Male Breast Reduction, Gynaecomastia Surgery, Gynaecomastia Treatment, Cosmetic Surgery Perth, WA

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Treatment of Gynaecomastia / Male Breast Reduction

Gynaecomastia is an excessive enlargement of male breasts. It is a medical term that originates from the Greek words for "women-like breasts." This is a common condition that affects an estimated 40 to 60 percent of the male population. It may affect only one breast or both. It can be a normal occurrence in some male teenagers and men.

Causes of Gynaecomastia

Breast tissue development is influenced by hormonal levels of Oestrogen, which is naturally low in males. Hormonal imbalances at puberty may give rise to tender gynaecomastia. Most cases normally improve within a few years or by the age of 20.

Gynaecomastia can also be caused by the use of anabolic steroids, medications containing oestrogen, alcohol, marijuana, etc., and medical conditions including cancer and impaired liver function. However in most cases the causes of gynaecomastia are unknown.

Assessment: Examination and Diagnosis

Enlarged breast tissue in men is composed either predominantly of fatty tissue, glandular tissue or a combination. Thick and excess skin also makes the breasts look larger.

In some cases Dr Pham may request an ultrasound or mammogram to further evaluate the breasts before surgery. Breast cancer in males may be detected but this is highly unlikely.

Management of Gynaecomastia

Options of treatment include

1. Observation - if the enlargement is mild or during a hormonal change period such as the puberty years. Dr Pham recommends that teenagers and young men with gynaecomastia wait for 2 years after the onset as most cases will improve without intervention.
2. Non medical - changing certain medications, cease heavy use of alcohol, marijuana or anabolic steroid. Obese men can lose weight by dieting and exercise.
3. Medical - hormonal treatments
4. Surgical

There will be scarring around the nipples of the breasts (areolas) from this procedure but the scars will fade over a period of time. There will be some post-operative bruising, swelling, and burning sensations. To assist with the healing process, patients are advised to wear an elastic pressure garment for 3-6 weeks. Avoid exposing scarred areas to the sun for at least 6 months.

Other considerations include temporary numbness or lack of sensation that could last up to a year. Infrequent complications may include infections, skin damage, fluid accumulation, bleeding, scarring or pigment changes. Post-operative asymmetry, whilst rare, is possible and very occasionally a second procedure may be needed to remove additional tissue.

MAKING A DECISION TO PROCEED WITH SURGERY

You should be informed as much as possible before making a decision to proceed with breast surgery. Men of any age who are healthy and emotionally stable are considered good candidates for male breast reduction surgery. The best candidates are those who have firm, elastic skin that will reshape to the body's new contours.

Indications for surgery

1. Failed non-surgical treatments
2. Cosmetic or psychological reasons - some men are self-conscious of their enlarged breasts.
3. Breast discomfort - tenderness and soreness
4. Suspected malignancy - in rare cases.

Male breast reduction surgery is an elective procedure, which means that it is a personal choice and not necessary for maintenance of good health. It is important to understand that neither Dr Pham nor any other surgeon can predict the exact outcome of the breast size and shape, nor can they guarantee to satisfy all of your expectations. There will be always some minor asymmetry between the two breasts after the procedure.

A good rapport between you and Dr Pham and realistic expectations are prerequisites for successful outcome. You are most likely to be pleased with the results if you have a realistic idea of what surgery can and cannot do.

You can expect a thorough explanation from Dr Pham regarding the procedure's risks and benefits. Dr Pham will inform you of the best methods of anaesthesia, the surgical facility where your procedure will take place and the cost of surgery. Following a joint decision by you and Dr Pham to proceed with surgery, photographs of you will be taken and Dr Pham will further discuss the options available. You are encouraged to seek the opinion of other surgeons if you are uncertain.

Private Health Insurance Rebate

Male breast reduction for medical or functional reasons is usually partially covered by Medicare and Health Insurance Funds. There will be an out of pocket or gap fee. You will be given a quote from Dr Pham (surgeon's fee only) and you should contact your health insurance fund to find out the amount you can expect to be rebated.

Understanding the Procedure

Surgery for gynaecomastia is performed under general anaesthetic or under sedation with local anaesthetic. Modern anaesthesia is safe but does have side effects and you should discuss these with your anaesthetist.

Specific techniques selected for your male breast reduction will depend on your individual factors and Dr Pham's preferences. In all cases there will be scars, which become less noticeable with time.

Techniques and Incisions

Enlarged male breasts can be reduced by:
1. Liposuction / liposculpture - to remove fatty tissue. One or two small incisions are made and a cannula is used to remove fat under suction.
2. Excision - to remove excess glandular tissue. A small cut is made at the lower edge of the areola and occasionally into the breast skin. A small drain is sometimes used and removed the next day. The scars generally heal very well.
3. Combination of liposculpture and excision.
4. Additional procedure - may be required in certain cases. If the skin, fat and breast tissues are excessive then the skin may be removed to restore the appearance of a flat chest wall. Fat flap sculpture is sometimes used to prevent a large crater forming.

How long is the procedure?

The procedure takes an average of 1 to 1 ½ hours, usually on an outpatient basis.

Results of surgery

Results are permanent, although subsequent obesity can create a gynaecomastia-like effect. Some of the benefits of surgery include a firmer, flatter, more contoured chest which may give the male patient a boost in self-confidence. There is little downtime, and you may return to work within one week unless you are involved in strenuous activities.