Introduction

What is a Male Breast Reduction (Gynecomastia)?

Male Breast Reduction (Gynecomastia) is a procedure to reduce breast size in men by removing excess skin and fat to flatten and enhance the chest contours. Gynecomastia is a condition of overdeveloped or enlarged breasts in men that can occur at any age. It can be the result of hormonal change, heredity, underlying disease, obesity or the use of certain drugs. It can cause emotional discomfort, depression and impair self-confidence due to difficulty in fitting in clothes as breast size and nipples are noticeable. 

Beneficial of reducing the breast size:

  • Flatter, and tighter chest
  • Gain the self-confidence
  • Better clothes fitting

Limitations of Male Breast Reduction:

  • If unable to correct the cause of the breast enlargement, breast growth may return
  • Excess glandular tissue development

Preparation

How to prepare for Male Breast Reduction surgery?

  • Consult with a plastic surgeon about the surgery including steps, techniques, incision, operating hours, results, risks, complications and recovery recommendation.
  • Evaluate your general health status by an Internist such as; blood test, Chest x-ray, ECG based on the hospital safety policy.
  • Continue taking the current medications for your underlying disease.
  • Stop smoking at least 2-4 weeks prior surgery.
  • Avoid taking aspirin and anti-Inflammatory drugs including herbal supplements which can easily cause the bleeding tendency at least 2 weeks prior surgery or according to the physician’s advice.

Process

What are the steps of a Male Breast Reduction surgery?

There are 4 types for Male Breast Reduction:

1. In cases where gynecomastia is the primarily result of excess fatty tissue, liposuction technique alone may be used. The incision will be located under the breast.

 

2. Excision techniques are recommended when glandular breast tissue or excess skin must be removed to correct gynecomastia. The incision will be located at the lower part of the areolar.

 

3. Sometimes male breast reduction is treated with both liposuction and excision. This is recommended when glandular breast tissue or excess skin and excess fatty tissue must be removed. The incision will be located in both under the breast and the lower part of the areolar.

 

4. Nipple and Areolar Graft is a combination of Liposuction and Excision to reduce the areola or reposition nipples to a more natural male contour. This procedure is suitable for those who are obesed or had extreme weight loss such that there is a lot of excess skin and fat causing the position of the nipple and the areolar to be lower than normal. The incision will be located under the breast as long as there is excess skin to be removed and another incision will be located around the areolar for the nipple and areolar graft.

Indication

Who is a good candidate for Male Breast Reduction surgery?

  • Healthy
  • Men who are bothered by the feeling that their breasts are too large and abnormal growth like feminine breasts
  • Able to admit after surgery that there might be some changes of feeling such as hypersensitive or loss of sensation of nipples 
  • Have realistic expectations

Result

  • The results are apparent almost immediately following the  procedure. But the final results may take up to several months after surgery.
  • At the beginning period after surgery, the incisions will be swollen until the internal wound is healed. It generally takes up to 1-2 weeks. 
  • The skin appearance and sensation will gradually improve.
  • The scar will be visible after surgery. The scar may be good or bad depending on the heredity and after wound care. Normally the scar will be less visible in 1-2 years after surgery.
  • In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
  • Following your physician’s instructions is essential to the success of your surgery.

Recovery

  • After a surgery, blood and fluid may collect inside your body in the surgical area. The surgeon will insert a surgical drain tube and leave it there for 2 days before it can be removed. 
  • Surgeon will wrap your chest with an elastic bandage and cover with the gauze on the nipple and areolar. A garment support must be worn after the surgeon removes the surgical drain tube. 
  • An appointment will be made to remove the external stitches 7-10 days after surgery. 
  • Usually patients can return to work within 7-10 days after surgery.

Post-op care

How to take care of yourself after surgery?

Bruising and Swelling

  • Bruising and Swelling will occur within 48-72 hours after surgery. The third day is usually the worst and then it will gradually get better after day 4. 
  • Bruising will be better after 4 days and will fade away within 21days.
  • Swelling will subside quite quickly in the first 2-3 weeks and then gradually subside up to 3-6 months. 
  • Cold compress with a cold pack or a bag of ice is needed in the first 3 days. It will help to reduce swelling and bruising.

Pain and Medication:

  • The most painful period is right after the surgery and on the first day after surgery. In some patients, it will take some time before all the pain disappears. 
  • Taking anti-flamotory medicine only when you are in pain. Do not take it more than 6 times per day. 
  • There may be some side effects such as nausea or dizziness.
  • If a rash or itch occurs after taking medication, the patient must inform the surgeon immediately.

Medication Dosage:

  • The antibiotic medication must be taken until it is finished. 
  • Any underlying condition and medication must be informed and adjusted by a surgeon or medical doctor both before and after surgery. 
  • Do not take Aspirin or any medication in the Aspirin group, Vitamin E, herbs, or any supplements at least 2 weeks before and after surgery As they can cause bleeding and bruising.

Smoking and Drinking:

  • Stop smoking 4 weeks prior and 4 weeks post surgery as the Nicotine causes the delayed wound healing. 
  • Stop drinking 2-4 weeks prior and 2-4 weeks post surgery.

Sleeping:

  • Get enough sleep and rest after surgery.
  • Use 2 pillows to elevate your head; it will help reduce swelling.
  • It is a good idea to place 2 pillows on either side of your waist to rest your arms and to keep you from turning onto your side.

Wound Care:

  • Before the surgeon removes surgical drain tubes, patients can take a sponge bath.
  • After the surgical drain tubes are removed, the surgeon will place  waterproof dressing so you can take quick showers. 
  • Waterproof dressing will be removed within 48 hours after you are discharged from hospital.
  • Make sure waterproof dressings are clean and dry at all times.
  • Do not touch the wound directly after waterproof dressing has been removed.
  • Use wooden cotton buds with normal saline to clean the wound and apply antibiotic cream twice a day. 
  • The surgeon will remove stitches in 7-10 days
  • If there is any sign of infection or complications, please inform surgeons immediately.
  • Scar cream, scar gel, or silicone sheet can be used 5-7 days after removing all stitches or as soon as the wound is recovered.

Support Garment:

  • You must wear a support garment 24 hours for at least 1-2 months after surgery or as long as the surgeon recommends

Exercise:

  • During the first 5 days after surgery, it is important to not engage in any activity which will elevate the blood pressure and possibly cause bruising or hematoma under the skin.
  • Avoid exercise for at least 2 months after surgery 
  • Only light exercise is recommended 4-6 weeks after surgery
  • No weight lifting or heavy lifting in first 6 weeks
  • Avoid hot tubs or saunas for at least 6 months after surgery 
  • Do not participate in any contact sports for at least 6 months

Risks

Risks and Complications:

General Risks & Complications:

  • Complications of general anesthesia
  • Infection
  • Bleeding 
  • Blood Collection
  • Deep Vein Thrombosis
  • Keloid scar
  • Poor wound healing
  • Painful

Risks and Complication of Male Breast Reduction:

  • Necrosis and wound separation
  • Seroma
  • Numbness and change of skin sensation and weak muscle
  • Asymmetry of both Breasts and Nipples. ( Nipples size and areolar )
  • Chance of revision
  • The nipple and areolar are still in woman’s shape which may need another correction.
  • After surgery, the result can be changed after massive weight loss or a lot of weight gain.

Review

FAQs

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