Gynaecomastia surgery: male breast reduction

Gynaecomastia (known as “man boobs”) is the abnormal development of male breast tissue that causes boys’ and men’s breasts to swell and become larger than normal. About 70-80% of most men have some breast development during puberty. On average 30% of men may develop prominent breasts, which can affect either one or both breasts.

Types of gynaecomastia

1) True gynaecomastia – is related to the growth of the glands.

2) False gynaecomastia (or pseudo-gynaecomastia) – is usually associated to overweight and obese patients where there is an increase of the adipose tissue and is mainly fatty.
 

What causes gynaecomastia?

• Hormonal disorders – from puberty there can be an imbalance between the sex hormones testosterone and oestrogen.
• Obesity – breast tissues grow due to extra body fat from being overweight.
• Ageing – as men age, they produce less testosterone and may develop body fat more easily.
• Gym fanatics – taking anabolic steroids, which increase muscle mass and the mammary glands.
• Medications – sides effects of drugs such as propecia (medication for hair loss).

Types of gynaecomastia treatment

Some hormonal treatments may be useful at first but surgery is the best treatment for gynaecomastia, carried out by a plastic surgeon who specialises in this. Patients who are heavily obese are advised to lose weight first to see the actual volume of the remaining gynaecomastia rather than just the excess fat.

What type of anaesthesia will be used?

General anaesthesia is required. However, patients who have very little growth, a protruding nipple, or who have already been operated on and require rework can be treated under a local anaesthetic.

What results can be expected after the surgery?

Usually, surgical treatment completely resolves the gynaecomastia and the results can be seen within a month or so. There is significant scarring from the surgery which can take 6-12 months to fade. A single operation is usually effective but more procedures may be required if there is a lot of excess skin.

Can male breasts regrow after gynaecomastia surgery?

As a rule, the breasts do not develop again although to improve the aesthetic result, a small piece of glandular tissue – just a couple of millimetres – is left behind below the areola. This is to prevent the areola from sinking, attaching to the breastplate and going askew. Depending on circumstances, the remaining glandular tissue could experience regrowth. This would be caused by a patient taking anabolic steroids or takes medication that can lead to gynaecomastia again. New growth could be in the areola but not as big as the growth that was removed.

How long does it take to resume everyday activities?

Normal activities after the treatment will depend on the level of the procedure carried out. Usually, a patient operated on for gynaecomastia can return to work and drive within three or four days. The patient needs to avoid physical exercise that affects the chest area for at least a couple of weeks. From the second week onwards, patients can start doing some exercises but not muscular exercises as this type of training will have to wait for at least a month. The recovery is fairly quick considering that there will be some bruising and inflammation for two or three weeks. Full normal activity can be resumed after a month.