Male breast reduction (gynaecomastia)

What is gynaecomastia?

Gynaecomastia is a surgical procedure which involves removing excess breast tissue, fat and/or skin to reduce the size of the male breast. The breast is made up of two main components, glandular tissue, which is firm and dense, and fatty tissue, which is soft. The ratio of glandular to fatty tissue in any breast varies from individual to individual and in gynaecomastia there may be an excess of both.

What does this involve?

Gynaecomastia surgery is carried out under a general anaesthetic and can be performed on a day case basis or may require a one night stay in hospital.

There are various techniques that surgeons can use to perform this operation. One approach is to make a half moon incision around or below the nipple, and then excess breast tissue, fat and/or skin is removed. Another method is the use of liposuction. A small incision is made under the nipple or towards the armpit. Using a fine cannula (a thin metal tube), the excess breast tissue and fat are broken up and suctioned away. Once the procedure is complete, any incisions are closed with sutures. Your surgeon will advise which is the most appropriate technique in your case.

Following the procedure you will be taken from the operating theatre into the recovery suite where you will be looked after until you are fully awake. After this, you will return to your room, where nursing staff will check your dressings and monitor your pulse and blood pressure at regular intervals.

The anaesthetist will prescribe painkillers and you should take these regularly for the first week or so. Pain can slow down your recovery, so it is important to discuss any discomfort with the nursing staff.

You may have drainage tubes in your chest - these have bottles attached to them and are there to drain away any excess fluid. The drains are removed before you are discharged home.

There may be a drip in one of your arms - this is to keep you well hydrated. This will be removed when you are able to drink a satisfactory amount.

You will have wound dressings and a supportive compression garment or vest in place.

When will I recover?

After gynaecomastia surgery you are likely to have some pain/discomfort, swelling and bruising in the chest area. These are temporary and should subside after the first few weeks. It may take several months for your chest shape to settle.

Your surgeon will advise you as to how long you are required to wear your supportive compression garment and whether it is to be worn day and night.

You will receive a post-operative telephone call from the specialist nurse one to two days after your discharge home to ascertain your progress and well-being. You will also receive a follow-up appointment at which your surgeon will assess your progress and give advice on when you can resume your normal activities.

You must avoid strenuous exercise, heavy lifting and swimming for four to six weeks after surgery. You should only resume driving when you are confident that you can safely perform an emergency stop without experiencing discomfort.

The length of time you will need to take off work will depend on your type of employment, but is usually a minimum of one week.

What risks should I know about?

Gynaecomastia surgery is a commonly performed and generally safe procedure. However, all surgery carries an element of risk.

The possible complications of any surgery can include an unexpected reaction to a general anaesthetic, excessive bleeding, infection and developing a blood clot (usually in a vein in the lower leg, known as a deep vein thrombosis).

You will be left with visible scars following your surgery. Initially they will be red and slightly raised, but they should gradually soften and fade over the following months. Some patients experience numbness in the chest area and/or a loss of nipple sensation. Rarely, alterations in the blood supply may lead to loss of part or all of the nipple.

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