What is it?
Gynaecomastia or ‘man boobs’ is enlargement of the male breast. It is actually more common than you would think with a third of men in their middle ages having some degree of it. A good number of adolescents will also develop it, but this will be transient for most of them.
What does it involve?
The surgery is performed under a general anaesthetic (with you asleep) and takes about an hour and a half. The enlargement may be reduced by either liposuction (sucking out the fat and breast tissue through small incisions) or by excision of breast tissue ± excess skin, using incisions around and near the nipple. The technique used will depend on the size, amount of excess skin and the nature of the breast tissue. I will discuss with you what will be most appropriate for you at your consultation. You will wake up with surgical tapes along the wounds and surgical drains (tubes) on each side. I will not use drains if you had only liposuction performed. A specialized form of suturing (Auesrvald haemostatic net) may help skin redrapping and healing.
What is the post operative care and recovery?
Liposuction alone will usually be a day case procedure. However, you may need stay in hospital for 1-2 nights after excision surgery. This is to ensure that there is only minimal fluid coming into your drains, which may then be removed. After the surgery the wounds will be dressed with medical tape. This is splash-proof and shower-proof (but not bath-proof!). You will be able to shower from the day after surgery, and dab the tape dry with kitchen towel (or use a hair-dryer on a cold setting). The Auesrvald haemostatic net sutures are removed after 2-3 days if used.
You will need to go into a tight-fitting cycle top or similar lycra top support garment from the day of your surgery. This should be worn for most of the day and night for 6-weeks.
Strenuous activity especially that involving your upper body, arms and hands should be avoided for at 6 weeks.
What are the possible complications?
- Bleeding or haematoma (collection of blood under the skin), may occur in about 3% of people usually in the first 48 hours. This may require a return to theatre to stop the bleeding and remove the blood.
- Sometimes body fluid (seroma) collects under the skin and may require the use of a needle and syringe in the clinic to drain. Wound infection & wound breakdown can occur but are uncommon.
- Lumpy scarring (hypertrophic or keloid scarring) which may be difficult to treat is the main long-term problem. The scar may also stretch.
- Change in nipple sensation (usually less sensitive, but occasionally more).
- Some degree of asymmetry may persist as no chest is perfectly symmetrical.