Gynaecomastia Surgery Guide
Most men would prefer to have a flat, manly chest. While pectoral exercise can create a toned, masculine appearance, there is a medical condition that prevents some men from having the chest they want. Gynaecomastia, or male breast gland enlargement, is estimated to affect up to 50% of men. The condition causes the development of breasts with a rounded, feminine shape that some men find cosmetically displeasing.
What is Gynaecomastia?
If one or both male breasts are enlarged despite reaching a healthy weight, gynaecomastia could be the cause. In true gynaecomastia, an imbalance of estrogen and testosterone levels are to blame. These hormones signal the breast gland to become overactive. This causes the breast tissue to grow excessively, mimicking the appearance of female breasts.
What are the Symptoms of Gynaecomastia?
Common signs of gynaecomastia include:
- Round breasts
- Tenderness or pain
- Enlarged or swollen nipples
- Firm, rubbery lump behind the areola
- Increasing breast size, despite maintaining a stable body weight
Not all symptoms must be present to diagnose gynaecomastia.
Why is Gynaecomastia a Problem?
Gynaecomastia is mostly a cosmetic nuisance. Yet for many patients, it takes a psychological toll. The condition can adversely affect a man’s quality of life in numerous ways.
Patients with gynaecomastia may:
- Lose confidence
- Fear being ridiculed
- Feel different from other men
- Use chest tape or compression garments
- Hide behind layers of clothes or wear jackets when it’s hot
- Avoid activities that require going shirtless, such as intimacy or swimming
How is Gynaecomastia Diagnosed?
Men with enlarged breasts should see their GP. Male breast enlargement has many causes. Gynaecomastia is just one of them. It is important to see a doctor because the condition may signal an underlying hormonal problem.
There are no diagnostic tests for gynaecomastia; Usually, a physical examination of the breast tissue is all that is needed. A doctor may diagnose gynaecomastia by feeling for the gland itself, which tends to be firm and rubbery. Diagnostic imaging may be used to rule out other causes. Patients may be asked about medications they are taking and lifestyle factors that may affect hormone levels.
What is Gynaecomastia Surgery?
After being diagnosed with gynaecomastia, a male breast reduction (or “gynaecomastia surgery”) may be the next step. This procedure removes the faulty gland and excess breast tissue. Chest liposuction is often done along with gland excision. The goal is to create a more masculine chest and stop the breasts from growing larger. A body contouring or cosmetic surgeon usually performs the surgery.
It is important to note that gynaecomastia surgery is a cosmetic procedure. It creates a flatter, more masculine chest. It removes the gland so that male breasts cannot continue to grow larger. However, it does not treat or cure the underlying cause of gynaecomastia, which is a hormonal imbalance.
What are the Benefits of Gynaecomastia Surgery?
Some of the advantages of gynaecomastia surgery may include:
- A flatter chest
- Better pectoral definition
- Increased willingness to go shirtless
- Freedom to wear tailored shirts and singlets
- Feeling more confident at the beach, pool, sauna, and gym
- No longer having to use chest tape, compression garments, or nipple covers
Who is a Good Candidate for Gynaecomastia Surgery?
Gynaecomastia can strike at nearly any time in a man’s life, from youth to retirement age. The sudden hormonal changes of puberty often lead to an increased breast size. Pubescent gynaecomastia may resolve on its own once puberty ends. If gynaecomastia persists into adulthood, surgery may be considered. Older men can develop gynaecomastia as well. Low testosterone levels and certain medications are often responsible for breast enlargement in mature patients. Finally, athletes with a history of steroid use may also develop gynaecomastia.
To learn if you are a candidate for gynaecomastia surgery, speak with a qualified surgeon. A body contouring surgeon, for example, can use their expertise to determine if removing the gland is the best approach. If the gland is not faulty, but excess fat is present, then chest liposuction may be performed without gland excision.
The typical candidate for gynaecomastia surgery:
- Is at least 18 years old
- Has a healthy body mass index (BMI)
- Can take at a few days off to recover
- Accepts that all surgery comes with risks
- Has been diagnosed with gynaecomastia
- Maintains a stable weight for at least six months
- Understands there will be a scar under the areola
- Has enlarged breasts with a feminine appearance
- Is a nonsmoker, or is willing to quit before surgery
What Happens During the Gynaecomastia Operation?
Gynaecomastia surgery is performed under general anaesthesia. The surgery involves removing the breast gland. Chest liposuction may be done at the same time. One or both breasts may be treated. Liposuction does more than remove fat. It helps to feather in the tissue that surrounds the gland to prevent a saucer deformity once the gland is removed. The gland is removed through a small incision beneath the areola. Most patients go home the same day.
The breasts should take on a more normal male appearance immediately. Post-operative swelling is common Therefore, it takes a few months to see the final results.
Aftercare is minimal. Typically, the patient wears a compression garment for several days or weeks. Drains (hollow tubes) are used to prevent fluid buildup at the wound site. They are usually removed by the surgeon a day or two after surgery. Pain relief medications may be prescribed.
Most patients take a few days off to recover. Work and driving may resume as soon as the patient feels ready. It is imperative to avoid rigorous physical exertion for at least six weeks. Upper body workouts and heavy lifting are off limits.
Swelling and bruising are likely to occur. Bruising usually resolves in 14 days or less. Most patients find the initial swelling goes down in just a few weeks. Swelling can persist for six months or more. The incision takes a few weeks to heal. Scar fading is a process that takes approximately one year. Mature patients may notice their scars fade faster.
Gynaecomastia Risks and Complications
Gynaecomastia surgery is considered safe for healthy nonsmokers. However, all surgery comes with risks. Minor complications are more common than serious ones. Possible risks include*:
- Nerve damage
- Wound breakdown
- Hematoma (bruising)
- Uncontrolled bleeding
- Poor reaction to anaesthesia
- Scar widening or keloid scars
- Seroma (fluid buildup, which may need to be drained)
- Undesirable cosmetic result that requires a revision surgery
*Other risks are possible.
Selecting a qualified surgeon is important. When choosing a gynaecomastia surgeon, be sure to ask about any credentials, medical schooling, fellowship training, licenses, and hospital affiliations the surgeon has obtained. The more experienced, the better. The surgery should take place in an accredited hospital or private surgery center.
Gynaecomastia Surgery FAQ
Will there be a scar?
Yes. The gynaecomastia scar usually follows the curve of the lower areola. Because the areola is darker than the surrounding skin, the scar is usually not obvious. Different surgeons may use different incisions. Consult with a surgeon to ask about the surgical approach they intend to use.
Does health insurance cover gynaecomastia surgery?
Rarely. In Australia, like most other places, patients generally pay out of pocket for cosmetic procedures such as gynaecomastia surgery.
How much does gynaecomastia surgery cost in Australia?
The gynaecomastia cost varies based on a surgeon’s skill, experience, equipment, and geographic location. It is often less costly than other cosmetic surgery procedures for the face and body. In general, patients can expect to spend a few thousands dollars. Some surgeons accept financing and payment plans.