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What Is Gynecomastia & Why Does It Develop?
Gynecomastia, colloquially shortened to ‘Gyno Surgery’, ‘Man Boobs’ or ‘Moobs’, is basically an excessive enlargement of the male breast.
Like the female breast, the male breast is made up of both glandular tissue and fat. An excessive amount of either tissue component, or sometimes both, will cause Gynecomastia.
Gynecomastia is very common — more than half of all boys develop the condition due to a hormone imbalance during puberty but it normally disappears as they grow older.
Approximately 35% of all adult males will develop Gynecomastia, and for treatment purposes, it is important to distinguish between TRUE GYNECOMASTIA and PSEUDO-GYNECOMASTIA.
TRUE GYNECOMASTIA is due to an enlargement of the glandular tissue of the breast. All males have a small amount of circulating oestrogen hormone in their bodies and any condition that causes an increase in the amount of oestrogen hormone, will cause gynecomastia.
PSEUDO-GYNECOMASTIA, on the other hand, is an enlargement of the male breast due to an excess of breast fat.
In some cases, Gynecomastia can be due to increased amounts of both glandular tissue and fat as shown in the illustration below.
Accordingly, an Ultrasound, Mammogram or MRI may be required to distinguish between the two types of Gynecomastia as the surgical technique required will depend on which tissue is responsible for the enlargement. This could be simple Liposuction if due to excess fat, excision of excess glandular tissue, or both.
How Is Gynecomastia Surgery Performed?
In the best interests of patient comfort and safety, we perform all Gynecomastia procedures in a Licensed Hospital under General Anaesthesia administered by our Specialist Anaesthetist.
Even so, in most instances, it is still a ‘walk in, walk out’ procedure with no overnight stay required. You can go home 1-2 hours after your procedure, but you must not drive or go home alone. You must be accompanied by a responsible adult.
Naturally, the actual surgical technique will depend
on the cause of the breast enlargement:
1. If The Gynecomastia Is Due Purely to Excess Fat:
Liposuction alone will suffice to remove the excess fat and correct the Gynecomastia.
This can be done either by regular Tumescent Liposuction or Vaser Liposuction. Your doctor will recommend whichever technique they feel will give you the better result.
Post-operatively, you will need to wear a sleeveless Compression Vest for the next 6 weeks.
2. If The Gynecomastia Is Due Purely to Excess Glandular Tissue:
Surgical Excision of the excess glandular tissue is required because liposuction cannot remove the firm and fibrous glandular tissue. The glandular element of the male breast is the firm disc of tissue that you can feel under the nipple. It needs to be removed surgically through a small curved incision along the edge of the areola.
3. If The Gynecomastia Is Due to an Excess of Both Tissue Components:
Both Surgical Excision & Liposuction will be required. In actual practice, the chest is marked according to how much fat and how much glandular tissue is present. A small circular incision is made beneath each areola. The excess glandular tissue beneath the nipple is removed and then liposuction is performed to shape the remaining breast. Post-operatively, a sleeveless Compression Vest needs to be worn for the next 6 weeks.
Watch Our Gynecomastia Animation Video
‘Before & Afters’ of Gynecomastia Surgery
Recovery After Gynecomastia Surgery
- Post-Operative Compression Garment: When you wake in Recovery, you will be wearing a sleeveless Post-Operative Compression Vest. This garment needs to be worn for 4-6 weeks but may be removed for showering after the sutures have been removed.
- Dressings will cover each incision. Do not remove them until your sutures are removed and do not get them wet by having a bath or shower. You can sit in a low bath to wash your lower body and sponge under your arms but do not wet the dressings.
- Bruising & Swelling: Expect some bruising on the chest which will disappear within 2-3 weeks. Swelling largely settles within 4 weeks but in some people total disappearance of all swelling can take several months. Do not be unduly concerned about these appearances – they are normal and temporary, NEVER permanent.
- Post-Operative Discomfort is easily managed by pain relievers your doctor will prescribe for you.
- Drains: If you have had a very large gynecomastia removed, you may find drains coming out of the sides of your chest. These drains are easy for you to manage at home and our doctor will show you how do this. These drains are usually removed within 7 days after your operation.
- Exercise: Light exercise within your limits of comfort can be resumed after 2 weeks. However, if whatever you do causes even slight discomfort, stop it and try it again after another 2 weeks.
- Sutures are usually removed 7-10 days after surgery.
- Resumption of Gym Activities: Lower body exercises (excluding treadmill) can be resumed after 3 weeks and gentle upper body routines after 8 weeks. However, always resume your exercise routines very gradually and always ‘listen to your body’. If whatever you do hurts you immediately or the next day, wait 2 weeks before trying it again. Eventually, you should be able to return to all your exercise routines completely without any discomfort at all.
- During The First 6 Months:
- Short gentle walks are recommended.
- Avoid body contact sports.
- Do not lift heavy things or over-exert yourself.
- Avoid potentially harmful activities or body contact sports which could result in a direct injury to the chest.
Final Scars after Gynecomastia Surgery
The final scars after gynecomastia surgery will naturally depend on the type of surgery you’ve had. Both types should eventually fade to white and be very inconspicuous unless you have brown or Asian skin in which case, they could end up pigmented.
- After Liposuction alone, there will be two inconspicuous scars under each breast approximately 4-5mm long.
- After Excision of Glandular Tissue, there will either be a scar half way around the edge of each areola or in the fold under the breast itself.
‘Pros & Cons’ of Gynecomastia Surgery
- Gynecomastia surgery is really the only effective way to reduce excessive male breast enlargement.
- It is a relatively safe procedure with few reported risks.
- No hospital stay is required. You can go home shortly after your procedure, but you cannot go home alone. You must be accompanied by a responsible adult.
- The results will be permanent provided you do not gain a lot of weight and increase the fatty tissue component of your breasts.
- There will be final scars as described above but for most patients, these fade over time to white and inconspicuous unless you have brown or Asian skin in which case, they could end up pigmented.
Potential Risks & Complications of Gynecomastia Surgery
Surgery and anaesthesia nowadays are considered generally safe but both have potential risks and complications which include:
Specific to Gynecomastia Surgery:
- Pain, bruising and swelling around the operated site(s). These are normal, expected and temporary.
- Hematoma (a collection of blood under the skin) which if large, may require a return to theatre to be evacuated.
- Wound infection requiring topical wound care and antibiotics.
- Wide or thickened scars (hypertrophic or keloid) could occur if you are prone to them, and pigmented scars are more likely in those with brown or Asian skin.
- Numbness or other changes in the skin or nipple sensation.
- Seroma (excess fluid accumulation under the skin) requiring one or more aspirations.
- Slow or poor healing. More likely in smokers and diabetics.
- Asymmetry between the two breasts.
- Allergic reaction to medications, sutures, dressings, or antiseptic solutions.
- Deep Venous Thrombosis (DVT) and its potential to cause life-threatening Pulmonary Embolism. To reduce the risk of DVT, Calf Massagers can be applied for the entire duration of your surgery to prevent the blood in your leg veins from pooling and clotting.
- Adverse Reactions to Anaesthesia or Medication: The safety of anaesthesia nowadays in Australia is well established. Nevertheless, potential risks exist with all anaesthesia and unexpected reactions can occur. These may include nausea, vomiting, and allergic reactions ranging from minor to severe. Respiratory failure, heart failure, heart attack and stroke are rare but documented risks of any general anaesthesia.
The Cost of Gynecomastia Surgery
The total cost of Gynecoamstia surgery is made up of the following individual costs:
- Surgical Fee: $9,900 – $14,000 depending on the extent of the surgery and the technique required.
- Hospital Fee: Hospitals differ in their hourly rates for Operating Theatres. Our doctor will advise you of the expected Theatre Fees once it has been determined which hospital you will be attending and how long your procedure will take.
- Anaesthetist Fee: This will basically depend on the duration of your surgery. Anaesthetic Fees are generally around $880/hour.
- Post-Operative Compression Garment
Can I Claim a Medicare or Private Health Insurance Rebate?
Surgical procedures for purely cosmetic reasons are not eligible for a Medicare Rebate.
Unfortunately, male breast reduction by Liposuction alone does NOT qualify for a Medicare Rebate and without a Medicare Rebate, Private Hospital Cover will not apply.
Male Breast Reduction by excision may qualify for a Medicare rebate for various rare medical conditions but the criteria are so stringent that few patients are eligible.