Industry Associations:
Gynaecomastia
By Dr. Mark P. Kohout Published: 11/03/2010
Gynaecomastia
If you are considering surgery we want you to be thoroughly informed about this procedure.Reading this information is the first step. However, a personal consultation with your surgeonis the best way to obtain any additional information you need.
What is gynaecomastia?
Gynaecomastia is a common disorder of the
male’s breast where there is a benign glandular
enlargement of that breast at some time in a male’s
life, affecting an estimated 40 – 60% of men. It
usually consists of the appearance of a flat pod of
glandular tissue behind the nipple that becomes
tender at the same time; it may affect either one
breast or both. Though certain drugs and medical
problems have been linked with male breast over
development, there is no known cause in the vast
majority of cases.
For men who feel self-conscious about their
appearance, breast reduction surgery can help.
The procedure involves reduction of the breast
tissue by excision of glandular tissue and/or fat
removal by liposuction. In extreme cases excess
skin is removed, resulting in a chest that is flatter,
firmer and better contoured. The scar can usually
be hidden along the border of the nipple, with the
results of surgery being very successful.
Surgery to correct any Gynaecomastia can be
performed on healthy, emotionally stable men
of any age. The best candidates for surgery have
firm, elastic skin that will reshape to the body’s
new contours. Surgery may be discouraged for
obese or overweight men who have not first
attempted to correct the problem with exercise or
weight loss. Also, individuals who drink alcohol
in excess or smoke marijuana are usually not
considered good candidates for surgery. These
drugs, along with anabolic steroids, may actually
cause Gynaecomastia therefore patients are first
directed to stop the use of these drugs to see if
the breast fullness diminishes before surgery is
considered an option.
Initial consultation
The initial consultation with your surgeon is very
important. Your surgeon will need a complete
medical history so be ready to provide this
information. This will include information about
any medical conditions, drug allergies, previous
operations and medication you are taking, if any.
Your surgeon will examine your breasts and check
for causes of Gynaecomastia such as impaired liver
function, use of oestrogen containing medications,
or anabolic steroids.
Your operation
The surgical procedure can be performed under
twilight sedation or general anaesthetic as a day
case. The surgeon can make a small incision
along the border of the nipple and removing
excess tissue and/or fat. It is usually combined
with liposuction. Rarely, is it necessary to remove
skin from the breast, therefore scarring should be
minimal.
How long does it take?
The operation takes approximately one hour.
Preparation for surgery
Smokers will be asked to stop smoking 3
weeks prior to surgery. Aspirin and some anti-inflammatory
drugs used for the treatment or
arthritis can cause increased bleeding, so you
should avoid taking these medications for 2 weeks
before surgery.
Day of surgery
Your operation may be performed in a hospital
under general anaesthetic or in a day surgery
facility under intravenous sedation. Medications
are administered for your comfort during the
surgical procedure.
After surgery
When surgery is completed you will be taken
into a recovery area where you will be closely
monitored. Your chest will be wrapped and you
will generally be able to go home within 5 hours
of surgery. You will need to wear a compression
binder for approximately 4 weeks following
surgery.
It is important to understand that recovery time
varies among individuals. Some discomfort may
be present but will resolve within three to four
days and is well controlled with oral medications
such as Panadeine. Showering is permitted one
or two days after surgery.
You will have stitches along the incisions, which
will be removed after four to seven days. Bruising
and swelling will occur initially but will disappear
quickly. Most residual swelling will resolve within
a month, however swelling may take from 6 to 9
months to settle completely.
Dependent upon your occupation, you may
return to work after 1 to 2 weeks.
What are the risks?
The subject of risks and potential complications
of surgery is best discussed on a personal basis
between you and your surgeon. Fortunately,
significant complications from Gynaecomastia
surgery are infrequent however every surgical
procedure involves some general risks. One of the
main risks is bleeding arising from a haematoma
(collection of blood tissue), infection, scar
formation and partial or complete loss of nipple
sensation. These complications are temporary
and will resolve in time.
You can help minimise certain risks by following
the advice and instructions of your plastics
surgeon both before and after surgery.
Maintaining a relationship with
your plastic surgeon
Should there be any questions regarding your
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.
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.
