Gynaecomastia: surgical advice for "man boobs"

Dr Mark Kohout
Friday, August 8, 2008
Gynaecomastia is a common disorder of the male breast where there is a benign glandular enlargement of that breast. Gynaecomastia affects an estimated 40 to 60 percent of men. It usually consists of two types of tissue: the breast tissue proper and fatty tissue in the breast.

Gynaecomastia can occur in one or both breasts. Although certain drugs such as marijuana and anabolic steroids may cause gynaecomastia, and medical problems may be linked with male breast overdevelopment, there is no known cause in the vast majority of cases.

For men who feel self-conscious about their appearance, surgery to remove breast tissue can help. The procedure removes fat or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a chest that is flatter, firmer, and better contoured.

Gynaecomastia surgery can enhance your appearance and self-confidence. Before you decide to have surgery discuss all the options with your surgeon and make sure that your expectations are realistic. The results of the procedure are significant and permanent and you will likely be very satisfied with your new look.

The procedure
The surgery is performed under general anaesthetic and takes about two hours to complete. An overnight stay in hospital may be required though day surgery is sometimes suitable. Drains are may be inserted at the time of surgery, along with a compression bandage to reduce the effects of swelling in the breast tissue.

If excess glandular tissue is the primary cause of the breast enlargement, it will be excised with a scalpel. The incision is usually made around the areola and the excision may be performed either alone or in conjunction with liposuction.

If the gynaecomastia is due to an excess of fatty tissue, this may be removed by liposuction. An incision for liposuction is made at the edge of the areola or higher up in the armpit. A cannula attached to a vacuum pump, is then inserted into the incision and moved through the different layers beneath the skin to break up the fat and suction it out.

In some cases large volumes of fat or glandular tissue are removed and the skin may not contract back around the smaller breast. In this case excess skin may need to be removed in order to re contour the breast. In this case, a vertical scar runs from the areola to the base of the breast to meet a horizontal scar. Recovery after gynaecomastia surgery is gradual. You would expect to take things very easy for the first week to minimise the risks of bleeding after surgery However, after the first week, progress is usually quite rapid. You will usually get back into light exercise after about three weeks and should be able to do most forms of physical activity including contact sports after six to eight weeks.

Maintaining a relationship with your plastic surgeon
Should there be any questions regarding gynaecomastia surgery be sure they are answered in advance. Well meaning friends are not a good source of information. Find out everything before proceeding with the operation — a well informed patient is a happy one.

After surgery, you will return to your plastic surgeon's office for follow-up care at prescribed intervals, at which time your progress can be evaluated. Once the immediate postoperative follow-up is complete, many surgeons encourage their patients to come back for periodic check-ups to observe and discuss the long-term results of surgery.

Please remember that the relationship with your plastic surgeon does not end when you leave the operating room. If you have questions or concerns during your recovery, or need additional information at a later time, you should contact your surgeon.

Dr Mark Kohout FRACS
Plastic Surgeon
Ph: 1300 551 151
Leichhardt — Bondi Junction — Orange NSW

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