Gynaecomastia refers to overdeveloped or enlarged breasts in men. It can occur at any age, and can be due to many different reasons such as increased weight, genetics, hormonal changes, or certain drugs.
Gynaecomastia can result in excessive amounts of fat around the nipples, excessive breast gland development, and sometimes excessive amounts of breast skin. The enlarged breasts may affect either one side (unilateral) or both sides (bilateral) of the body.
These changes can affect men to a significant extent, including loss of confidence, avoiding activities that may involve removing their shirt, and avoiding wearing certain clothes that may accentuate the area.
Gynaecomastia is most effectively treated with surgery, either surgical excision of the fibrous gland, and/or liposuction of any excess fatty tissue that may be contributing.
You may be a good candidate for gynaecomastia surgery if:
You are bothered by the feeling that you have excessive breast tissue.
You are in good general health and have relatively normal body weight.
You are a non-smoker, or able to stop completely four weeks before surgery.
You have realistic expectations.
The exact surgical steps performed may vary depending on multiple factors, but in general:
Gynaecomastia surgery is performed under general anaesthetic (with you asleep) and as day surgery (meaning you don’t have to stay overnight in the hospital).
Excisional techniques may be appropriate if your gynaecomastia is due to excessive breast gland. This involves removing the excess tissue through incisions that are placed around the nipple. In some cases excessive amounts of skin may also need to be removed.
Liposuction techniques may be used if your gynecomastia is due to excess fatty tissue. This involves inserting a small tube (called a cannula) through several small incisions. The cannula is attached to a suction device and carefully moved back and forth through the fat, resulting in removal of the excess fat.
All incisions are meticulously closed with fine dissolvable (absorbable) sutures with surgical dressings placed on top. A bandage or compressive garment is then applied on top to help reduce any postoperative swelling. You will be given specific instructions on how to care for your incisions, any medications to take, and when to follow up with Dr Colbert.
Gynaecomastia surgery is usually completed as day surgery, meaning you don’t have to stay overnight in the hospital.
You will be discharged with a compression garment, which needs to be worn full time for six weeks.
Once discharged you should maintain activity within the limits of your discomfort.
Strenuous or vigorous activity should be avoided for at least two weeks.
Driving is possible once you feel comfortable in being able to perform an emergency stop, with most patients able to do this by one to two weeks.
The location of scars from gynecomastia surgery will depend on the technique used.
Liposuction techniques will involve placing several incisions around the chest to allow a suction cannula to be inserted. These incisions are approximately one centimetre wide and usually hidden in a discreet location.
Most excisional techniques will involve placing an incision around one half of the nipple, hidden in the border with normal chest skin.
If you have significant amounts of excess skin then other scars may be required, however Dr Colbert will discuss these with you before the operation.
Gynaecomastia surgery is associated with following potential risks:
Wound infection: incisions may become red or tender, and require antibiotics for treatment.
Bleeding, bruising, and haematoma: haematoma refers to a collection of blood that needs to be removed in the operating room.
Scarring: scars are initially lumpy, but settle down over several months. Rarely they may be permanently lumpy or thick (hypertrophic or keloid scarring).
Change in nipple sensation: nipple sensation may be reduced, stay the same, or sometimes increased.
Complete or partial loss of your nipple: this is rare, but is an important complication to discuss before any breast or gynaecomastia surgery.
Asymmetry: Dr Colbert tries to make results as symmetrical as possible, but as every person’s chest is naturally asymmetrical some postoperative asymmetry is expected.
Deep vein thrombosis (DVT) and pulmonary embolism (PE): DVT refers to a blood clot that forms in a vein in your limb, which can break off and travel to your lung (PE). This can be serious, but is thankfully rare.
Further operations: sometimes a second operation may be beneficial to improve the result or improve symmetry.
Gynaecomastia surgery is like any surgical procedure in that it carries risks. Therefore before having any operation you should also seek opinion from an appropriately qualified health practitioner to discuss these potential risks.
Costs associated with cosmetic plastic surgery can be confusing. To help make things clearer we have listed the the following fees that make up the final cost.
Surgical fee: Medicare will partly pay for some surgical procedures that are itemised by the government, however depending on the nature of your operation there will be some out of pocket expenses. Dr Colbert will discuss these costs with you during your consultation.
Anaesthetic fee: Medicare covers most of the anaesthetic fee, except in the case of some cosmetic operations.
Hospital fee (this includes operation room fee, bed costs, surgical or medication fees, and any other hospital extras): Medicare does not cover this fee. If you have private health insurance then this may be covered by your insurance fund, but you should check with your fund if there is any out of pocket expenses. If you have no private insurance then you will have to pay this fee on discharge from the hospital.