Understanding gynaecomastia is essential to knowing whether it needs treatment or not. Often called “man boobs”, gynaecomastia is a common problem that can develop during the teenage years. It usually disappears as an adult. It is not life threatening and adult men can develop it which may impact their self-esteem.

Gynaecomastia is when the breast tissue grows larger than normal and the tissue around the nipple starts to feel rubbery and spread across your chest. This tissue can be painful or tender to touch.

Changes to your breasts may be a red flag for breast cancer but, if the changes relate to gynecomastia then it is benign. It can cause anxiety and stress and embarrassment about how the chest looks. This can cause men to avoid some activities or clothes that may make the condition more prominent.

Causes include gaining weight, the onset of puberty and medications such as steroids.

Treating Gynaecomastia

Often gynaecomastia resolves itself without any sort of treatment. It can also be the result of a medical or hereditary condition or a side effect of some medications.

If it affects your self-confidence, causes pain or the area is tender can be when surgery is recommended for gynecomastia. Before surgery is offered as a treatment option, your specialist plastic surgeon will give you a physical examination.

Questions to Ask Your Surgeon

Questions to ask your surgeon about gynaecomastia include:

• Are you an experienced, qualified gynaecomastia surgeon?
• Will the surgery be done in a hospital or your clinic?
• How long does the surgery take?
• Is it day surgery or do I have to stay in hospital overnight?
• Am I a good candidate for gynecomastia surgery?
• What technique would you use?
• Do I need to make any lifestyle changes before the surgery?
• How long is the recovery?
• How much time will I need off work?
• What are the potential risks and complications?
• If the results are not as expected, will you do revision surgery?

Preparing for Gynecomastia Surgery

You specialist plastic surgeon will give you a list of pre-operative instructions. These may include:

• Losing weight or making changes to your lifestyle to minimise complications so you get the best results.
• If you are a smoker, stop smoking for a couple of months before and after the surgery to promote better healing.
• Avoid lying out in the sun because a tanned chest may increase the risk of darker scars.
• Make sure you are hydrated before undergoing surgery to help your recovery.
• Let your surgeon know if you are coming down with a cold or feel sick in the seven days prior to the surgery.
• Stop taking medications that contain aspirin and blood thinners. It is important that you let your surgeon know about all the medications, including over-the-counter and herbal supplements, so they can advise you how to adjust your regime before the procedure.
• Do not shave your chest hair for two weeks before the operation.
• Submit the results of all tests your surgeon asks you to do.
• Make sure you have clean, comfortable, loose-fitting shirts to wear in the first four weeks of your recovery.
• Take a week off work or two weeks if your job is physically strenuous.
• Prepare a recovery area to make it easier to access everything you need.

Gynecomastia Surgery Process

Before having surgery, make sure you have realistic expectations of the outcome.

On the day of the surgery:

• You will either have the procedure in a hospital or your specialist plastic surgeon’s clinic.
• The procedure will take around three hours to complete.
• You will normally have a general anaesthetic but there are some cases where the procedure is done under a local anaesthetic.
• The surgeon will follow the surgical plan as discussed with you prior to the surgery.
• Once surgery is complete, you will go to a recovery area and be continually monitored.
• There may be drains from the wound to remove fluid from the surgical site.
• You should be able to go home once you wake up and everything is going well.

The Procedure

Once you are asleep, your specialist plastic surgeon makes an incision at the edge of your areolas. They then lift these up to remove the excess breast tissue (and sometimes skin). If you have severe gynecomastia, they may also make an incision under each breast to remove any excess skin. The areolas are then stitched back in place.

In some cases, your surgeon may also use liposuction to remove excess fat from the area through small incision which are then stitched closed. You will receive pain medication to take home.

Recovery and Aftercare

If you only need liposuction to treat your gynecomastia, your recovery from the procedure will be less than a week.

Where you have surgery to remove excess tissue and skin, your recovery can take between two and four weeks before you can go back to your normal activities.

A rough recovery and aftercare timeline can include:

• Rest immediately after the procedure. When you feel able, eat a light meal and take your medications. Walk around for about 15 minutes every hour to keep your blood circulating. Avoid lifting anything heavier than a few kilograms, the children and having sex for at least two weeks.
• Avoid showering for the first 24 hours after surgery. You do not want to get the bandages wet. If you want to, have a sponge bath. You can shower normally once your surgeon removes the bandages.
• Sleeping position.For the first three days, sleep and rest at a 45 degree angle on your back. Use pillows or cushions to help you maintain this angle. You can go back to your normal sleeping position when it feels comfortable.
• Do not drive for the first three days, or if you feel dizzy or are taking pain medications that make you sleepy.

If you think you have gynecomastia and want to see what your options are, make an appointment for a consultation with an experienced specialist plastic surgeon at Pure Aesthetics.