Gynaecomastia, is abnormal breast enlargment in the male. Up to 60% of men may be affected by so-called ‘man-boob’ or ‘moob’, commonly around puberty. A second peak occurs around 60-years because of a testosterone/oestrogen imbalance. Some drugs (eg., cimetidine, cannabis) may be at fault, but medical treatment for gynaecomastia is unlikely to work. As excess fat also collects in the breast, weight loss helps.
There are 3 degrees of gynaecomastia:
- Grade 1 – a small mass beneath the areola that causes protrusion and the expression puffy nipple is often applied.
- Grade 2 – exists with a moderate and visible enlargement of breast tissue, but no skin excess.
- Grade 3 – indicates not only an excess of breast tissue, but skin also. Here much larger scars and possibly nipple grafting is required.
Although many hope ‘moobs’ may be removed by liposuction alone it removes only fat so the only secure method may be surgical removal, which leaves a small scar. Liposuction is frequently used, but to help smooth the edges.
More questions about male chest reduction surgery?
Naturally, you must be fit for surgery, but aims, expectations and compromises need discussing in detail. You must stop smoking both before and after the surgery.
General anaesthetic (GA) is required and incisions today are placed in the breast crease. Absorbable stitches are used and the procedure can be undertaken as a day-case if preferred.
Overnight stay is generally recommended as wound drains are used and you will awake to find your dressings concealed beneath an elasticated garment. There is usually little pain, but you may experience some tightness.
Light activities may start immediately after surgery in order to reduce the risk of clots forming. For any discomfort you will be provided with analgesia. Regular paracetamol is very effective and note that many strong painkillers can make you constipated.
There will be swelling that peaks over the first 2-3 days. Arnica helps settle bruising and most patients are back at work, and driving, 1-2 weeks after the operation. The incisions will have been closed with absorbable stitches so your dressings must remain dry and undisturbed until the wound review at one week.
It will be 6 weeks before you may attend the gym. You should wear the garment constantly as it helps mould the body, compresses the tissues and reduce swelling.
Whilst highly satisfactory, gynaecomastia carries risks, including infection, bleeding, altered sensitivity and active scar formation. There may also be some asymmetry, contour irregularity and the surgeon will be trying to avoid over- and under-correction.
Expectations are fundamental to any area of aesthetic surgery and you must consider many factors including any limitations.
