While the causes are not certain, the excess development of breast tissue in men is more common that you think. It can cause great anxiety, social inhibition and self-consciousness for many men.

Male breast reduction, or gynecomastia surgery, removes tissue from the breasts and in extreme cases excess skin. It can improve the appearance of the chest in cases where diet and exercise have failed and the results are significant and permanent.

The first thing to do is to talk to your GP who will refer you to Mr Meagher. By talking to your GP and Mr Meagher you are more likely to get the results you want from the surgery.

Most teenage boys experience some degree of breast enlargement which affects one or both breasts and by early adulthood less than 10% have a residual problem. This incidence rises with age, reaching approximately 30% in older men. Although the cause of gynecomastia is largely unknown some possible causes include:

• Medicines for high blood pressure, heart disease and prostate cancer
• Drugs such as marijuana and anabolic steroids
• Disease such as liver failure and some cancers
• Rare congenital abnormalities

Before the operation

To ensure that everything goes as well as possible, there are a number of things you should do before the procedure:

1. Maintain an appropriate weight for 9-12 months
2. Don’t drink alcohol for 7 days
3. Stop smoking 2-3 months beforehand
4. Don’t take anti inflammatory medicines (Aspirin™, etc) for 14 days due to the increased risk of increased blood loss during surgery
5. Tell us about all medicines you are taking and for what condition

The most important thing to do is to talk with Mr Meagher so that there is a clear understanding of your desires and expectations, in light of any biological prerequisites. We want you to be well informed and have realistic expectations of the results.

We will evaluate your current physical health and health history and also explain the procedure. Because Gynaecomastia surgery is an elective procedure, we will carefully discuss the benefits and risks.

Mr Meagher will take dimensions of your breast and surrounding tissue to determine the best surgical approach.

If you decide to proceed with the operation you will be required to confirm your understanding of all aspects of the surgery and agreement to proceed by signing a consent form.

We will also take photographs as a record and to help plan your surgery.

In general, the most suitable candidates for Gynaecomastia male breast reduction surgery are:

• Mature enough to fully understand the procedure
• Experiencing embarrassment or social inhibition
• Informed about the surgery
• Fortunate to have good skin elasticity
• In good physical and psychological health
• Eager to improve their appearance or comfort
• Realistic in their expectations of the surgical outcomes
• Willing to initially try dieting and exercising as first options
• Non-smokers or able to stop smoking during the healing process
• Not using marijuana or anabolic steroids
• Not heavy users of alcohol

During the operation

Your operation will be performed by Mr Meagher in a major hospital and can last from 1 ½ to 3 hours. You should be able to go home within a few hours of the operation and spend the night in the comfort of your own home. In some cases, patients are advised to spend a night in the hospital so that the recovery process can be monitored by medical staff.

Either general anaesthesia or a combination of intravenous sedation and local anaesthesia are used and the anaesthetist will explain the type and risks of the particular form of anaesthesia for your operation.

The surgical technique performed by Mr Meagher will depend on the degree and extent of the breast reduction. The options include removal of the tissue under the breast or liposuction of the chest wall. In both instances, a small elliptical incision is made on the lower half of the nipple area (areola). For those men with tissue that is more glandular in nature, all breast tissue directly under the nipple is removed.

If the tissue is more fatty in nature, liposuction can provide excellent results. During liposuction, a small suction rod or cannula is inserted into the incision to remove fat and other tissue.

Occasionally repeat procedure is necessary to remove tissue that was missed during the first procedure. In a few cases, if there is a large amount of extra skin, it will be necessary to remove this tissue, which will result in a larger scar.

You may feel some pain the extent of which can vary from minimal to moderate, and will last from several days to 2 weeks.

After the operation

After the operation your chest will be temporarily swollen and bruised and it will be difficult to assess the full effect of the surgery. You may also experience numbness or a burning sensation. You may be given a compression garment to wear for several weeks after the surgery.

If you have severe pain or discharge in the surgical area, or if you experience muscle aches, dizziness or a general ill feeling with fever, nausea or vomiting, contact us immediately.

You can resume light activities within a few days, although your chest will be sore. Most people are able to return to non-strenuous work within 3 to 7 days and resume more strenuous activities in 2 to 3 weeks. You should avoid exposing the operated area to the sun for at least 6 months to prevent permanently altering the skin pigmentation.

Routine physical activity and exercising (especially lifting, pulling and pushing motions) should be avoided for at least 6 weeks to help the scars to heal. Mr Meagher will advise on the level of physical activity that is appropriate for you. Some degree of swelling and bruising may last for 3 to 6 months.

The improvement from this procedure is permanent, but weight gain or use of certain drugs could result in recurrence of the enlarged breasts.

Potential complications

The vast majority of breast reduction procedures don’t create any side effects or complications. However, there are risks associated with any type of operation and this surgery is no exception. Mr Meagher will explain the possible risks, which are rare, but may include wound infection, hematoma (blood collection), seroma (fluid collection), changes in the nipple-areolar complex sensitivity and loss of portion or all of nipple and areolar complex through inadequate blood supply and fat necrosis which may feel like a breast lump after surgery.

1. Pain: As with any surgical procedure, pain of varying intensity may occur following your surgery. You will be prescribed some pain medicine to take in hospital and at home after your discharge, if you need it.

2. Infection: Infection does not happen very often and you will be given an antibiotic at the time of your surgery to prevent this. If you do develop an infection, see Mr Meagher as soon as possible. Most infections can be treated with an antibiotic but they can cause serious problems and increased scarring.

3. Haematomas: Haematomas are a solid swelling of clotted blood within the tissue and they can happen after any surgery. The risk of infection is higher if a large haematoma or seroma (a collection of watery fluid within the tissue) collects immediately after surgery. Mr Meagher may use a surgical drain to help prevent small haematomas but, in some cases, Mr Meagher may need to re-operate to remove a large haematoma.

4. Poor wound healing: Healing can take longer in cases of:

• Infection
• Bleeding
• Fluid accumulation
• Contour defects due to overly tight stitches
• Improper support during healing
• Pressure against the scar tissue

Wound healing may also take longer in patients who have diabetes, or other medical conditions, or who smoke.

Other potential issues

In gynecomastia, serious complications are quite rare but the risks include:

• Injury to the skin
• Bleeding
• Rippling of the skin
• Contour defects due to inadequate tissue removal
• Haematoma formation
• Excessive scarring
• Pigmentation changes along the scar line
• Altered sensation in the nipple areolar complex.