Gynaecomastia

Length of operation: from 1 hr 30 min to 3 hours
Type of Anaesthesia: General
Length of stay in hospital: day case/1 night hospital stay
Recovery time: 10-14 days for the bruising and swelling to subside. Full recovery is between 3-5 months
Time off work: 5 – 7 days

About gynaecomastia: Gynaecomastia affects about forty to sixty percent of males in varying degrees, right from their teens to their 60s. It is the enlargement of the male breast caused by an accumulation of fat in the glandular tissue. The cause could be hormonal or due to the the intake of certain medicines. In most instances, there is no specific cause and no detectable abnormality, either on blood tests or clinical examination. Gynaecomastia can be dealt with by a procedure which involves a combination of liposuction of the fat accumulated in the breast and excision of the breast disc, if required. This surgery will give you flatter, better-contoured, and firmer breasts than before.

Suitable candidate:  Men who are self-conscious of their appearance due to the largeness of their breasts or due to asymmetry in breast (chest) size.

Reasons not to go ahead:  patients on blood thinning medicine, active smoking, excessively overweight patients.

Pre op: The consultation with your surgeon will be your opportunity to discuss your expectations, learn about the surgery and ask queries or clarify any doubts you might have. The surgeon will perform an examination in order to be able to assess your individual needs and discuss the results in length with you.

On the day: If you decide to go ahead with the procedure, you will receive advice about what to do and what to avoid, prior to surgery. Following the operation, a small dressing is applied to the site for the incisions made for liposuction or for the removal of the breast disc.

Post op: Most patients are able to shower and change the dressing themselves at home. Dressings need to be kept dry and clean for one of two weeks after surgery. An appointment will be made for removal of sutures about seven days following the operation, when the wounds will be inspected and cleaned. A pressure bandage or binder is applied around the chest to decrease the swelling. This is normally worn for a week or two after the procedure. The patient will receive a complete list of postoperative care instructions before leaving the hospital, including how to care for the surgical site and scars including application of moisturising cream and massage to help the swelling and the bruising to settle, medications to take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in overall health.

A review appointment is usually offered one to three months after the operation.

Convalescence: For the first couple of days you will feel tired and sore. The breasts can be bruised and swollen. There may not be a significant change in the size of the breast following surgery in the first few weeks as the fat that is removed is replaced by fluids . In approximately six weeks this fluid will be absorbed and a reduction in size is then visible. There will be scars after the operation and they will be firm and pink for about a month and a half. They may even remain the same size for several months. These scars may take up to two years to fade – the time differs from patient to patient

It is possible to do light activities for the first few days but it is not advisable to do any strenuous activity for the first four weeks. On average, recovery will take around four weeks.

Risks and complications:  A small percentage of patients can have complications just like for any surgical procedure. However, significant complications from gynecomastia surgery are infrequent.
Infection – can be usually readily treated with an antibiotic.
Haematoma (blood clot under the skin) or bleeding – a re-visit to the operating theatre may be necessary.
Delayed healing of the wound – particularly true in case of diabetic patients or those who smoke. This needs to be discussed with the surgeon during the consultation stage.
Mild asymmetry – may occur especially when the breasts are uneven to begin with.
Necrosis or vascular impairment of the nipple is very rare following this procedure.

Effects of the procedure:  Most patients who go through this surgery are pleased with the results. Very rarely it may be necessary for patients to have a revision procedure following treatment of gynaecomastia.