Cosmetic breast surgery
Gynecomastia (enlarged breasts in men)
Gynecomastia is characterised by the presence of visible breasts in men
The male breast is normally characterised as an insignificantly sized bud. The mammary gland can develop and lead to the formation of a relatively large breast in men, called gynecomastia. Gynecomastia can be unilateral or bilateral. It forms a firm mass, tender to touch and centered on the areola. An adipomastie (accumulation of fat in the breast) may be associated, this is called gynecomastia adipocytes.
The presence of breasts in men, particularly during adolescence, is distressing and leads to lower self-esteem with an impact on the social, emotional and sexual life.
Gynecomastia can be caused by several diseases or hormonal imbalances. Therefore an assessment is always done to try to identify the origin of the disorder, so that its treatment can achieve a more or less complete regression of the gynecomastia.
It should be noted that transient gynecomastia is common in puberty and disappears within a few months. In practice, in most cases, no cause is found. This is called idiopathic gynecomastia which is corrected surgically.
Principle of the male breast reduction
In the case of gynecomastia the surgeon must reduce the breast size by liposuction whereas for glandular gynecomastia the glandular tissue is removed through an incision located around the areola (subcutaneous mastectomy). Often, the surgeon combines these two methods.
For a moderate excess of skin that is of good quality, natural tightening will allow the skin to disappear over a few months. In cases where tightening is not enough, the surgeon will remove excess skin leaving a larger scar. This resection of the skin can be performed at the same time as the procedure to decrease the volume or during a separate procedure.
Either general anesthesia (rarely) or assisted local anesthesia (diazepine-induced analgesia) is used depending on the severity of the gynecomastia. The duration of the procedure varies from 45 minutes for an isolated liposuction to a maximum of 2 hours in case of a more complex intervention. Similarly, the hospital stay varies from several hours (outpatient) to 24 hours.
The intensity of the pain varies and is similar to muscle aches. It is relieved by appropriate analgesics. Pain decreases rapidly after the first day. Edema (swelling), ecchymosis (bruises) and a hindrance to elevate the arms are frequent in the early stages. Complete healing is achieved within 2 to 3 weeks. The dressings are semipermeable, therefore showers are allowed. Special adhesive dressings will be applied to the scars for 2-3 months in order to improve their appearance.
Wearing a compression garment (bolero) is recommended 24 hours a day for 1 month to facilitate the tightening of the skin. Returning to work is possible between 5 days and 3 weeks after surgery depending on the job.
The patient can resume sporting activities after 1 or 2 months.
Visible improvement is often immediate. 1 to 3 months is required to obtain the final result (reduction of edema, skin retraction).
In some cases, if the excess skin has been removed immediately and if the spontaneous skin tightening is deemed insufficient, excision of excess skin can be performed at least 6 months after initial surgery.
The scars are almost non-existent in the cases of isolated liposuction, and subcutaneous mastectomy around the areola. They are more visible with the removal of excess skin. You need to wait for about one year before the scars are fully developed and thus more discreet.
Risk of complications after male chest reduction
As with any surgery, a number of complications can occur. But the likelihood of these complications is reduced in the hands of a qualified plastic surgeon and in the presence of a competent anesthetist. The patient’s compliance to instructions given by the surgeon is also essential and include :
- stopping smoking 1 month before and after the procedure (reduction of all risks) ;
- not taking aspirin for 10 days before and after the procedure (reduced risk of hematoma).
Fortunately, postoperative effects are generally manageable following a male chest reduction that has been carried out properly, so serious complications are rare.
In spite of the fact that complications are so rare you must be aware of the following problems :
- Haematomas are quite rare but can occur. They can be evacuated.
- Infection : this is extremely rare when the procedure is carried out in sterile environment.
- Numbness of the skin may be observed. It is usually transient and most patients recover normal feeling after 6 to 18 months.
In case of a complications, your surgeon will treat them successfully if necessary.
In practice, the vast majority of cases take place without any problem and the patients are satisfied with the result.
Health insurance coverage
As this procedure is considered purely for aesthetic purposes, no coverage is provided by health insurance.
In some cases, a partial reimbursement of the cost of the procedure may be considered.
Author: Dr. Christophe Laveaux
Specialist in aesthetic surgery - Antibes
Reproductions, even partial, of the texts are allowed on the express condition cite the author (Dr. Christophe Laveaux) with a direct link to the article mentioned.