Men’s Breast Reduction (Gynaecomastia)

Gain a more positive outlook on life and feel more comfortable about your body image.  40-60% of men suffer.  But you needn’t.

What is Gynaecomastia?

Gynaecomastia is a rather oddly-named term derived from Greek given to the condition of over-developed or enlarged male breasts.  Gynaecomastia can cause some physical discomfort, but primarily it causes psychological distress.

Many men suffering from the condition feel inhibited about showing their torso and may even refrain from close intimacy, some sports and certain situations.   Breast reduction surgery can therefore help you gain a more positive outlook on life and feel more comfortable about your body image. 

It can occur, among other reasons, because you are over weight or obese or because you are taking certain medications or drugs, drink excessively or are a heavy smoker. 

It is possible then to resolve gynaecomastia by taking non-invasive measures.  We advise you therefore to take advice from your regular physician before considering surgery abroad to correct gynaecomastia. 

Enlarged or over-developed male breasts, gynaecomastia, can occur in both or either breast and is estimated to affect between 40 to 60 per cent of men at some stage in their life.  

The condition is signaled by:

• A build up of excess, localised fat 
• Excess glandular tissue
• Both the above
• Swollen breast gland tissue
• Breast tenderness
• Some nipple discharge
• Swollen nipples (possible in pubescent boys)

The causes of gynaecomastia are numerous, but key reasons include:

• hormonal changes
• heredity conditions
• disease
• Uses of certain medications and/or illicit drugs
• Excess weight or obesity
• Health issues, such as liver disease or thyroid problems (less common)
• Conditions such as Hypogonadism, the term for a defect in the reproductive system (less common)
• Low testosterone production
• Ageing: hormonal change due to the normal ageing
• Tumors: mostly those affecting the testes, adrenal glands, pituitary, lung and liver

In around 25 per cent of men suffering from the condition however, the cause remains unknown.  It can occur at any age, and is common in boys at puberty as their hormone levels change and balance out.  Surgery is not recommended for adolescents.  It can be performed for this age group for specific reasons, although revision surgery may be needed later. 

Gynaecomastia is corrected by liposuction or excision (invasive surgery to cut away tissue) or both.  If the enlargement is caused primarily by excess fatty tissue, then liposuction alone might be used.  Generally, surgical incisions are small and in the case of liposuction only, you will notice very little scarring.  Your surgeon will examine your chest to determine the structure of the breast tissue and then make recommendations on the best procedure for you. 

Why you might consider gynaecomastia?

You are a good candidate for male breast reduction surgery if you: 

• are physically fit
• are preferably a non-smoker
• have a body weight appropriate to your frame (appropriate Body Mass Index) 
• have fully developed (ideally age 18 years +)
• are distressed by the feeling that your breasts are too large
• have eliminated other reasons for your gynaecomastia (weight, medications, illicit drug taking, alcohol consumption or smoking etc)
• have a clear understanding of the outcome of the cosmetic surgery, are emotionally stable and have a positive outlook

Ideally, you will be physically fit and be a non-smoker (or be prepared to stop smoking before your operation and during your convalescence) and be emotionally prepared for any new body image your breast reduction is likely to give you.  Breast reduction is ideal for mature men, post puberty.  It is not usually carried out on men younger than 18 years.

There are no guarantees about how you will look or feel after your surgery, but breast reduction is one of the most successful cosmetic surgery interventions as it yields high satisfaction rates post-op. 
While male breast reduction surgery usually gives permanent results, future illnesses, the taking of certain medications or illicit drugs, alcohol and smoking, as well as weight gain can alter your breast size again. 

The Consultation

It is important at your consultation with the surgeon that you establish your aims for seeking breast reduction.  Be candid with your surgeon and honest about your medical and physical history.  Be prepared to discuss emotional issues such as self-consciousness, body image, and any embarrassment your breast size has caused you.  Only by exploring the issues, will your surgeon be able to advise you of the best surgical procedure to correct your gynaecomastia, and be able to advise of the likely outcome of your surgery.  

What to expect from the surgeon

Be prepared to supply information on and/or discuss:

• Your expectations of the surgery
• Any medical conditions, drug allergies and medical treatments
• Use of current medications, vitamins, herbal supplements, alcohol, tobacco and drugs
• Any previous surgery
• Any family history that may be relevant such as hereditary characteristics, certain medical conditions (pituitary gland issues for instance) and any instances of male breast cancer 

During the consultation, your surgeon is likely to:

• Assess your general health
• Evaluate any health conditions
• Examine your breasts and draw on them to indicate incision marks and reduced breast size
• Ask to you undergo a mammogram
• Discuss the likely results of your surgery
• Discuss the value of and any complications of your breast reduction
• Take photographs for medical records
• Talk about the type of anesthetic used, its effects etc

You may be asked in preparation for surgery to:

• Take or stop certain medications or adjust your current medications
• Have certain lab tests or further medical evaluation such as an X-ray mammogram or diagnostic tests on your endocrine system (hormonal production system)
• Refrain from smoking in advance of surgery
• Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Questions you should ask

It is important that you are fully informed of the after care, any possible complications and the likely results of your surgery.  You will also need to know how the procedure is carried out, in particular where incisions are made and where any scarring is likely.  Below is a checklist of some key questions to ask:

• How will the surgery be performed? Where are incisions made and why?
• How do I best prepare for the operation
• Do I need assistance in post-operative care?
• What results can I expect?
• What side effects or complications may occur? 
• What discomfort will I have? 
• How will my breasts look immediately post op (bruising, swelling etc) and in the longer term?
• Are there any activities or environments I should avoid while I recover?
• Following the operation, how much exercise can I take and when can I start?  
• What other cosmetic procedures can I consider in conjunction with my breast reduction – either back to back or at the same time?
• What instructions should I follow after the operation?