What is a Gynaecomastia?
Gynaecomastia or excess male breast tissue is also called “MOOBS”. Although hormone imbalance can be a cause often no underlying cause is found. MOOBS can cause men a great deal of embarrassment and many avoid swimming and feel embarrassed removing their clothing. It may be treated by liposuction only or by excision of the excess tissue directly in combination with liposuction.
What to expect during your consultation?
The success of the consultation depends on your openness and honesty in relation to what troubles you and your expectations of surgery. You will be asked questions about your health, desires and lifestyle. Different operations can be tailored to your needs and the potential outcomes and the risks and complications will be discussed with you. Various types of liposuction procedures are available. A consultation regarding the risks and limitations of surgery will help you to choose a procedure that will meet with your expectations.
Preparing for gynaecomastia surgery
Gynaecomastia surgery may be performed under local or general anaesthetic. Your health is a prime importance and any cosmetic surgery should be postponed if you are unwell for any reason. It is important that if anything changes with your health that you make contact with us. You should ideally stop smoking 6 weeks prior to surgery and stop taking aspirin, anti-inflammatory drugs and herbal supplements before surgery. You may need preoperative tests prior to surgery, which we will arrange if required. You will generally experience discomfort following the surgery and should aim to be off work for at least 1 week depending on the type of work you do.
Gynaecomastia surgery often takes between 1 and 2 hours. Anaesthetic fluid is placed into the area in question and an incision that is usually less than 1cm is made overlying or close to the area where the fat needs to be removed. In the case of body jet liposuction fluid is infiltrated under high pressure and if under local this can give a strange sensation. A cannula is used to remove the fat. If body jet liposuction is used then fluid is infiltrated at the same time as the fat is removed. Once the fat has been removed the small incisions are closed with dissolvable stitches. Following liposuction it may be necessary to perform direct excision of any remaining excess tissue. The incisions need to be tailored to your individual needs. An incision may need to be made around the areola. In cases of severe gynaecomastia horizontal or vertical incisions or a combination of both may be required and the nipple areola complex may need to be repositioned or occasionally removed and replaced. The need for extensive incisions are only required in those with excessive breast tissue in combination with excess skin and in the majority of cases liposuction only or an areola incision is all that is required. The incisions are closed with dissolvable sutures and a compression garment is usually applied.
If your surgery is under local anaesthetic you will be able to mobilize straight away. If you require a general anaesthetic you will usually return to the ward within an hour following surgery and you will be encouraged to mobilize. You will usually not have drains in place and you will be able to eat, drink and mobilize. You will feel swollen and have generalised discomfort that will usually require analgesia. You may be able to go home the same day and should keep the wounds dry for the next week. You should arrange for someone to pick you up following surgery and have some support at home when you are discharged. You will be reviewed in clinic and the wounds checked at a week. You should avoid excessive straining in the first couple of weeks and should continue to wear a support garment for 4-6 weeks after surgery. You will be able to resume light exercises after a week and normal exercise by 1-2 weeks. You should begin massage to the scar once healed.
Risks and Complications
The vast majority of patients are delighted with the procedure although common complaints include numbness, bruising and swelling. Uncommon complications include infection, haematoma, delayed healing/skin necrosis/skin loss, seroma formation and thickened scar. There are uncommon risks of general anaesthesia such as respiratory / cardiac compromise and deep vein thrombosis. Liposuction removes fat cells and although these cells do not come back other fat cells can occur in the same area. It is unusual to have irregularities although over time these can develop. Your contour will also change and irregularities can become more apparent with fluctuations in weight. Although tissue is removed the aim is to reduce the volume and not remove all the tissue. The final result takes a number of months to become apparent.