Gynaecomastia Correction surgery (male breast reduction) is on the rise according to recent reports, but what exactly causes it? More commonly referred to as ‘man boobs’, Gynaecomastia is the build-up of breast tissue in men and can be distressing and embarrassing for sufferers.
A degree of breast development can be common in male puberty, but in some men, this does not spontaneously resolve, remains into adulthood. Certain drugs, hormonal disorders and weight issues are also causes of Gynecomastia; bodybuilders are easily susceptible to developing gynaecomastia with steroid use.
Gynaecomastia cannot be treated with diet and exercise, and unless a patient is grossly overweight no amount of exercise or healthy diet will re-establish a normal chest contour. It’s widely considered that the only option available to men suffering with Gynaecomastia is surgery
The type of Gynaecomastia surgery which is suitable depends largely on the severity of the condition. This will depend on the degree of fat or glandular tissue present along with the degree of skin excess. For most mild to moderate cases, liposuction along with some glandular removal is the normal procedure. If there is skin excess then skin removal and additional scars may be needed although this is relatively uncommon. In the severest cases of female-like breast development in men, a formal breast reduction will be necessary.
Mild to Moderate Gynaecomastia...
The most effective treatment for mild gynecomastia is liposuction. Since the fat on the chest is quite fibrous VASER liposuction is particularly useful in fat removal for the male chest.
In many cases Vaser liposuction can be used to re-¬contour the male chest, however in many cases Vaser on its own will not effectively remove the glandular tissue. Dr Chana has researched this and presented his work at the annual BAPRAS meeting (British Association of Plastic Reconstructive and Aesthetic Surgeons).
At this presentation a study of 100 cases of gynecomastia corrections using VASER liposuction were analysed, and demonstrated that a majority of patients required some degree of surgical gland removal combined with Vaser liposuction. The conclusion was that Vaser is not effective at removing the gland tissue but is effective at removing the fat on the male chest. In fact, a large part of Dr Chana’s work is carrying out secondary corrective surgery on patients who have had bad results from Vaser liposuction at non-surgical and commercial VASER clinics. The reason for this is that the doctor has failed to appreciate the need to remove the gland tissue. Also, the surgery is carried out under local anaesthetic which limits the complete removal of excess fat and limits the glandular removal. The majority of ‘practitioners’ at such clinics are not fully trained surgeons without any surgical qualifications let alone being fully trained Plastic Surgeons.
This picture taken during a procedure demonstrates the breast gland that is left behind after VASER liposuction. Obviously leaving this amount of tissue behind would result in an unsatisfactory result. This glandular tissue is removed by surgical removal that involves herniating it through a small incision in the areola as shown in this photograph. The patient’s right side has been completely treated and can be seen to be flat.
Vaser Liposuction
This procedure uses advanced technology to break up and draw off excess fat through a fine cannula.
• Vaser liposuction is a highly effective treatment for many gynaecomastia sufferers, often completely resolving the problem when combined with a gland removal.
• A small incision is made before a safe form of ultrasound energy is used to emulsify the unwanted fat. Generally considered more effective than standard liposuction, treatment with Vaser liposuction provides a quicker recovery time and enhanced skin retraction for patients, making it a popular solution to gynaecomastia.
• This is a surgical procedure, so you should expert some tenderness post-surgery. A compression garment may be provided to give the necessary pressure for healing.
A typical result following Vaser liposuction and gland removal is shown below:
Gynaecomastia Correction usually involves some degree of gland removal…
• Vaser liposuction can’t remove the very fibrous breast and glandular tissue usually found just behind the nipple, so in these cases surgery will be Vaser combined with some surgical removal.
• An incision is made at the lower margin of the nipple to gain access to fibrous male breast tissue behind the nipple. This is removed as shown in the photograph above.
Gynecomastia correction using surgery alone without liposuction…
• In some very rare cases, usually bodybuilders, there may be very little fat but primarily some mild to moderate gland tissue which can be palpated as a hardness behind the nipple. Usually in such cases the main complaint is not overall breast enlargement but protrusion of the nipple and areola over a well-developed pectoral muscle. In these situations, a simple gland removal on its own may suffice using a small incision at the edge of the nipple. These situations are particularly common in bodybuilder who have used steroids
Severe Gynaecomastia...
Severe cases of gynecomastia are characterised by excess skin. In most cases the best option is to undertake the VASER liposuction and gland removal first and then leave the skin to retract over a 6-month period. After allowing the skin to shrink, the scarring from any subsequent skin removal can be limited to a circular scar around the nipple.
In the most severe cases of female-like breast development in men, then a formal female type of breast reduction is required with an inverted ‘T’ or ‘anchor shaped scar. However, this is a very rare situation and the scars from it are much more visible.
What is the Recovery after Gynaecomastia Surgery?
Immediately after gynaecomastia correction surgery a flatter contour to the chest will be apparent but it can take around three months for the final result to be truly visible. Mr. Chana’s top tips for recovering from gynaecomastia correction surgery include:
• Patients should also avoid vigorous activity for a few days to reduce the swelling.
• Sleep upright at night for the first few days will reduce the swelling.
• It’s strongly advised patients avoid taking any aspirin like medication in the days straight after surgery since this exacerbates bruising and swelling.
• You should be aware that bruising of the skin may occur but will disappear in two to three weeks.
• Vigorous exercise should be avoided for about four weeks.
• Avoid smoking to reduce the risks of surgery.
• A compression vest is needed after surgery
If you’re considering gynaecomastia correction surgery booking a consultation with Dr Chana will provide you with comprehensive information about the procedures available.