Gynaecomastia is a medical term to describe an abnormally large male breast. The condition is usually idiopathic (ie meaning no specific cause) and is more common than people think. Gynaecomastia can also be caused by certain medications, drugs, congenital conditions and certain diseases. Physiological gynaecomastia occurs in pre-pubertal boys but usually resolves once they reach early adulthood. Gynaecomastia surgery can help reduce the size of the male breast by removing tissue and in severe condition skin as well. It will improve the appearance of a sagging chest and help to improve the contour. Gynaecomastia can be divided into fatty, fibrous or a mixture of both. Liposuction can remove mainly fatty tissue however for more fibrous type an excision of the breast tissue is done through an open incision. Patients who want gynaecomastia reduction surgery are usually affected by the appearance of their body especially in an environment where they are seen by other males such as at the gym or the swimming pool.
During the initial consultation, patients will have the opportunity to discuss their goals and desirable results with the plastic surgeon. Every patient is different, therefore a specific treatment regimen is planned to suit an individual’s need.
PROCEDURE
The procedure is usually performed under general anaesthesia. Depending on the type and severity of gynaecomastia, the patient might require either liposuction only, liposuction and excision or breast lift surgery. If liposution only is required , small stab incisions are made on the chest wall, axilla and in the areolar. The fatty breast tissue are then removed as in a normal liposuction procedure. If open excision is required, a separate incision is made around the areolar for removal of the breast tissue. After the surgery, the wounds are closed with fine sutures.
Once the procedure is completed, a compression dressing and antibiotic ointment will be applied to the incision site. The surgeon will advise you on how to take care of the wounds at home and you will be given a follow-up appointment.
CANDIDATES
- Generally healthy individuals with well-controlled medical conditions such as hypertension or diabetes (if they have any)
- Individuals with clear and realistic expectations of their desired result.
- Men of any age can be a candidate for gynaecomastia reduction surgery.
RISKS
Although serious complications from male breast reduction surgery is uncommon, potential candidates should understand that every procedure comes with it a certain risk for possible complications and has a recovery period (down time). Preoperative preparation and postoperative preparation will minimize their incidence.
The more common complications from male breast reduction surgery are:
- Bleeding (primary or secondary)
- Swelling
- Bruising
- Infection
- Poor wound healing (especially in smokers)
- Numbness
- Scarring
- Skin discoloration
- Asymmetry
- Possibility of revision surgery
- Anaesthesia risks
The risks mentioned above can be minimised if proper preoperative and postoperative instructions are adhered to.
PRE-OPERATIVE PREPARATION
- Stop all non-medical supplements for at least one week before surgery.
- Stop taking any anti-inflammatory pain medications , blood thinning medications (anti-platelets, anti-coagulant), and aspirin one week before the procedure.
- All medical conditions (hypertension, diabetes, etc) need to be optimized prior to surgery.
- Smokers need to stop smoking well in advance.
- Some individuals might require prior blood investigation or further medical assessment.
POST-OPERATIVE
After the surgery, there will be some swelling, bruising, discomfort, numbness and discoloration for several days that can be controlled with oral medications, cold compression and ointments. The swelling and bruising usually last between 2-3 weeks but in some patients, this can last longer.
Oral antibiotics and analgesics will be prescribed to reduce the risk of infection and postoperative pain respectively. Stitches will be removed about 7 days after the surgery. The final result of surgery will appear within several weeks, but it may take up to a year for the scar to fully mature.
CARE
- Wear compression garment for 4-6 weeks after surgery.
- Avoid strenuous arm activities and swimming for 1-2 weeks.
- Regular antibiotic ointment on the surgical wounds.
– COPYRIGHT OF DR FAIZAL ALI
