By definition, Man boobs or Gynaecomastia is condition in which males develop abnormally large breasts that causes social and professional embarrassment.
Gynaecomastia is a spectrum and not a single condition. It can come in different forms, from mild to severe, but most of them have one thing in common, “excessive breast tissue “.
Man boobs affect 20- 30 % of the Australian population without any underlying cause.
Puberty with its growth spurt causes breast emlargements in 85-90% of males. This resolves in majority of the males as they grow into adulthood. In those whom this breast tissue fails to shrink , it presents as Gynaecomastia.
In some patients there is an underlying cause that causes Gynaecomastia. Anabolic steroids in body builders, hormonal effects of certain drugs and kidney and liver disorders to name a few.
In vast majority of cases there is no identifiable medical cause and hence surgical treatment is the only option to correct this deformity.
|Surgical time||2-3 hrs|
|Hospital||General anaesthesia and day surgery hospital Mild cases can be done under local and sedation in rooms|
|Length of stay||2-3 hrs|
|Back to work||4-5 days with the garment on|
|Final outcome||6 -9 months|
|Cost||Some private funds cover a small amount of fees .We factor that rebate ( if any ) when we give you a quote .|
Please upload 3 photos .
1. Front view
2. 45 degree view &
3. Side view
A formal face to face ( in person or online ) consultation is necessary before the surgery. Its important to discuss procedure details and address your concerns if any.
The type of procedure and the hospital stay depends on the severity of the Gynaecomastia. The average time ranges from 1-3 hrs and hospital stay varies from no stay to 2 overnight stays.
Patient should stop any blood thinners 10 days before the surgery. Medically graded pressure garment should have been organised ( by you or your surgeon) before the procedure. which gets applied to your chest on the operation table immediately after surgeryThere are 2 procedures
1. Liposuction and
2. Gland excision.
A ‘ Tumescent Solution’ ,containing local anaesthetic ( reduces post- op pain) and adrenaline ( shrinks blood vessels to reduce bleeding) is infiltrated through a tiny cannula into the chest .
Specialised liposuction cannulas ( power assisted or Vaser lipo) through 3-4 tiny openings ,breaks the excess fatty tissue on your chest and sucks it out . Your side chest and armpits in severe cases can be taken care of with liposuction as well to give you a better contour.
Thick and dense fibrous tissue beneath the nipple-areola complex doesnt respond to liposuction alone. A semicircular incision at the areola-skin junction is made to cut out the excess nobbly gland in that area. Scars are hidden with meticulous suturing.
Combination Procedure –
In majority of the patients , you need both procedures in combination to address each element separately. Different size cannulas help the surgeon the feather out lumps of localised fat deposits to achieve pleasing contours.
The expanded skin contracts after surgery . the procedure also incites inflammation and scarring so that the skin re drapes into a firmer and better contour.
|Most patients will go home same day. Moderate pain, discomfort can be controlled to larger extent by strong analgesia.|
|Pressure garments is to be worn for 6 wks to reduce swelling and better skin redrape.|
|Normal physical activities are allowed after 4 wks including gym.|
|It could take upto 6 months before complete resolution of swelling to get the final outcome.|
Although every effort is made to minimise compliactions they still can occur.
General risks associated with any surgery are bleeding, infection , chest infection and clots in the legs.
In present day males are equally concerned about fitness and beauty Along with the breast enlargements at puberty, nipples also tend to enlarge. Failure of nipples to regress in adulthood causes large nipples.They can be either too long or too thick giving a feminine look..
Nipple surgeries are easier in males given they don’t have milk ducts.
Male areolas are narrower than females . Even with no breast tissue enlargement, an enlarged areolar diameter tends to produce a feminized breast/chest appearance.
Areola reduction is a surgical procedure in which a circumference of the pigmented peripheral excess areola skin is excised. Meticulous suturing to hide the scar is the key if you want a good result.
This can be done as an isolated procedure ( if breast is not enlarged) or combined with gynecomastia surgery . The scar is circumfential along the areola- skin junction and fades well after a few months.
Enlarged but soft homogenous breast like a female breast is Pseudo- Gynaecomastia. True gynaecomastia is firm, rubbery breast tissue underneath the areola.
Majority patients have a combination of both ,with one element more than the other.
Surgical treatment remains the same for most . So honestly speaking, it doesnt matter which terminology is used.
Liposuction – Fatty element is treated with liposuction
Excision of gland – nodular element needs excision.
Majority patients it’s a combination of the two. In borderline cases you can get away with a fine cannula liposuction under the nipple.
Dr Mahadik reserves the right to excise some tissue depending how it feels after liposuction. This is factored into the consent and cost which means you don’t have to pay for the excision if not needed.
One type of gynecomastia is referred to as “puffy nipples”, when the excess tissue (typically gland) is confined to the borders of the areola. This is infact a mild form of gynaecomastia .
Typically this will show more on contraction of the pectoral muscles.
It needs a tiny puncture incision to remove the excess gland, with or without liposuction. Liposuction feathers out the sharp edges and helps to redrape the skin better.
It’s a combination of excess diet resistant fat to the chest combined with glandular tissue, which is a white rubbery substance.
Exercise may make it worse by making it more obvious.
recovery depends upon the procedure done. In the standard gland excision and liposuction surgery this is our recommended protocol .
Discomfort and mild pain can be controlled by good pain relief for 2-3 days.
The pressure garment applied stays for 4 days before shower. It should be continued for a further 3 wks fulltime and another 3 wks during day time only.
Desk work can start after 4 days and normal activities after a week.
Numbness and bruising over the chest is quite normal for 2-3 wks from when it starts getting better. The swelling might take upto 6 or 9 months to completely settle.
Cardio exercises and non strenuous work can start after 2 wks and normal gym workout after 4 wks.
Scars will be raised and turn red after a few days . Once mature they tend to fade away in around 3 mnts.
Nipples and areola will be significantly swollen and puffy after surgery. If it feels puffy and ‘especially nodular ‘ even after 6 months of surgery please see your surgeon.
It could be just residual swelling or inadequate excision or just the inside sutures that are still dissolving .
We recommend to wait till your are 18 . 90 % of enlarged pubertal breasts will shrink.
This is a cosmetically very unpleasant deformity if the procedure isn’t done properly. Please choose a surgeon experienced in doing Gynaecomastia.
Overzealous excessive cut out of the gland under the nipple can leave a dent. Skin contracts and gets stuck into this dent due to scarring and it looks like 2 craters sitting on your chest.
The gland excision should be “ just right, not too less and not too much” for a pleasing result.
Small lumps and bumps after the procedure should not worry you. They are fat deposits and the skin still in the process of evenly redraping.
Massage around the areola and if later than 6 months a few steroid injections will contour the clumps from disorderly healing.
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