Gynaecomastia refers to a condition affecting men in which there is excess breast tissue. This may affect both breasts or just one and can occur in small children, during adolescence and in adulthood. A variety of factors can cause gynaecomastia but in general there is an imbalance of oestrogen (female hormone) over androgen (male hormone). Some cases are hereditary or related to weight gain, medications, liver disease or recreational drugs (anabolic steroids, marijuana, alcohol). The majority of people seeking treatment for this condition are in their teenage years or older. The condition is particularly evident when patients wear tight fitting clothes or T-shirts. Gynaecomastia can result in significant psychological distress and affect self-esteem. Prior to referral to a Plastic Surgeon many patients have investigations (blood tests to assess hormonal levels) ordered by their GP or Endocrinologist. In many cases no cause is found and patients are then counselled regarding the benefits and risks of surgery.
Good candidates for surgery are in their later teen years or older (so that they have finished their pubertal growth spurt), have a stable weight in a healthy weight range, do not smoke, drink excessive alcohol or use recreational drugs. They must be willing to accept surgical scars and have realistic expectations of what can be achieved. Your Plastic Surgeon will assess each individual patient and determine your suitability for this procedure.
Surgical procedures for this condition consist of liposuction, breast reduction surgery or a combination of the two. While liposuction is suitable for some patients and avoids large scars, it is not suitable for patients with excess breast skin, nipple-areolar deformities (e.g. pouting nipple, or large areola – the pigmented skin around the nipple). These patients benefit from an open excision of the excess breast tissue and re-shaping of their nipple and areola. This can be performed through an incision around their areola, which effectively camouflages the resulting scar. Often liposuction is combined with this open procedure. In a minority of patients with a large amount of excess skin, scars may need to be more extensive and as such harder to hide.
Your surgeon will discuss your anticipated postoperative course at the time of booking in for surgery. It is important that you understand at this stage the level of activity you can undertake after surgery. In many instances this may require time off work, recreation and usually a period where you will not be able to drive your car.
Before your surgery your surgeon will ask you to bring a garment, which is tight fitting and elastic (e.g. sports compression vest) to put on after surgery. The surgery is usually performed in hospital as a day case or an overnight admission and requires a general anaesthetic. You will have a small dressing over each breast, which may need to be kept dry for a week.
After surgery, your surgeon will talk to you or a family member where possible to explain what was performed and how the surgery went. Patients receive local anaesthetic into the surgical site and have minimal discomfort in the first few hours after surgery. At discharge from the hospital, you will be given pain-killers (analgesia) and in some cases, antibiotics. If you develop a rash, nausea, headache or vomiting this may be a side effect of medications, please contact us and discontinue the tablets. Keep your dressings on and dry until the first postoperative review. Please ask nursing staff in the hospital how you can shower while keeping your dressing dry. The review date and time will be written down and given to you prior to discharge.
Please report any increasing pain (especially sudden), redness, warmth or discharge from your surgical site. These signs can indicate a wound infection, and necessitate a prompt review at our rooms. Also report excessive bleeding, as this may be a sign of a collection of blood under the breast. Please contact our nurse on 9853 9705 if you have any concerns about the wound. In case you are unable to get hold of our nurses and the matter is urgent you can contact your surgeon on the mobile number.
Please modify your activity as indicated by your surgeon. These limitations vary and should be discussed with your surgeon before and after surgery and at the postoperative review. In general, avoid public pools, strenuous activity or activity that can potentially lead to excessive stretch of your wound(s). All of these can compromise wound healing and the final outcome. Patients can start running one week after surgery, but should avoid contact sports and heavy lifting or gym work for 6 weeks.
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*Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.