Male Breast reduction

Go Bare Chested with Confidence

Gynecomastia (enlarged male breasts) – ‘Gyne’ stands for female and ‘mastia’ stands for breast. Gynecomastia is strictly a male disorder, which occurs due to excess breast tissue/glandular tissue growth with or without excess fatty tissue in men. These enlarged male breasts have a hard lump under the nipple which can also extend outside the borders of the areola depends on how much excess tissue is there. The enlarged breasts are firm, irregular and sometimes even painful to touch. Generally it is treated by surgical gland excision along with liposuction but in severe cases of gynecomastia the perfect contour of male chest can be achieved through a combination of fat removal, glandular tissue excision, and skin tightening of the sagged breasts. Plastic surgery to treat gynecomastia is technically called as reduction mammaplasty

Causes of Gynecomastia

There are three primary causes for each type of gynecomastia.
  • Excess breast tissue
  • Excess body fat
  • Excess skin
  • Or a combination of all these

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Often, the exact cause of a person’s gynecomastia cannot be pinpointed because the exact causes can range from intake of medications to hormonal changes to genetic predisposition. In fact, this medical condition is common and physiologic for healthy adolescents, to have this problem for 1 to 2 years during puberty. Some of the known reasons for gynecomastia may be:
  • Excess Estrogen- Naturally high level of estrogen or a high ratio of estrogen to testosterone may cause gynecomastia.
  • Steroid use- Anabolic steroid use may cause gynecomastia
  • Excess weight- It may cause pseudogynecomastia
  • Medications /supplements- Some medications/supplements are known to cause gynecomastia in some men
  • Klinefelter Syndrome- It is a sex chromosomal abnormality in men in which patient has extra ‘X’ chromosome resulting in abnormal “XXY” chromosomal combination due to which the male have female like characters which may include gynecomastia.
  • Hyperthyroidism- Hyperthyroidism (high level of thyroid hormone in blood) is predominantly found in females but males can also have this medical condition and this is also considered as one of the causes of gynecomastia.
  • Ageing- When males get older, the testosterone levels either become dormant or decrease from their earlier levels and this can lead to a dominance of the female hormone estrogen which may cause Gynecomastia.

Types of gynecomastia

Gynecomastia may be of following types:
  • ‘Pure glandular’ gynecomastia- It is true gynecomastia in which enlargement of the breast area occurs due to proliferation of fibrous breast tissue/glandular tissue.
  • ‘Mixed’ gynecomastia- It is the most common form of gynecomastia in which enlargement of the chest occurs by both excess fibrous breast/glandular tissue and fatty tissue.
  • Pseudo gynecomastia- It is false gynecomastia in which culprit of enlargement of the male breast area is excess fat only.

Stages of Gynecomastia:

Gynecomastia is seen in three stages of the life span of an individual and is associated with hormonal changes in the body.
  1. Neonatal gynecomastia: The first stage is during neonatal period (birth to 1 month) when 60-90% of babies develop breast tissue. It is asymptomatic which occurs as a residual effect of androgens to estrogens conversion by the placenta. This temporary gynecomastia usually subsides within two to three weeks.
  2. Pubertal gynecomastia: The second stage being in teenagers or between 10-15 years, when 48% to 64% of all teenagers have some form of breast tissue growth due to estrogens (female hormones) hormone imbalance.
  3. Senescent gynecomastia: The third stage being in old age or between 60-80 years. Hormone changes occur in parallel to development of gynecomastia in all three stages.

Am I a Candidate for Gynecomastia:

  • If you are unhappy and experiencing physical discomfort with the size or appearance of your breasts.
  • If you are mentally and physically healthy with normal body weight.
  • If you are feeling embarrassment to take off your shirt at the gym or beaches.
  • If your breast development has stabilized or you have passed the age of 20. Dr. Hassan Nurein always recommends waiting until after puberty before considering surgery, as pubertal gynecomastia can resolve over time.
  • If your enlarged breasts cannot seem to flat out despite attempts through diet and/or exercise.
  • If you are not significantly overweight/an obese person.
  • If you have good skin elasticity because successful gynecomastia surgery involves adequate skin contraction after your excess skin is surgically removed.
  • If you are not currently taking any medications/supplements known to cause gynecomastia. Medication induced gynecomastia can resolve if you substitute these medications or stop using them.
  • If you are emotionally stable with realistic expectations for surgical cosmetic achievement.

The Gynecomastia surgery procedure

Gynecomastia surgery can be carried out under intravenous sedation, local or general anaesthesia depending on patient and surgeon preference. The surgery can take 1-2 hours to complete which depends on the method of treatment (eg. Gland removal and/or Vaser Lipo) and the severity of the condition. On the basis of stage and degree of severity of the disease these are the following options available at Be Cosmetic Clinics, Kenya to treat gynecomastia
  • Gynecomastia surgery with Liposuction technique- This technique is generally used for the treatment of Pseudogynecomastia where gynecomastia is primarily the result of excess fatty tissue with or without excess skin. To remove excess fat from your breasts we generally use our minimally invasive VASER liposuction technique in which a very small ultrasound probe is inserted into your breast area which emits the high-frequency sound energy to break up and dislodge fat from nearby soft tissue fibers. The fat then becomes liquified and is gently removed by a thin metallic tube called cannula via suction through keyhole incisions. Lastly the tiny incisions are closed.
  • Gynecomastia surgery by using Excision technique- This technique is generally used for the treatment of pure glandular gynecomastia (puffy nipples) where gynecomastia is primarily the result of excess glandular breast tissues with or without excess skin. To remove the excess glandular tissue, firstly your surgeon carefully makes an incision around the edge of the areola(periareolar incision) and then excise the excess glandular tissue. Lastly the incisions are sutured and the treated area is bandaged. Excision also is necessary if the areola will be reduced or the nipple will be repositioned to achieve a more natural male contour.
  • Combination of liposuction and excision techniques- This technique is generally used for the treatment of mixed gynecomastia where gynecomastia is the result of excess glandular breast tissues along with excess fat with or without excess skin. To treat this severe gynecomastia your surgeon combines the Vaser liposuction technique for stubborn fat removal with tissue excision technique for glandular tissue excision to sculpt a new chest contour that looks natural to your body.

Downtime and recovery

Gynecomastia surgery typically requires only a couple of hours for recovery. The patient can return home after the surgery, and often resume normal activities after a few days. Exercise, bathing and swimming should be avoided for at least two weeks, any strenuous exercise or lifting for six weeks should be avoided, you can however take shower the next day of surgery. Generally for best results, we consider at least 2 weeks for recovery time after surgery. You should be available for a follow up one week-ten days following your treatment.

You should wear a support garment or an elastic bandage to minimize swelling and to support your new chest contour as it heals after surgery. Swelling and bruising after a gynecomastia treatment subsides after a few weeks and there is normally no noticeable scarring after a few months.

Risks and complications

Potential complications and risks associated with gynecomastia surgery are initially related to the drugs used, such as an allergic reaction. There are also surgical risks, as with any other surgery.

The common risks include: bruising, pain and temporary swelling.