man boobs,male breast reduction, gynaecomastia,man boobs

Gynaecomastia (Male Breast Reduction)

Gynaecomastia (man boobs) is a condition where female like breast development occurs in males. Male breast reduction  is essentially a liposuction procedure combined with a limited open surgical excision. 

Before male Breast Reduction

 Before Male Breast Reduction and After Male Breast reduction surgery at The Clinic, Sandymount Green, Dublin 4

Causes:

In the vast majority of cases no cause can be found – the condition is termed idiopathic. In certain individuals the condition may rarely be linked to an underlying condition. A muscular male breast as seen in bodybuilders may lead to prominence of the breast. Prominent breasts have also been described in bodybuilders who use anabolic steroids.

Apart from Klinefelters Syndrome, a rare condition, there is no association between gynaecomastia and breast cancer.

Age Group:

Gynaecomastia is particularly prevalent in adolescents. However it also occurs with relative frequency in adults and older men.

Assessment:

Assessment of the individual with gynaecomastia is based on two fundamentals:

  1. Is there an underlying condition ? In the vast majority of cases there will be no associated medical condition. A thorough medical history and clinical evaluation must be carried out. Unless these reveal any underlying problem further investigation, laboratory tests or screening are not required.
  2. In the majority of individuals a detailed assessment of the breast is the basis of a successful outcome. The distribution of glandular breast tissue and fat must be recorded. The significance between the two tissue types is that fat can be successfully removed by liposuction whereas the firmer glandular tissue cannot be suctioned. It must be removed by open surgical excision.

Anaesthetic:

Local anaesthetic and sedation. General anaesthesia is required in adolescents.

Hospitalisation:

The majority of patients undergoing surgery for gynaecomastia do not require overnight admission to hospital and they can therefore be treated as day case patients.

The Procedure:

This entails the reduction of:

  1. The fibrous glandular tissue which is usually concentrated in the centre of the breast behind the areola / nipple.
  2. The fat tissue which is distributed more widely throughout the breast.

The glandular tissue is more difficult to remove. It requires an incision on the margin of the lower aspect of the areola. Through this incision a disc of glandular tissue is dissected and removed, the fat is removed by liposuction. Small puncture incisions are made in the fold under the breast through which the suction cannula can be introduced. The incision at the edge of the areola can also be used as a portal for the suction cannula.

If the amount of glandular tissue is small the correction can be carried out entirely through liposuction without any need to make an incision at the edge of the areola. Previously in the pre-liposuction era extensive incisions were made across or under the breast which left unsightly scars. There should rarely if ever be any need to resort such invasive procedures today but surprisingly I occasionally see patients in my Clinic with extensive scars on their chest following surgical correction of gynaecomastia carried out elsewhere.

On completion of the operative procedure the areolar incision is closed with dissolving buried sutures which do not require removal. The puncture incisions for liposuction are small and do not require suturing. Also leaving these small wounds open allows the fluid to drain out of the breast which reduces bruising and assists healing. Light dressings are applied over the incisions.

Operation Time:

Surgery for gynaecomastia can take approximately one to one and a half hours.

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Gynaecomastia Compression Garment worn post male breast reduction

Aftercare:

An elastic compression  vest is worn immediately following the surgery. It is worn for at least four weeks. It may be removed periodically for showering or other short periods. The chest area should be kept dry for seven to ten days by which time the wounds will have healed and the light dressings can be removed. Medications will include an antibiotic for five to seven days and pain relief.

Movement will be restricted and you will be confined to your home for about five days. After about four weeks you should begin gentle massage of the skin overlying the breast with skin cream.

Recovery:

This is usually relatively quick. Most individuals will be back on their feet within a day or two. You will be able to drive a car a short distance within one week. Repetitive movement of the arms must be avoided. You will not be able to resume jogging or gymnasium activities for about six weeks, particularly exercises that involve the arms. As regards work you could return to a desk job within one week, physical work in two to three weeks.

Risks of Male Breast Reduction:

Correction of gynaecomastia is essentially a liposuction procedure combined with a limited open surgical excision. There should therefore be few complications. One of the commonest errors that I see is overdoing the excision of breast tissue which leaves an unsightly appearance on the chest. This deformity can be difficult to repair but modern day fat transfer produces a reasonably good restoration of male breast shape. The objective of gynaecomastia surgery is to restore a normal male breast contour – not elimination of all breast tissue. There is also the risk of under doing the correction and leaving breasts that are still female in appearance. A re-do procedure may be required. Infection is a rare complication. Antibiotic medication for one week following the procedure reduces this risk.

To arrange a consultation with Mr James  Small

Tel: 01 219 6050 / 219 6051

Mobile: 086 021 1188

Fax: 01 219 6055

Email: info@theclinicsandymountgreen.com

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