Gynaecomastia

Gynaecomastia (Breast Enlargement in Men)

 

 

Gynaecomastia refers to the enlargement of breasts in men. Even though gynaecomastia usually has no serious health implications, , the enlarged breasts can draw unwanted attention from the others and cause great embarrassment. Gynaecomastia often causes significant psychological and emotional distress to the male patients.

Causes of gynaecomastia:

      1. Any conditions that cause estrogen-androgen hormone imbalance:
        1. The commonest cause is physiological hormone changes during puberty and old age.
        2. Medicine such as anti-androgens, anabolic steroids, diazepam, cimetidine, spironolactone, etc.
        3. Health conditions, such as liver problems, malnutrition, hypogonadism,
        4. Herb and supplements that have excessive estrogenic activity.
      2. Increased sensitivity of breast tissues to the circulating hormone estrogen that cause the male breasts to enlarge.

 

The enlarged breast in gynaecomastia consists of two components, glandular tissue, and fatty tissue. While fatty tissue can be removed by liposuction, the only effective way to remove glandular tissue is by surgical excision. The complete removal of gynaecomastia requires the combination of liposuction and surgical excision to achieve satisfactory results.

 

 

 

 

Preparation

      1. Inform the doctor of any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.
      2. Stop smoking at least one week before surgery. Smoking is harmful to wound healing and increases the risks of other post-operation complications.
      3. Stop the following medications and supplements from one week before surgery until one week after surgery.
        1. All supplements containing vitamin E, ginseng, ginkgo, garlic, fish oil, and other ingredients that increase bleeding during the procedure. Other supplements, traditional medicine, and herbs, in which ingredients are unknown, have to stop as well.
        2. Medicine that increases bleeding during the procedure such as aspirin, NSAIDs, and warfarin. However, you may need to consult your physician who prescribed the medication before you stop them.
      4. On the day of surgery, wear simple and comfortable clothing. Do not wear any makeup. Do not wear any jewelry and metal objects on the face and body.

 

 

 

 

Surgery

Duration: 2-3 hours

Anaesthesia: Usually surgery can be done under local anaesthesia. General anaesthesia may be needed for very large gynaecomastia.

Hospitalization: Not required for cases done under local anaesthesia. Cases done under general anaesthesia require half day hospital stay.

Recovery*: Back to work in 3-7 days, light exercise after 1 week, heavy exercise after 4 weeks.

* The actual speed of recovery may vary from person to person.

Surgery Technique: Both liposuction and excision are performed in the same operation. Liposuction is performed through a small incision (around 3-5m) on the lower chest and breast tissue is excised and removed through an incision around the lower border of the areola.

 

 

 

Post-operative Care**

      1. What to expect:
        1. Swelling usually peaks on the second to third day after surgery and will gradually subside after that.
        2. Use a supportive garment to support the chest during the first month.
      2. General care:
        1. Avoid smoking for at least one month. Smoking increases the risk of wound complications.
        2. Adequate rest and adequate sleep are helpful for a speedy recovery.
        3. Sleep on the back. Avoid sleeping on one side to prevent pressure on the breasts.
        4. Be relaxed and calm. Contact the clinic if there are any queries.
      3. Medicine:Finish the oral antibiotics as prescribed. Take the painkiller as prescribed when necessary.
      4. Wound care:Clean the wound with a clean cotton tip soaked with sterile water/saline. Apply antibiotic ointment.
      5. Physical activity:Avoid heavy physical activity and exercise for at least one month.
      6. Follow-up:Come back one week after surgery for the removal of sutures and review.
      7. Emergency: If there is heavy bleeding, a rapid increase in swelling or severe pain, immediately contact the clinic/doctor for advice.

 

** The instructions in this list are only for general guidance. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for further advice.

 

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