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Gynaecomastia Surgery (Male Breast Reduction) in Hull, York, Grimsby, Lincoln & London

Introduction

Gynecomastia is a medical term for male breast enlargement. In the majority of cases there is no known cause and, although rarely talked about, it is a common condition. Teenagers experience some degree of breast enlargement however, by early adulthood most have resolved and the incidence rises with age, reaching approximately 25% in older men. Male breast enlargement may rarely be caused by certain medicines, steroids, drugs (marijuana) and some diseases.

The breast is made up of three components, skin, glandular tissue (firm and dense) and fatty tissue (soft) and the proportion in any breast vary from one individual to another. For men who feel self-conscious about their appearance, surgery can be helpful. This procedure removes tissue from the breasts, and in more severe cases excess skin also.

Operation Types:

  • Liposuction: Only is used in a few patients with breast enlargement mainly made up of fat without skin excess.
  • Excision: This is required in most patients since the enlargement is often made of firmer breast tissue and skin.
  • Combined (liposuction & excision): Used in majority of patients. The liposuction acts as an aid to surgery and imporves the sides of the breasts (chest).

Limitations

  • Breasts are naturally asymmetrical and some degree of discrepancy will persist in the scars and shape of the breast
  • Contour irregularities are common and somewhat inevitable with this operation
  • Chest wall creases / folds under the nipples and sides are common and improve but don't disappear with time

Type of Scars

  • Half-moon (Hemi-areolar)
  • Around the nipple (Circum-areoalar)
  • Extended scars (Anchor, Keyhole, Others)

Post-Operative (Aftercare)

Most patients are discharged on the first or second day post-op on pain killers and antibiotics with aftercare instructions and outpatient arrangements to be seen within two weeks.

Following the surgery the chest is swollen and bruised for a while and it can be difficult to assess the full effect of the operation in the initial three months after surgery. To help reduce swelling, an elastic pressure garment is often prescribed to be worn continuously for one to two weeks. We usually advise abstaining from exercise and, in general, it takes about four to eight weeks to return to normal activities.

Complications

Complications occur in about 15-20% of patients, mostly relatively minor and do not require further surgery. The more severe the pre-operative breast enlargement, the grater the amount of tissue removed and consequently, the higher the complications. Breast (chest wall) numbness is a normal occurrence that often improves with time.

  • General complications of wound infection, delayed healing and prominent (hypertrophic) scar may occur.
  • Haematoma (bleeding) requiring surgical evacuation occurs in 5-10% of patients and fluid accumulation (seroma) is common (10-20%) complication usually treated by needle aspirations.
  • Contour irregularity and chest wall creases / folds are common and sometimes inevitable particularly in patients in whom a lot of tissue has been excised.
  • Partial or complete nipple loss though uncommon can occur in addition to decrease in nipple sensation.
  • Under or overcorrection is a common and often subjective patient complaint.
  • Some asymmetry is inevitable as with any bilateral surgical procedure.
  • Redundant / excess skin ("dog ears") at either ends of the scar can sometimes occur
  • The overall patient satisfaction with this surgery is ~75% (modest, relative to other breast procedures) and this is largely determined by patient expectation which maybe difficult to attain if unreasonably too high, severity of the gynaecomastia and occurrence of complications.
  • A significant proportion (20-25%) of patients have revision surgery to improve the final outcome
  • Pre-existing lateral chest wall / armpit fat pad (prominence) may be improved but will not disappear with this operation when combined with liposuction
Procedure

OPERATION TIME
1.5 - 2.5 Hours

ANAESTHESIA TYPE
General (asleep)

LENGTH OF ADMISSION
1 - 2 Days

RECOVERY
2 - 4 Weeks

Post-Op &
Discharge
  • Home on simple pain killers
  • Dressing Check: 10-12 days
  • Outpatients Clinic: 2 to 4 weeks post op