Gynecomastia is a source of anxiety in the male population. The physical and mental concerns associated with gynecomastia warrant prompt and adequate treatment. In some cases, natural remedies and herbal medicines treat gynecomastia successfully. Statistically, however, the results from those types of treatments are not everlasting and acceptable. The persistence of gynecomastia instills a lack of confidence and self-esteem in males. They doubt their capabilities and can become profoundly anxious.

It is well accepted in the medical community that the definitive treatment of gynecomastia lies in surgery, assuming all medical treatments have been explored  –  such as removing inciting drugs like anabolic steroids, for example . Usually, surgery inculcates anxiety, and fear. Gynecomastia surgery has outstanding results as it restores the normal size and proportions of the chest. Gynecomastia surgery gives a chance to celebrate confidence once again. 

The duration of gynecomastia surgery recovery is always a concern with patients and will vary depending on the age of the patient, the extent of the gynecomastia, and the type of procedure performed to remove the gynecomastia. Typically speaking, gynecomastia is performed on an outpatient basis, and patients resume their normal day to day activities the next day, although exercise of the upper body is usually discouraged for a period of 2-4 weeks, again, depending on the nature and extent of the surgery performed.  

What is gynecomastia?

Gynecomastia, a medical term for what’s often referred to as “man boobs”, is a condition in which the size of breasts in men increases. This condition is observed in different age groups due to different underlying causes.

Gynecomastia is commonly experienced by individuals of old age, although infants and boys of adolescent age also experience gynecomastia quite frequently. In teenagers or young adults, gynecomastia typically resolves within months or years as hormones balance. Generally it is men of an older age who require definitive surgical treatment for gynecomastia. There are several factors associated with gynecomastia in the adult male population. 

The root cause of gynecomastia lies in hormonal imbalances that occur in males. Normally, men have high testosterone levels and low levels of estrogen. Any pathology that disrupts this balance leads to the proliferation of breast tissue in the male that manifests clinically as gynecomastia. Examples of such diseases include kidney disease, liver failure or liver cirrhosis, tumors with excess production of estrogen such as testicular tumors, thyroid gland disorders, and Klinefelter syndrome.  

If gynecomastia doesn’t resolve on its own, a trial of estrogen blocking agents are initiated orally to shrink the breast tissue. Some physicians also advise male hormones in addition to the female hormone-blocking agents. If the signs and symptoms of gynecomastia don’t resolve with medical treatment or worsen in some cases, surgery might be the only option for curing gynecomastia. 

What is gynecomastia surgery?

Gynecomastia surgery, also called male breast reduction, is an operative procedure designed to remove gynecomastia. The surgeries may be performed awake or asleep, depending on the extent and nature of the gynecomastia.  Depending upon the type of gynecomastia, one or both of the following techniques are employed.

Gynecomastia Treatment

In patients who have gynecomastia solely due to an increase in fatty tissue of the chest area, also known as pseudogynecomastia, Vaser-assisted liposuction is performed as a curative gynecomastia treatment. 

In this technique, the breast is primarily injected using a tumescent solution, which acts to provide anesthesia as well as preventing blood loss during surgery.  Next, Vaser is introduced, which is a highly focused ultrasound device which acts to dissolve the fat and break down attachments to help expedite the liposuction.  Lastly, a cannula is inserted into the breast through a couple small incisions.  The fat is then aspirated or sucked out, and at the same time, contouring is performed to give the chest its optimal look – one that is more youthful, athletic, and balanced as compared to the pre-procedural state.  Lastly, a compression garment is applied to the chest, and will remain in place for a period of 2-4 weeks, aside from showering.  The garments are critical in reducing swelling as well as optimizing the chest contour. 

Gynecomastia Excision 

In patients who have gynecomastia due to an increase in glandular breast tissue or excess skin, the gynecomastia excision technique is used. This technique also favors reducing the size of the areola and repositioning of nipples according to natural male contour standards.

The extent of the gynecomastia excision will be based on the size of the gynecomastia.  For example, some patients may only have a small gynecomastia underneath the nipple-areola.  In these cases, a very small incision is made along the areolar border.  The gynecomastia is then removed, and the skin is closed, leaving a very imperceptible scar line. Small procedures such as this can be performed under a local anesthetic.  In more involved cases where the gynecomastia is significant and there is associated skin excess with nipple sagging, more extensive surgery is required.  This may vary from a simple excision of the mass via an areolar excision, to performing a formal breast lift with the gynecomastia excision in order to correct the breast sag and excess skin.  The more extensive gynecomastia procedures are typically performed under a general anesthetic.

Combination Gynecomastia Excision with Liposuction Technique

In cases where the patient has breast-tissue overgrowth as well as fatty tissue in the chest, the best results are achieved by gynecomastia excision through an areolar incision, and then strategically performing liposuction of the chest.  This achieves two things:  It allows for correction of any dents or divots that may result from removing a substantially sized gynecomastia mass.  It also improves the chest contour by correcting the fatty tissue component of the gynecomastia.  The liposuction or lipoplasty is performed with Vaser

What is gynecomastia surgery recovery like ? 

Gynecomastia surgery offers promising results. Gynecomastia surgery recovery is typically not grueling. However, it is necessary to educate yourself about the expected conditions during the recovery.

Low energy levels following gynecomastia surgery

Following gynecomastia surgery, you will return to your home  likely experiencing low on energy, especially if you have undergone a general anesthetic. The feeling of fatigue may persist for some weeks.  Maintain a healthy and balanced diet, drink lots of water, and request a family member to take care of strenuous tasks if possible.

Swollen and sore chest

You will notice your chest to be swollen and sore following gynecomastia surgery.  There is generally no need to worry about it. After the procedure, it is normal for the chest area to be sore and swollen for several weeks. Moreover, one side of the chest may heal earlier than the other because the body heals asymmetrically. You should do your best to relax and realize that it will take up to 4 months for swelling to reside completely.

Incision scars

Initially after your gynecomastia surgery procedure, the scars may appear raised and the incision line may be red. As time passes by, these scars eventually fade to a light color and resemble a fine line. Surgical tape is applied to the incision and is generally worn for a period of 2-4 weeks. Once the surgical tape is removed, it is recommended that silicone sheeting be applied for a period of 3 months.  If silicone tape is inconvenient, silicone gel may be applied twice daily as an alternative.  Over time, the scars improve remarkably. They don’t vanish completely but fade and settle, leaving the incision hard to see with the naked eye. If you are dissatisfied with the incision line due to discoloration, a treatment option includes medical tattooing, which is specifically designed to minimize the appearance of surgical incisions. 

Emotional effects

After gynecomastia surgery, you may experience mood imbalances and other emotional effects.. This is a common finding, especially if you require opiate medications for pain control, which is typical after gynecomastia surgery. Not only in gynecomastia surgery but in other surgeries as well,  patients experience a wave of anxiety and despair followed by a wave of excitement and happiness. These emotional ups and downs are part of the recovery process. Stay connected to your friends and family. Remind yourself about the ideal chest you have always admired which is right there beneath the bandages.

Itching of incision

No matter what, do not scratch the gynecomastia incisions following surgery.  Itching is a sign of healing. Scratching can further irritate the itchy area and cause discomfort or open the scars, potentially producing a sub-optimal scar. 

Sensitive nipples

For the first 3 months, your nipple-areola may be hypersensitive.  Your nipples might be highly sensitive to any stimulus or not sensitive at all. In some patients, both conditions occur together. This condition goes away on its own. It is also common to experience intermittent, sharp pains, which indicate the healing of nerves. This will resolve over time, but may last weeks to months.

References

  1. Kasielska-Trojan A, Antoszewski B. Gynecomastia surgery—impact on life quality: a prospective case-control study. Annals of plastic surgery. 2017 Mar 1;78(3):264-8.
  2. Barros AC, Sampaio MD. Gynecomastia: physiopathology, evaluation and treatment. Sao Paulo Medical Journal. 2012;130(3):187-97.
  3. Zavlin D, Jubbal KT, Friedman JD, Echo A. Complications and outcomes after gynecomastia surgery: analysis of 204 pediatric and 1583 adult cases from a national multi-center database. Aesthetic plastic surgery. 2017 Aug 1;41(4):761-7. 
  4. Fricke A, Lehner GM, Stark GB, Penna V. Long-term follow-up of recurrence and patient satisfaction after surgical treatment of gynecomastia. Aesthetic Plastic Surgery. 2017 Jun 1;41(3):491-8.

Pin It on Pinterest

Schedule Consultation