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Gynaecomastia – Symptoms, diagnosis and treatment

Cosmetic Clinic Dubai | 24 November 2019

Some men find that one or both breasts may be abnormally large. Known as gynaecomastia, this condition can result from a hormone imbalance or from being very overweight, which can increase levels of oestrogen and cause breast tissue to grow. Breast reduction surgery is an option for men with this condition. It may also be used to tighten the breast area after dramatic weight loss that has caused the skin to sag. However, it is not suitable for men whose large breasts are simply excess fat from being overweight. Gynaecomastia is the benign (non-cancerous) growth of male breast tissue and can be due to a number of causes. It may be due to hormone imbalance or as a consequence of medication you are taking. It can also be due to alcohol excess or recreational drug abuse. I will discuss the cause of your gynaecomastia with you. Along with causing swelling of the breast and nipple, gynaecomastia can be uncomfortable and the nipple can become sensitive.

How can gynaecomastia be treated?

Some cases of gynaecomastia will get better without any form of treatment. If one of your medications is thought to be causing the gynaecomastia, it may improve with changing or stopping a particular tablet. Whilst gynaecomastia itself can be uncomfortable and unsightly, it is not dangerous and no harm will come from having it. When cancer has been ruled out, many men are happy to have no treatment. Another form of treatment is to have medication. These medications are often good at reducing discomfort and sensitivity but may not reduce the size of the breast. The third form of treatment involves surgery to your breast.

Surgical treatment of gynaecomastia

There are three main surgical procedures which can be undertaken:

Liposuction

Liposuction is used to remove the fatty tissue under a general anaesthetic. Small incisions (cuts) are made on the chest wall. A small metal tube (cannula) is used to suck out the fatty tissue. The incisions are then sutured to give a flatter, firmer and better-contoured chest. Any stitches will be of the dissolving type and so do not need to be removed.

Excision of gynaecomastia

In excisional surgery, i will make a cut around the nipple to remove the breast tissue. This may be combined with liposuction of the breast tissue at the same time.

Male breast reduction

If the breast is very large more tissue and skin may have to be removed. This will give more scars. The degree of scarring will depend on how much skin needs to be removed. I will advise you about this.

After surgery

After surgery for gynaecomastia your breasts will look discoloured and feel firm and swollen. Bruises can occur. You may need to have a drain (a fine plastic tube) inserted into the breast during the operation. This will be removed by the breast care nurses seven days after your operation. You should be able to go home the same day. You may be advised to wear a corset for up to four weeks after the operation to help with the swelling. You will not be able to drive home after your operation and it may be two to three days before you can drive.

The dressings can be removed after 7-10 days and you should be able to return to work after one weeks. For the first three weeks after the operation, don’t lift anything heavy or do heavy manual work. Most men resume normal activities within two to three weeks. 

Follow up

You will be given an appointment to return to the clinic in 7-10 days where the dressings and drain(s) will be removed and the wounds inspected. You will also be reviewed after your surgery once the bruising and swelling has completely settled.

Long term outlook

If liposuction is performed and only fat is removed, weight gain can make the gynaecomastia return. If the breast tissue itself is removed, as in the excision surgery or male breast reduction there is a chance the breast tissue can regrow. You will have medical photography before and after surgery of your chest. There will be nothing which will identify you to anyone else on these and they are used as a record of your treatment.