Males also have breast tissue under the nipple and this can enlarge along with fatty tissue to give a breast. This most commonly occurs in teenage boys but can be at any age. In most cases there is no specific cause. Occasionally it can result from a hormonal imbalance or after certain medicines. The breast swelling can be composed mostly of fat, brea st tissue or a mixture. Although it can reduce in some patients it frequently remains life long.

Procedure in brief

Gynaecomastia can be a mixture of breast and fat. It can be a small marble sized lump or a large fully formed breast. When it comprises of a small lump of breast tissue it is best removed via a small cut through the nipple. When the breast swelling is mostly fat then liposuction is to be used. This involves the use of 3-4mm needles to suck fat out from the breast.

Length of surgery

Operation takes 1 to2 hours depending upon technique and size of breast.

Nights in hospital

As a day case or one night.

Dressings

You will wake up with dressings on the wounds and elastoplast support tape on the chest (say if allergic to elastoplast). These dressings will stay on for three days. They are to be kept dry during that period. You will then return to have lighter dressings applied to the wounds if required at all.

Drains

The use of a small surgical drain into the breast is common to remove any unwanted blood/fluid. Usually have drains for 24 hours. Occasionally will be kept in for 48 hours.

Time off work

Allow 3 days to 2 weeks depending on size of surgery. People vary in recovery if you have a highly active job you may require longer.

Time to exercise

Walking a distance at 1-3 days, swimming by 10-14 days (if fully healed). Strenuous exercise (aerobics etc) should be avoided for 3-4 weeks.

Recovery and Final outcome

 

You should expect bruising and some swelling. This will last 1-2 weeks. Some leaking from the wounds is common for the first few days as they heal. You will have a good flat shape immediately but it will continue to improve (especially in larger operations) over 4-6 weeks by which time the skin and nipple will be much softer.

Follow up

Wound check and dressing change a day 3 and 7. Then see Dr Deepak Kalia at day 3.

Complications

This is a routine operation that is a great success for the vast majority of men. However, it is very important you understand what can go wrong as well as right with an operation. With gynaecomastia surgery the potential problems are listed.

Nipple loss: This is very uncommon and occurs from the blood supply to the nipple being stopped. Only a risk in very large cases of gynaecomastia. If occurs the nipple will be lost and be replaced by a scar. Although rare in any patient the risks are increased by smoking, obesity, old age and surgery for massive breasts. If you fit into this category Dr Deepak Kalia will discuss potential alternative surgical techniques to avoid it.

Loss or altered nipple sensation: About 15% chance. Could happen one side and not the other. The risk increases in surgery for very large breasts.

Remaining asymmetry or irregularity: Most cases will give a good flat result to both sides. However, small differences between the sides is possible.

Scars: Patients vary in the quality of scars they produce.

Wound breakdown: Uncommon.

Bleeding: A blood clot can collect in the breast needing you to go back to theatre for its removal. If it occurs this will be within the first 24 hours, in approximately 3% of patients.

Infection: Quite uncommon but if occurs you will need a course of antibiotics.