Male Breast Reduction (Gynaecomastia Excision)

Gynaecomastia is an enlargement of the male breast as a result of an abnormal increase in the glandular tissue and/or fat. It is quite common, affecting an estimated 40% to 60% of men in varying degrees. For men who feel self-conscious about their appearance, surgery to reduce the breast can improve personal confidence and self-esteem.

There are a number of techniques that are used for gynaecomastia excision. I have modified some of these techniques to minimise scars and hide them within the areolar (the pigmented area). This is possible for most cases but occasionally, if there is excessive skin then larger scars may be required. The surgery selected depends upon skin quality and the amount of breast tissue and fat that has to be removed. Liposuction is used to remove any fatty tissue. This is achieved through several stab incisions, hidden within the areolar. These heal with an almost invisible scar. If there is still a hard glandular element of the breast remaining, then this can be removed via the liposuction incision itself. In cases with lots of excess skin, which usually occur in massive weight loss, then it may be necessary to put a horizontal scar at the bottom of the breast and one around the areolar. The surgery takes about 2 hours to complete.

A gynaecomastia excision is usually performed under a general anaesthetic (you will be asleep during the procedure).

The operated area may be swollen for a few days and you will experience some pain. Simple painkillers are all that is normally required although aspirin should be avoided for the first few weeks following your operation.

Providing all is well, you can expect to go home the day after surgery.

Having cosmetic surgery can be a very positive experience. Complications are infrequent and usually minor. However, no surgery is without risk and it is important that you are aware of possible complications.

Scar – scars hidden in the areolar tend to settle remarkably well, so that they are barely perceptible. However some patients heal with thick scars and this can make them more noticeable.

Bruising and swelling – this is very common and bruising may take a couple of weeks to settle.

Infection – this is rare but may require antibiotics

Haematoma – this can happen if a bleed occurs under the skin, allowing a large blood clot to form. If this does occur, it is likely to happen within four to six hours of surgery. Any increase in pain should be reported immediately. Sometimes a patient will need to have this blood removed with another short operation.

Breast asymmetry/shape irregularities – these can occur following this operation. In rare cases, further surgery is needed to correct this. It is very common for men to naturally have asymmetrical chest muscles (pectoralis major). If you have not clearly seen these muscles because they have been covered with breast tissue, removing the breast tissue will likely reveal this difference. Prior to surgery, it is important to note this or you will understandably assume that surgery caused the difference in appearance.

DVT/PE – following any surgical procedure it is possible to develop a blood clot in your legs, which could potentially break off and move to your lungs. If the blood clot is large enough it could prove fatal. In order to reduce any risks of this we give you special stockings to wear in bed and a blood thinning injection if you are not mobile.

All the risks will be discussed in detail at your consultation. However, if you have further questions or concerns, do not hesitate to discuss these with me. Decisions about cosmetic surgery should never be rushed.

All the incisions are closed with dissolvable sutures that do not need removing. A waterproof glue-based dressing is applied to the incisions so that you do not require any traditional dressings. You can shower as soon as you like after surgery. You will be given a compression garment to wear day and night for the next four weeks to give support and prevent bruising or fluid collecting.

Before you leave the hospital, you will be given a follow up appointment to see the nurse at 1 week and with me in 4-6 weeks. You will not be able to drive yourself home from hospital and ideally, you should have someone to stay with you for a few days to assist you.

Most patients take 2 weeks off work and gradually increase activity over the next few weeks. You can return to lower body exercise at the gym at 4 weeks but should refrain from upper body exercises for 5 weeks.

Anne Dancey

I hope you find this information useful. If you have any questions or require a little more information then please do not hesitate to contact me.

Anne Dancey

Plastic and Reconstructive Surgeon FRCS(Plast), MBChB(Hons), MMedSci(Hons) and MCh(PASP)