Male Breast - Gynaecomastia
Gynaecomastia is a condition by which males develop breast tissue due to an imbalanced ratio of oestrogen and androgen activity. It is a common condition with at least a third of men experiencing gynaecomastia in their lifetime. This can cause considerable embarrassment and there can be a concern to the patient for the potential of breast cancer developing although this is a rare occurrence.
What is gynaecomastia?
Physiological gynaecomastia most commonly occurs in
adolescence as delayed testosterone surges at puberty relative to oestrogen. It is less common in the older population secondary to decreasing testosterone
levels with increasing age.
Pathological gynaecomastia results from changes in the
oestrogen/androgen activity ratio and underlying mechanisms such as:
Lack of testosterone: Causes include Klinefelter’s syndrome, androgen insensitivity, testicular atrophy or renal disease.
Increased oestrogen levels: Causes include liver
disease, hyperthyroidism, obesity, adrenal tumours, or certain testicular subtypes.
Some types of medication can cause this such as digoxin, metronidazole, chemotherapy, anti-psychotics or anabolic steroids, as well as all of the prostate cancer medication. It is important to differentiate between Gynaecomastia and adipose tissue in the breast region due to being overweight and therefore in this case surgery should not be carried out. Investigations are only necessary if the cause of Gynaecomastia is unknown.
Gynaecomastia surgery is carried out to reduce the appearance of a man having “breasts”. By removing excess glandular and fatty tissue from the area flattens it resulting in a more muscular appearance to the chest area. This result can restore self-confidence and boost self-esteem.
Your consultation for plastic surgery with Mr Ferrando is an important step in the process of considering and undergoing cosmetic or reconstructive procedures.
This initial meeting allows the patient and surgeon to discuss goals, expectations, and potential outcomes, as well as evaluate the patient’s eligibility for the desired procedure. It will be an opportunity to ask questions or clarify any concerns that you may have. You will look at the “before and after” images of previous patients and get further information you need to make a decision.
Mr Ferrando will review your medical history and conduct a physical exam. He will then discuss all options suitable for you and explain each stage of the procedure or treatment. The exact procedure depends on the anatomy of the patient.
Our team believes that a well-informed, comfortable patient is one of the most important elements of the process. Whether you move forward with surgery or simply learn more, Dr Ferrando is looking forward to meeting you!
If the Gynecomastia consists primarily of excessive fat, Mr Ferrando will perform Liposuction to remove the excess fat. A small incision is made around the edge of the areola placed in the underarm area. A thin tube called a cannula which is attached to a vacuum pump and is then inserted into the incision. Using strong, deliberate strokes, moving the tube through the layers beneath the skin, breaking up the fat and suctioning it out.
If excess glandular tissue is the main problem of the Gynecomastia, an incision is made in an on the edge of the areola or in the under arm area. Working through the incision, Mr Ferrando cuts away the excess glandular tissue, fat and skin from around the areola and from the sides and bottom of the breast. If Liposuction is used to remove excess fat, the tube is usually inserted through the existing incisions.
A small drainage tube may be inserted through to draw off excess fluids. Once closed, the incisions are usually covered with a dressing. You chest may be wrapped into a compressive garment the skin firmly in place.
Anaesthesia and length of the procedure
Gynecomastia Surgery is performed under general anaesthetic. The operation normally takes around 2 to 3 hours to complete depending on the extent of the procedure. You will need to stay in the clinic overnight.
After the surgery, the compressive garment must be kept on for about a week. Drainage tubes will be removed before you leave the clinic. You may experience bruising and swelling for the first few days. Mr Ferrando will prescribe you pain relief medication to ease your discomfort.
Some type of stitches are dissolvable and will disappear over time, whereas others will need to be removed 5 to 7 days after surgery.
You should feel fine after 2-3 days after surgery. Patients are recommended to have at least 3 days off work to allow their body to rest and recover comfortably at home. Any strenuous exercise or activities should be avoided for at least 3 weeks after surgery.
Follow up appointments will be made for you after surgery, but if you have any questions, or you should feel unsure about anything, please contact Mr Ferrando and he will gladly talk to you. The well being of his patients is of utmost importance to him.
Risks and Side Effects
All surgeries carry certain risks and even though they are rare you should be aware of them before making your decision. Mr Ferrando will talk you through any possible risks and side effects at his consultations as they will vary depending on the patient’s anatomy, age, condition and lifestyle.
During his procedures and treatments, he does everything possible to minimise the risk of complications by practicing a meticulously detailed approach and applying his world-class training background.
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This initial contact allows the patient and surgeon to discuss goals, expectations, and potential outcomes, as well as evaluate the patient’s eligibility for the desired procedure.
It will be an opportunity to ask questions or clarify any concerns that you may have and get further information you need to make a decision.