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Gynaecomastia

Gynaecomastia

 

Gynaecomastia (sometimes referred to as “man boobs”) is a common condition that causes boys’ and men’s breasts to swell and become larger than normal. 

What are the signs of gynaecomastia?

Signs vary from a small amount of extra tissue around the nipples to more prominent breasts. It can affect one or both breasts. Sometimes, the breast tissue can be tender or painful, but this isn’t always the case. 

What causes gynaecomastia?

Gynaecomastia can have several causes. 

Hormone imbalance

Gynaecomastia can be caused by an imbalance between the sex hormones testosterone and oestrogen. Oestrogen causes breast tissue to grow. While all men produce some oestrogen, they usually have much higher levels of testosterone, which stops the oestrogen from causing breast tissue to grow. Sometimes, the cause of this imbalance is unknown. 

Obesity

Some growth in breast tissue is not due to extra body fat from being overweight. Also being overweight can increase levels of oestrogen, which can cause breast tissue to grow.

Older age 

As men get older, they produce less testosterone and also tend to have more body fat, and this can cause more oestrogen to be produced. 

Medications 

Some anti-ulcer drugs or medication for heart disease 

Illegal drugs – such as cannabis or anabolic steroids 

drinking too much alcohol  

Testicular conditions

Lumps or infection in the testicles. These need to be investigated urgently. 

 

Surgical Treatment for gynaecomastia

Once medical causes have been excluded, and there is no medical treatment available, most patients will surgical treatment. The treatment depends on how advanced the condition is. 

Mild- liposuction alone could be sufficient

Moderate- liposuction plus breast tissue excision

Major- a procedure where the breast is opened to remove the extra breast and skin tissue. 

 

 Duration – 1 – 1.5 Hours

 Hospital stay – Day surgery or Overnight stay

 Costs – from £3999

 Return to work – 1 week

 Location – London, Manchester, Beirut, Doha

Frequently Asked Questions

Will the condition come back after gynaecomastia surgery?

This is very unlikely however if the underlying cause is not treated then it is possible for the breasts to grow again. 

Where will the scars be after gynaecomastia surgery?

The location of the scars depends on the type of surgery. With liposuction there will be small entry sites for the ports of the liposuction cannulas. For more advanced cases a scar around the nipple might be needed. For the bigger cases, scars down the chest wall might also be needed.

What are the potential risks for gynaecomastia surgery?

There are always potential risks and complications associated with surgery. Complications are rare but can occur. The main complications of breast reduction surgery include:

Bleeding

Bleeding can occur after your procedure and oozing from the wounds is common. Some bleeding can accumulate under the skin resulting in a haematoma or blood collection. Small haematoma will usually resolve with time and may not need any further treatment. Larger haematomas, however, may need a return to theatre to remove them and find the source of bleeding.

Infection

Infection can occur and most often can be managed with antibiotics. Sterile procedures and antibiotics given during the operation try to reduce the risk of infection.

Wound breakdown and healing problems

There are pre-existing risk factors for poor wound healing such as smoking and diabetes.

Scarring

There will be permanent scars on the breast depending on the type of skin incision pattern. Scars can sometimes become hypertrophic or keloid which means they may be raised, red and lumpy. This can occur around the areolar or along all the scars. Patients will usually have a tendency to develop this type of scarring or there may be a family history of abnormal scarring.

Asymmetry

There is always some degree of asymmetry between breasts and nipple areolar complexes. Occasionally, after breast reduction there may be residual asymmetry or patients may become more aware of pre-existing asymmetries.

Change in Nipple Sensation

Due to the nature of surgery and movement of the nipple there is risk of changes to nipple sensation. This is usually reduced nipple sensation after surgery that is often temporary but may be permanent.

Nipple Loss

Very rarely there is risk of nipple loss that can occur when the blood supply to the nipple is disrupted. 

Fat Necrosis

Fat necrosis occurs when the fat in the breast loses its blood supply. This may result in firm hard areas where the fat has not survived. Small areas often resolve with time.

Saucer pan deformity?

This is when the breast sinks into the chest wall. In these cases corrective surgery might be needed.