Gynecomastia (enlarged or overdeveloped male breasts) is encountered at any age. It may be the result of hormonal changes, heredity, some medicines or diseases. Gynecomastia may be more than just a physical problem – it may cause emotional discomfort and may affect an adolescent or adult male’s self-confidence. Wishing to hide their physical defect, some patients end up avoiding certain physical or intimate activities.
If you have gynecomastia breast reduction surgery may be a solution. Excess skin, glandular tissue and fat are removed. This leads to a more masculine, a better proportioned torso.
What is gynecomastia?
Gynecomastia’s main feature is the presence of enlarged breasts, disproportioned to a masculine body. The surgery designed to correct this anomaly is reduction mammoplasty; the result is a flattened and improved contour of anterior thorax. In severe cases, the weight of excess mammary tissue may cause the aspect of sagging breasts, with enlarged areolas. In this situation, areolar size and position may be improved and the excess skin surgically removed.
Gynecomastia may develop following the hormonal changes in adolescence; it may be the result of heredity, certain medicines, excessive alcohol consumption and smoking, use of marijuana or anabolic steroids. Enlarged breasts in obese males are not categorized as gynecomastia; they are just the consequence of being overweight.
In gynecomastia cases we encounter three types of modifications:
- localized excess fat;
- overdeveloped glandular tissue;
- o combination of the previous conditions.
Gynecomastia may affect just one or both breasts. In some cases, correcting gynecomastia may be considered a reconstructive procedure, not an aesthetic one. The surgery may be performed at any age, but the best results ensue if the natural growth process is complete. Therefore, if the patient is an adolescent, new surgery may be required in the future should breast development continue.
The ideal candidate for this surgery is the normal weight man whose breast development is complete. Before surgery is mandatory to obtain a full medical history, to perform a physical exam associated with diagnostic endocrine lab tests in order to uncover any possible cause.
Where do I begin?
A consultation with your plastic surgeon is the first step to understand how a reduction mammoplasty can correct the torso profile, giving you a more masculine appearance. Your doctor will discuss with you the available options according to your wishes. You will be informed about the possible results and the associated risks. The success of your surgery needs that you honestly share your expectations, any ongoing medical treatments, the use of alcohol, tobacco and recreational drugs (marijuana).
Make sure your surgeon is a board-certified member of the Romanian Association of Plastic Surgeons.
Correction of the gynecomastia
Choosing the right technique for correcting gynecomastia depends on several factors:
- the underlying cause;
- the excess of mammary tissue and particular composition (fat, glandular tissue or skin);
- age and overall health.
If it’s just an excess of adipose tissue, liposuction techniques only will be used. These require that a cannula (a hollow metal tube with multiple holes) is inserted through several small incisions. The cannula is connected to a surgical aspirator which helps to remove the excess fat.
The surgical excision is recommended when we have to excise excess skin or glandular tissue. Sometimes a reduction of the areolar diameter or nipple repositioning may be necessary . The incisions may vary according to necessities and surgeon’s preferences. Most of the incisions are made around the areola or in the breast crease.
Preparing for surgery
The plastic surgeon will inform you about every aspect of the operation. You will be instructed about any necessary lab tests, any recommended medicines and the chosen type of anaesthesia.
You will be asked to sign an informed consent in order to assure your surgeon that you fully understand the procedure with all the possible risks and complications. Among the possible risks are bleeding, developing an infection, alterations in nipple sensibility. Any surgical procedure comes along with anaesthetic risks.
What to expect?
The surgical procedures to correct gynecomastia require hospitalization for 2-3 days.
After surgery
After completing the surgery, the incisions are covered with dressings. An elastic bandage will help minimize the edema and will support the new breast contour. Sometimes drains are inserted to evacuate any fluid or blood collections underneath the skin.
At discharge, you will be instructed about any local wound care, necessary medication to help the healing process or to reduce the risk of infection and also about follow-up visits.
The healing process
In the first days following surgery you will feel some swelling and discomfort at the incisions. These can be controlled with medication. An elastic bandage is recommended. A return to light activities is possible a few days after surgery. If non-absorbable sutures were used, they have to be removed at 10-14 days. You will be able to return to work in 10 days if you don’t have to do any heavy lifting.
The healing will continue over the next few weeks as the edema subsides and the new chest contour settles. The scars will improve in time.
Results
The aspect obtained by breast reduction is permanent in the majority of cases. If your gynecomastia was a consequence of using certain medicines, steroids or marijuana you have to renounce them completely. All scars are permanent, but are easily concealed in the natural anatomic contours. They are the tribute paid to restore a male chest profile; you will have a better self-image and confidence.
Your surgeon, your choice
The decision to have cosmetic or reconstructive surgery is important, as well as choosing the right surgeon. Not all the doctors performing these procedures are plastic surgeons. Make sure your doctor is a board- certified plastic surgeon, member of the Romanian Plastic Surgeons Association.
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