GYNECOMASTIA – enlarged male breasts
Gynecomastia is the condition of the enlargement or over development of male breasts. This could be a persistent enlargement of the breast tissue from puberty hormonal changes, or could occur as a result of anabolic steroid use or hormonal changes due to medications or other medical conditions.
It is a source of embarrassment and/or distress for the adolescent or man affected. Obesity could also cause enlargement of male breasts.
- Your doctor might prescribe medications that block the conversion of Testosterone to Estrogen usually called “ Aromatase inhibitor”. Sometimes discontinuing the medication which has caused the estrogen/testosterone imbalance might be suffice. However frequently if the gynecomastia has persisted for a while, then these interventions won’t help and surgery becomes the last resort.
- Gynecomastia surgery is a procedure to remove excess fat, glandular tissue and from overdeveloped or enlarged male breasts. In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola (the dark skin surrounding the nipple). Under these circumstances, the position and size of the areola can be surgically improved and excess skin may need to be reduced. In order to improve the contour of the breast and debulk the fat tissue, liposuction (extraction of the excess fat with the help of cannula) is also utilized either by itself or in conjunction with the removal of the breast gland.
Risk & Complications
- Bleeding: rarely a blood vessel may cause bleeding post operatively. Following the post operative care protocol will reduce the risk of bleeding.
- Infection: you are required to take antibiotics post operatively therefore this risk is very minimal.
- Reduced or loss of sensation in the nipple: this may occur commonly as a result of the surgery, which may be permanent at times.
- Contour and shape irregularities may occur after gynecomastia. Visible and palpable wrinkling may occur.
- Nipple retraction may occur after gynecomastia surgery.
- Scarring: may occur and may look unsightly in people prone to disfiguring keloid scar or show some darkening (hyperpigmentation)
- Seroma: Fluid accumulations infrequently occur in between the skin and the underlying tissues. Should this problem occur, it may require additional procedures for drainage of the fluid.
- Damage to Deeper Structures: There is the potential for injury to deeper structures including nerves, blood vessels, muscles, and lungs (pneumothorax) during any surgical procedure. The potential for this to occur varies according to the type of procedure being performed. Injury to deeper structures may be temporary or permanent.
Smoking, Second-Hand Smoke Exposure, Nicotine Products (Patch, Gum, Nasal Spray)- Patients who are currently smoking, use tobacco products, or nicotine products (patch, gum, or nasal spray) are at a greater risk for significant surgical complications of skin dying, delayed healing, and additional scarring. Individuals exposed to second-hand smoke are also at potential risk for similar complications attributable to nicotine exposure.
The operation including the liposuction is usually performed under oral or intravenous twilight sedation as well as local anaesthetics. If you prefer to have this surgery performed under General anaesthetic, you will discuss this with your surgeon.
It is normal to feel some discomfort for a few days after your procedure. This can be controlled with medication. After surgery, it is advisable to arrange to be driven home and have someone to help you manage for a day or two. You will be able to walk around the day following the surgery and return to work after a couple of days.
Bruising and swelling will occur. You will be advised to wear an elastic pressure garment around the clock for 2 week, and then another 4 weeks at night. Much of the swelling will resolve in the first few weeks but it will be three months before your final result is visible.
If you required excision of glandular tissue, you should avoid heavy exercise for about three weeks. You must avoid any activity or job that risks a blow to the chest area for at least a month.
Follow- up visit
Your surgeon would need to see you first day, 1 week, 4 weeks, 12 weeks and 1 year post surgery. Make sure you make appropriate time arrangement