True gynaecomastia refers to a condition in men where excess breast tissue develops. This may be associated with various medications, steroid use or hormone induction. More common is a perfectly normal anatomical variant where excess adipose tissue or fat collects in the breast area causing 'manboobs' or 'moobs'. Being overweight exaggerates these collections, but they may affect slim men too.
Surgical options for gynaecomastia or male breast reduction
Different surgical strategies are available for reducing breast development or fat collections. Generally the technique used will be the one that achieves satisfactory chest contouring with the least scarring possible.
Liposuction allows removal of fat and chest wall contouring through perhaps 2 or 3 5mm incisions using a suction cannula or 'mini hoover' to suck out some of the fat held in thin walled cells. The fat in the breast area can be held in fibrous support tissue and this may limit just how much fat can be removed in this way.
For more stubborn collections or breast tissue an incision can be made along the edge of the areola, at the junction between pigmented and non pigmented skin. Although such an incision will leave a scar, its impact is hidden to some extent by the distraction of the natural change in colour in this area. The nipple is elevated and tissue removed from the breast and chest area through this access incision.
Occasionally a more extensive mastectomy or full breast excision is required. This achieves excision of excess breast tissue but can leave quite extensive scarring visible below the breast or around the nipple extending to below the breast.
Some men will choose or need a combination of procedures and usually this can be done at the same time in a single operation, for example excision plus liposuction.
Risks and complications of surgery for gynaecomastia or male breast reduction
Each of these procedures has limitations, consequences and risks associated. During a full consultation it is important to go through with your surgeon exactly what it is that you want to change and how this can be done surgically, including what risks there are in general, and for you in particular.
It is possible to under-correct, over-correct or to create contour irregularities with surgery. Sometimes a second procedure is required in these circumstances to achieve or come close as possible to achieving the desired contour.
After surgery for gynaecomastia or male breast reduction
In order to maintain contours or even to smooth off contours after surgery it is a necessary to wear a tight vest or fitted surgical garment for 6 weeks while the tissue is healing up and contours are becoming, as it were, set.