Gynaecomastia is a condition caused by an over-developed breast in men that can occur at any age.
This condition can be caused by:
- Hormonal changes
- Use of certain drugs (particularly anabolic steroids and alcohol abuse, but not only)
Gynaecomastia can cause physical and emotional discomfort and impair your self confidence at the point that some men avoid certain activities and certain clothes to hide their condition. Gynaecomastia can be unilateal (only one side is affected) or bilteral (both breast are affected).
It can be caused by localised fat excess (pseudo-gynaecomastia) or by an excessive development of breast tissue (gland) in men, or by a combination of the two. In more pronounced cases it is accompanied by skin excess.
Male Breast Reduction Information
The goal of gynaecomastia surgery is to reduce breast size in men, flattening and enhancing the chest contour.
Reduction methods include liposuction, cutting out excess glandular tissue and if necessary skin excision or more often a combination of these.
- Anesthesia: The operation will be under general anaesthetic so you will be unconscious during the procedure
- Liposuction: Is the only procedure needed in cases of pseudo-gynaecomastia (caused only by excess of fat) or can be used in combination with excision of gland or gland and skin. Liposuction is performed with a small cannula inserted through a very small incision and connected to a vacuum system that allows the suction of the excessive fat. There are various liposuction technique and Mr Netri will recommend the most appropriate type for your specific case during the consultation.
- Gland (breast tissue ) Excision: In cases of real gynaecomastia the excess of breast tissue must be removed through a surgical incision. The incision (and the resulting scar) usually extends along the circumference of the bottom half of the areola in the natural passage of colour between the areola and the rest of the skin so that the final scar result is well disguised.
- Skin Excision: In bigger cases where the excision of tissue (fat or gland or both) can cause loose skin, or when the breast are already saggy, or when the areola are too big or the nipples are pointing downwards it is necessary to remove some skin. Usually the skin will be removed from the central part of the breast and the resulting periareolar scar will sit all around the areola in the natural passage of colour with the skin. In extreme circumstances where breasts are very large and saggy a breast reduction (like in women) can be necessary and the resulting scars will be visible on the chest with an anchor shape.
Usually it is necessary to perform a combination of two or three of the surgical steps described above to achieve the best result.
Mr Netri will discussed the best treatment for your specific case during the consultation.
You may be a candidate for gynaecomastia surgery if:
- You are over 18
- You are physically healthy
- You have realistic expectation
- You are unhappy with the size or appearance of your breasts and you are reluctant to remove your shirt in public, to swim or to exercise at the gym
- You experience physical discomfort because of your breasts
- You are not significantly overweight and you have firstly tried diet and exercise to reduce your breast size
- You do not use steroids, marijuana or drink alcohol in excess (these substances can cause recurrence of the condition)
- You have an asymmetry
The decision to have plastic surgery is very personal and only you can decide if the benefits will achieve your goal and if the risks and potential complications of surgery are acceptable.
You will be asked to sign a consent form to ensure that you fully understand the procedure, its benefits and any risks and potential complications.
Possible risk of a male breast reduction include:
- Anesthesia risk
- Seroma (fluid accumulation)
- Leakage of fluid and blood from the site of liposuction
- Irregularities to the skin
- Changes in nipple and breast sensation (can be permanent)
- Poor wound healing and unfavourable scarring
- Persistent pain
- Deep vein thrombosis and pulmonary embolism
- Damage to deeper structures (i.e. lungs)
- Possible need for revision of surgery
- Recurrence (especially in case of weight gain or use of steroids, marijuana and large consumption of alcohol)
These risks and others will be fully discussed by Mr Netri prior to your consent.
Gynaecomastia surgery can be scheduled as day case surgery or as an overnight stay depending on different circumstances that will be discussed at the time of your consultation.
Before leaving the hospital you will be given specific instructions on how to care for your chest, medications to take and when to follow-up with your surgeon.
You will need to keep the dressing clean and dry for a week after surgery.
You will need to wear a compressive garment after surgery for four weeks (night and day). You should refrain from exercise and heavy lifting for four weeks after surgery.
You can drive after one week and go back to work after one to two weeks depending on the physical requirements of your job.
Results are usually very good and immediately visible but the final result can take up to 6 months because of post surgical swelling. The scars can take over one year to fade and will never disappear completely.
The result will vary significantly from person to person. It is very important to understand that anatomical features will determine the type of result that you will achieve. The conformation of the chest, asymmetries, size and position of the nipple-areola complex, the quality of the skin, the lifestyle (smoking, exercise etc) and previous weight loss are all elements that will contribute to the final result.
Looking at or showing pictures during consultation will only be useful for you to explain the kind of result that you are or you are not looking for and for your surgeon to understand your expectation but the results can be significantly different from the ones shown.
Your consultation with Mr Netri will last approximately one hour. During this time you will be able to discuss the reasons why you are considering this procedure, your expectations, your desired outcome and concerns.
Mr Netri will collect your family history and your personal medical history and will ask you for the permission to contact your GP in order to receive all the important medical information that will make the operation as safe as possible. A psychological assessment may be required as recommended by new guidelines for cosmetic surgery in the UK.
Mr Netri will examine and measure your chest and take note of size, shape, nipple position and skin quality.
You will have all the time that you need to make questions and Mr Netri will do his best to answer these as clearly as possible.
You will be offered a second consultation to re-discussed the surgical plan and to make questions that you might have forgotten to make during your first appointment.
A cooling off period of a minimum of 14 days is required by Mr Netri from the last consultation up until the day of your operation.
- Before surgery you may be asked to see an anaesthetist for an assessment and have a blood test or other investigations performed
- You may be asked to suspend or adjust your current medications (especially steroids)
- You will be asked to stop smoking and suspend aspirin or other anti-inflammatory that can increase risk of bleeding or any other supplement (including protein shake or bars and creatine)
- Arrange somebody to pick you up from the hospital and somebody that can stay with you for the first night
An average price for gynaecomastia surgery would be between £4,000-5000. Prices may vary depending upon facility, grade of gynaecomastia and the need for liposuction.
- Anesthesia fees
- Hospital facility costs
- Surgeon fees
*Extra costs can be applied for preoperative tests, medication, compressive garment, and revision of surgery. Discuss these details at the time of your consultation.