Male Breast Reduction (Gynaecomastia)

Male breast reduction surgery is an important surgical procedure which has the power to restore body confidence to teenage boys and older men suffering with gynaecomastia (where men’s breasts swell and become larger than they should). 

Gynaecomastia can be very distressing for men, with many avoiding activities (like swimming and other sports) that involve dressing and undressing in front of other people. 

It usually requires surgical correction, but an assessment with a breast and testicular examination and blood test investigations are usually required by your GP first, to rule out discrete lumps or known causes of breast enlargement (hormonal changes, medication or some drugs).  Titus Adams sees those men with idiopathic gynaecomastia once hormonal or drug-induced causes have been ruled out. 

There are different procedures avaiable to remove specific tissue and include:

  1. Liposuction
  2. Peri-areolar breast bud reduction
  3. Combination surgery
  4. Standard breast reduction surgery (in rare or syndromic cases)

Mr Adams will discuss the best procedure for you during your consultation.

The type of surgical correction depends on the size of the Gynaecomastia, the nature (density) of the tissues involved in the enlargement, as well as patient wishes and desires. In general, liposuction is usually employed. However, in many cases, the nature of the tissue lying under the nipple area is too dense and fibrous for liposuction alone, and some type of formal removal is required. Surgical access is usually required around the lower part of the nipple/areola area. Occasionally, if there is a significant amount of skin laxity, the redundant skin will also need removing which would be managed through a scar running around the complete circumference of the nipple itself. In some cases, an additional (horizontal) scar may be needed on the lateral aspect of the chest skin for improved access to large amounts of breast tissue or to excise greater redundancies of skin. In rare cases, and especially after Bariatric Surgery (weight-loss surgery), the amount of skin and tissue excess can be considerable and may require further scars on the chest in order to improve the male chest profile.

The nature of the surgery is tailored specifically to the severity of the condition and the wishes (and expectations) of the individual. This is discussed very clearly with patients at the time of their consultation. Photographs are also available for viewing at this time.

Male Breast Reduction

What You Need to Know

What Happens When I Leave Hospital?

Tape is applied to the scars in theatre. A pressure garment is applied to the chest to aid compression. Drains may be in place but removed the following day before leaving the hospital. Further dressings (exchanged at one week by the nurse) are required for up to 4 weeks and usually involve micropore tape only, which can be replaced if it comes away. Showering can take place from 5 days.
Patients use a pressure garment or a tight-fitting top which must be brought to theatre for fitting at the completion of surgery. This garment must be used as much as possible for 6 weeks, removed only for washing/showering. Two garments may be necessary (one for cleaning and one for wearing). The garment improves the final outcome by protecting the surgery performed, moulding the result as evenly as possible and reducing the risk of seroma (collection of body fluid within the surgical space, which can prolong the swelling and delay the final result).
All the stitches are dissolving. At one-week follow-up, the nurse will check and trim stitches as required.
Severe pain is not a significant feature of this surgery. Regular analgesics are prescribed on discharge from hospital, and can be continued for 1-3 weeks, and intermittently thereafter.
Initially the chest will appear swollen. Bruising may become significant but not uncomfortable, and the bruising may extend down the side of the body. This is particularly the case following prolonged liposuction. Sometimes persistent swelling can observed as a result of lymphatic drainage issues. This swelling will take time to resolve with or without massage.
Scarring can be unpredictable. The scars may go red and lumpy. When healing of the skin is complete at 4 weeks, and after tape removal, massage with Vitamin E containing cream is useful. Occasionally, a steroid treatment to the scar or a silicone gel or sheeting may be required to settle lumpy (hypertrophic) scars. Red scars can take up to 18 months to fully fade.
Minor wound infections or small areas of delayed healing can occasionally occur but should not cause significant concerns. These wounds respond well to antibiotics or regular dressings or both. The most significant complication is of sudden swelling over the first few days following surgery, caused by a collection of blood (haematoma). Another complication might be an increased redness and soreness on one side of the chest, which might represent an infection. If there are any causes for concern, then either contact the hospital or Mr Adams’ secretary.

Resources

Read the full male breast reduction fact sheet for more information on the types of surgery, pre-operative advice and what to expect following the procedure.
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“Recommendation after recommendation has put Adams firmly on the Cotswolds map (he has clinics in Berkshire and Oxfordshire). It’s partly down to his nature (he’s a wonderful conversationalist and has charisma in spades), but also his manner, which is thoughtful and careful. His forte? Womanly tummies, with curves in the right places. New mummies in particular love the way he recontours the waistline and creates the illusion of a lightly toned abdomen.”

“Titus Adams makes light work of postpartum tummies, slimming the silhouette and nipping in waists by pulling the underlying muscles tight, like a corset. ‘Though it’s best to leave some fat behind,’ he says. ‘It allows fluid to drain from the body, rather than building up in the tissues’. The fat he does take, however, is useful if there’s need to plump a deflated cleavage. And, because he’s chatty and approachable, smoothing over even the most awkward of questions (like ‘how do you wear your undergarments?’ – crucial, as it ensures the best positioning of scars), you feel at ease. You trust him.”

“Adams listens carefully & closely. And his results are truly top notch whether he is tidying things up after some impressive weight loss or putting you back together after the last baby. The key phrase is ‘preservation of tissues’, to retain a natural appearance.”