Male Breast Reduction (Gynaecomastia Correction)

Male breast reduction is an operation to reduce the size of enlarged breasts by removing excess fat and glandular tissue Although rarely discussed, male breast enlargement (gynaecomastia) is a common condition. Gynaecomastia is mostly developmental in teenagers and young adults but can also be due to drug intake, hormonal abnormalities and rarely liver or testicular problems. Being overweight can also increase the likelihood of having excess breast tissue but most cases have no obvious cause. It can occur after puberty or later in life. It is important that gynaecomastia is fully investigated by your GP, Paediatrician, Breast Surgeon or Urologist. The indications for gynaecomastia treatment include social embarrassment, self consciousness and persistence despite medical treatment.

Male breast reduction can be undertaken usingliposuction alone, open excision of the breast tissue or often a combination of the two depending on the extent, distribution and consistency of the breast tissue and your skin quality. Pendulous breasts, more common in adolescents, often require a reduction of not only the enlarged breast tissue but also the excess skin via larger circular or elliptical incisions. Excess skin is present in males with very large breasts or in patients in whom rapid weight loss has caused a sagging of the skin across the chest and left the breasts looking more pronounced. After examination Professor Malata will determine in conjunction with you the technic most suited to your anatomical abnormality. Professor Malata is an international authority on gynaecomastia correction.

Liposuction leaves minimal scars; Dr Malata uses the acclaimed ultrasonic assisted liposuction, which minimises bruising, increases skin contraction and is far more effective than traditional liposuction. Overall ultrasonic liposuction of gynaecomastia leads to less likelihood of open excision of tissue and revisional surgery compared to conventional liposuction.

Where the breasts are significantly enlarged, liposuction may not be adequate, as it would leave loose folds of skin, which would be unsightly and asymmetrical. In these instances combination of liposuction and the surgical removal of excess skin would be performed. Such open excision of gynaecomastia is also performed when the breast tissue is too firm to be treated by liposuction effectively.

Incisions (and scars): Stab incisions for liposuction are generally made in the infra-mammary crease or occasionally in the axillary line. Where open excision of the breast glandular tissue is needed this is performed via a peri-areolar incision that is a cut around the lower ½ of the dark skin surrounding the nipple (the areola), and through it the excess fat and breast tissue are removed. In Professor Malata’s practice a variable degree of liposuction is always performed at the start of all operations to remove excess fat in the breast area and to taper in the contour. Often liposuction alone is enough on its own to treat fatty or largely fatty breasts. For removal of excess skin different skin reduction patterns are used.

After surgery: Following the operation, you will need to wear a pressure garment for up to four weeks, to help reduce bruising and swelling, fluid collection under the skin (seroma) and to help the healing process. The breast area will feel sensitive, sore and tender for a few weeks after surgery but this will reduce with time. There will also be some scarring and how noticeable it is will depend on the amount of skin that has been removed. The scarring will fade over time and Professor Malata will discuss this with you before the operation.

To view the before and after photos in Professor Malata’s publications on gynaecomastia or male breast reduction click here:

• Ultrasonic Liposuction in the Treatment of Gynaecomastia;

• A systematic approach to the surgical treatment of gynaecomastia;

• Gynaecomastia - An algorithmic approach to surgical management (with special emphasis on liposuction)

As in any cosmetic surgery, there are risks as well as benefits and the final results are not guaranteed. The chance of complications following surgery for male breast enlargment depends on the exact type of operation needed and other factors such as your general health. Professor Malata will explain how the risks apply to you. Detailed postoperative instructions will be discussed during consultation and a procedure-specific handout given to you by Professor Malata.

Some risks of gynaecomastia correction:

Frequent:

• Bruising & swelling: common

• Sensory alterations of the nipple areas: numbness, tingling, sensitivity, tenderness, etc

• Lumpiness or irregularities of the breast areas – often temporary

Infrequent:

• Bleeding and haematoma: uncommon

• Seroma formation

• Residual asymmetry

• Nipple inversion/ tethering

• Depression of the nipple areas

• Skin redundancy: loose folds of skin

• Wide scars hypertrophy

• Occasional need for revisional surgery: asymmetry, residual tissue, skin excess, depressed nipples

Very Rare:

• Infection: rare

• Skin necrosis: very rare

• Recurrence

Alternatives to gynaecomastia surgery:

• no surgery: loose clothes

• weight loss (diet & exercise): if breast enlargement due to overweight, may ↑ droopiness

• drug treatment: for early onset tamoxifen, etc

• radiotherapy: can work preventively – elderly men before prostate cancer treatment