction of the chest wall.
    • Likely outcomes and potential risks involved.
    • Take pictures to compare post-surgery outcomes.
  • Before Surgery:

    • Evaluation of general health status.
    • Medical examination including tests to rule out other causes of Gyanecomastia like liver diseases, hyperthyroidism etc.
    • Avoid anti-inflammatory drugs such as Ibuprofen and Aspirin that may interfere with the healing process.
    • Stop smoking and alcohol at least 4 weeks before the surgery.
  • After Surgery:

    • Arrange for help to be driven home from the hospital.
    • Plan to stay home and limit activities for a few days after surgery.
  • How is Male Breast Reduction surgery for Gyanecomastia done?

    Anesthesia:

      • The procedure is usually performed under local anesthesia with intravenous sedation or general anesthesia.

    Steps of the Procedure:

    Liposuction Procedure to Treat Gyanecomastia:

      • In cases where the tissue is fattier in nature, liposuction of the chest wall provides excellent results.

      • Small incisions are taken on each side of the chest.

      • Through these incisions, the surgeon shall remove the excess fat/glandular tissue from your breast by sucking it out via liposuction. This is done by inserting a small tube/cannula through the incision to remove the excessive fat.

      • The surgeon shall work on sculpting a natural looking new chest contour.

    Male Breast Reduction with Tissue Excision:

      • Tissue excision is usually performed in more severe cases of Gyanecomastia.

      • Patients presenting with stretched or sagging skin around the breast shall require this approach.

      • Tissue excision allows the surgeon to remove a greater amount of skin/fat/glandular tissue that cannot be optimally treated with the help of liposuction.

      • Location of the incision: usually along the natural creases of the chest/in the areola (peri-areolar).

      • Length of the incision depends on the extent of the surgery needed.

      • A small semicircular incision is taken so as to leave the smallest scar possible.

      • Excess fat/tissue is removed with the help of a surgical knife.

      • If a lot of tissue is removed, repositioning of the nipples is done.

    Time to Operate:

      • This depends on the surgeon and individual candidate. However, the average time taken to operate is about 1.5 to 2 hours.

    Possible Complications and Risks:

      • Unevenly shaped breasts or nipples.

      • Thick scarring

      • Loss of sensation over nipples.

      • Delay in wound healing

      • Temporary swelling/bruising or numbness

    Recovery

      • The usual recovery time post-surgery is 1-2 weeks.

      • Avoid strenuous activities – such as lifting heavy weight/jogging etc.

      • A compression vest shall be provided by the surgeon. This helps the skin retract and also prevents any fluid accumulation.

      • Over-the-counter pain medications for any soreness/pain/bruising.

      • You may begin to resume normal activities after 1-2 weeks as per the surgeon’s recommendations.

      • You may resume driving when it is no longer painful to wear a seatbelt.

      • The final results shall take about 6 weeks to be apparent.

    Maintaining an Improved Chest Contour:

      • Exercise regularly to avoid excessive weight gain.

      • Avoid use of steroids/drugs that influence the testosterone levels.

    Dr. Aditya Aggarwal is a renowned Senior Aesthetic Surgeon who has trained at premier national and international institutions. He is the President of the Indian Association of Aesthetic Plastic Surgeons (2023-24).