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Male breast reduction (Gynecomastia)

What is the Male breast reduction (Gynecomastia)?

Gynecomastia or gynaecomastia is the abnormal development of large mammary glands in males resulting in breast enlargement. Gynecomastia must be distinguished from pseudogynecomastia, which refers to the presence of fat deposits in the breast area of obese men. True gynecomastia results from growth of the glandular, or breast tissue, which is present in very small amounts in men.

Gynecomastia usually occurs on both sides but can be unilateral in some cases. The enlargement may be greater on one side even if both sides are involved. Tenderness and sensitivity may be present, although there is typically no severe pain.

Gynecomastia is caused by an imbalance in the two major hormones in a man’s body – estrogen and testosterone. When men are born, when they go through puberty, and as they age, there are certain hormonal changes that occur. There are internal factors (genetic) and external factors (drug use, diseases, medicine) that can both affect the balance of these two key hormones. Also, when men get older and start to age, their hormones will change and if something isn’t quite right internally, gynecomastia can occur.

Men who feel self-conscious about their appearance are helped with breast reduction surgery. The procedure removes fat and/or glandular tissue from the breasts, and in extreme cases excess skin may need to be removed, resulting in a contoured chest that is flatter and firmer.

What is the procedure?

The aim of male breast reduction surgery is to restore a more normal chest contour. In general, it consists of a combination of fat removal by liposuction as well as removal of any breast tissue usually through a small incision in the lower portion of the areola (area around the nipple). For larger breasts some skin reduction is also carried out and may involve more scarring.

Male breast reduction surgery usually takes around 90 minutes. The surgeon will make an incision around the areola and liposuction may be used to suck out excess fatty tissue. If there is a lot of tissue to remove, cuts may extend down the chest from the areola and the nipples may need to be repositioned.

You will be required to stay in hospital overnight, take a few days off work to rest and avoid lifting or strenuous physical exercise for one month after the operation. An elastic garment also needs to be worn for one to four weeks after the operation to encourage smooth results.

What kind of result can you expect?

Male breast reduction surgery typically reduces the size of the male breasts and reduces puffy nipples. After most male breast reduction procedures, men report a stronger, firmer chest that looks and feels more masculine, and as a result, a better self-image and higher confidence.

Results are permanent but weight gain, hormonal imbalances and the use of certain drugs can cause the breast area to enlarge again.

Recovery period and recommendations

After surgery, dressings or bandages will be applied to your incisions and an elastic bandage or support garment may be used to minimize swelling and support your new chest contour as it heals.

A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will be required to stay in hospital overnight after the surgery, take a few days off work to rest and avoid lifting or strenuous physical exercise for one month after the operation. An elastic garment also needs to be worn for one to four weeks after the operation to encourage smooth results.

All scars are permanent, even though some scars may be concealed in the natural contours of the breast.

Possible side effects and complications

It is generally a very safe procedure, but it is important to discuss possible complications with your surgeon.

Although complications associated with male breast surgery are rare, they include:

- scarring. This is usually restricted to the areola, in more advanced cases scars may extend onto the chest;

- bleeding. The male breast has a rich blood supply and some bleeding is not uncommon. Drains are often left in for a short period of time;

- seroma (fluid collection). Occasionally fluid can collect under the skin after removal of the breast tissue. This can be drained using a syringe until the fluid stops collecting. This drainage can be done as an out patient;

- reduced sensation;

- asymmetry/shape. Mild asymmetries are not uncommon following this procedure including some indentation behind the nipple. For very extensive gynecomastia more than one procedure may be required to obtain an optimal result.

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