Gynecomastia Surgery - Is It Safe?, Before & After, Side effects

Gynaecomastia or man boobs occurs when men have an overgrowth of breast tissue. There are different surgical approaches used for gynaecomastia, taking into account its grade and severity. 

Gynaecomastia surgery is considered when patients suffer from mental and physical distress due to the condition. The goal is to remove excessive glandular tissue and restore the natural shape of the chest. 

Surgical methods include breast tissue removal, liposuction, and a combination of techniques. Reducing mammoplasty is recommended for severe cases (stage III gynaecomastia and beyond), considering the extent of glandular tissue and the surgeon's expertise. 

When there is excess skin, techniques like skin reduction or mastectomy with nipple repositioning can address it. Scar-reducing techniques have also been developed to minimise unsightly scarring during open surgical procedures. 

Liposuction, with a 'pull-through' technique, can remove glandular tissue without additional incisions but may not address excess skin.

Anatomy and Physiology of Male Breasts

The size and appearance of the male breasts can differ. It is influenced by factors such as age, the accumulation of fatty tissue underneath the skin, and individual body characteristics. The anatomy of male breasts is as follows:

1. Glandular Tissue: Male breasts contain a small amount of glandular tissue. The internal structures, like lobules and ducts, are not well-developed. 
2. Nipple and Areola: In men, the nipples and areolas are typically small and less prominent.
3. Fat Tissue: The majority of the male breast is composed of fat tissue, which gives the chest its shape and contour.

Gynaecomastia can happen at any age and is triggered by an imbalance of hormones in the body. It is particularly due to a rise in oestrogen compared to testosterone. 

The surgery is performed for both cosmetic and medical reasons. The candidates for gynaecomastia surgery are:

1. Men who experience physical discomfort or embarrassment due to enlarged breast tissue.
2. In cases where gynaecomastia symptoms include enlarged breast tissue, breast tenderness or pain, and nipple discharge. It may pose a significant health risk, leading to medical gynaecomastia surgery.

Surgical treatment has been proven to offer advantages leading to enhanced physical and emotional well-being. According to Stephanie W. Holzmer, patient satisfaction following surgical correction is generally reported to be exceptionally high. It ranges from 84.5% to 100%.

The benefits of the procedure are:

1. Improved Physical Appearance: Enlarged male breasts can lead to self-consciousness, especially during swimming and exercising. Gynaecomastia surgery can enhance the appearance, creating a more masculine and balanced look.
2. Boosted Self-Esteem and Confidence: Many men who undergo gynaecomastia surgery report increased self-esteem and confidence. Removing excess breast tissue can help build self-assurance, making them feel more comfortable in their bodies.
3. Enhanced Physical Comfort: Enlarged male breasts can lead to physical discomfort, including chafing and skin irritation. Gynaecomastia treatment can alleviate these issues, enhancing physical comfort.

Patients often have concerns about what happens during the surgery. This section provides insight into the anticipated preparations before and on the day of the procedure.

Before Gynaecomastia Surgery

Prior to gynaecomastia surgery, the medical team follows a set of protocols to guarantee the safety of the patient.

A plastic surgeon does gynaecomastia surgery. It is on an outpatient basis. It takes 60-90 minutes to complete.

Gynaecomastia treatment can be performed through different methods:

1. Liposuction: This is suitable when excess fat is the main cause of gynaecomastia. The surgeon uses small incisions to remove excess fat.
2. Tissue Excision: When gynaecomastia involves glandular breast tissue or excess skin, tissue excision is recommended.

In some cases, combining both techniques achieves the best results.

Below are the steps involved in the gynaecomastia surgical procedure:

1. The surgeon will carefully choose where to make the incisions under general anaesthesia. 
2. Small incisions are used for liposuction for cases primarily involving fat reduction. If glandular tissue removal is needed, slightly larger incisions along natural skin creases are made.
3. Through these incisions, excess fat tissue and skin are removed.
4. After the surgery, the incisions are closed using internal and external sutures. Sometimes, temporary drain tubes are placed under the skin at the incision sites to remove excess fluid. 
5. The patient will be monitored for a few hours, with bandages covering the incisions. 

A compression garment may need to be worn for a few weeks to help shape the chest. Incisions and drain tubes are removed within 7 to 10 days after the surgery.

Recovery in the Hospital

As it is an outpatient procedure, the patient will be monitored in the recovery room for a few hours. Expect initial swelling and bruising, which is natural and part of the healing process. Hospital staff will monitor this closely.

Below are the steps of the recovery process in the hospital:

1. Immediate Post-Op Care: Patients are closely monitored in the hospital recovery area after gynaecomastia surgery to ensure they wake up safely from anaesthesia.
2. Pain Management: Pain and discomfort are common. Hospital staff will administer prescribed pain medications as needed to keep the patient comfortable.
3. Monitoring Vital Signs: A nurse or a doctor will monitor vital signs such as blood pressure and heart rate to ensure the patient's stability.
4. Compression Garments: As soon as anaesthesia wears off, the patient is made to wear the compression garment. 

At-Home Recovery

1. Pain Medications: Your surgeon will prescribe pain medications for you to take at home. Follow the dosing instructions carefully.
2. Dressings and Compression Garments: At home, you'll continue wearing dressings and compression garments as your surgeon directs to minimise swelling and support healing.
3. Wound Care: Proper wound care is important. Keep the incision sites clean and dry as instructed by your surgeon.
4. Rest: Adequate rest is essential. Plan to take it easy for several days, avoiding strenuous physical activity.
5. Hydration and Nutrition: Stay well-hydrated and maintain a balanced diet to support healing. This includes drinking water and eating nourishing foods.
6. Swelling and Bruising Management: Continue to monitor and manage swelling and bruising by following your surgeon's recommendations, which may include cold compresses.
7. Avoid Strenuous Activities: Follow your surgeon's guidance on when it's safe to resume regular activities, such as exercise or heavy lifting.

First Follow-up Appointment

Having a one-week follow-up with your surgeon after gynaecomastia surgery is standard. During this visit, the surgeon will:

1. Examine your recovery and confirm that the incisions are healing well.
2. Remove any stitches or staples and offer further guidance on caring for the treated area.
3. Review whether additional treatment or ongoing care is needed.
4. Go over the surgical results and address any questions you might have.

Gynaecomastia surgery has a high success rate. The major complication of the surgery is hematoma formation, which is the most common, followed by seroma.

The following are the risks and complications of the procedure:

1. Haematoma or Seroma: Haematoma is a blood collection, and seroma is a fluid buildup at the surgical site, which may require drainage.
2. Infection at the Surgical Site: An infection can occur at the incision area, leading to redness, swelling and pain.
3. Changes in Nipple Sensation: The surgery can affect nipple sensation, resulting in temporary or permanent changes in sensitivity.
4. Asymmetry in Chest Appearance:  The results of the surgery may not lead to perfect chest symmetry, with one side looking different from the other.
5. Skin Contour Irregularities: The skin may develop irregularities, such as dimpling or unevenness, affecting the cosmetic outcome.

Gynaecomastia surgery works best when done soon after the condition starts. Waiting can raise the chance of issues and make the surgery less effective or more complicated. The risks of delayed surgery are:

1. Increased risk of complications: It can increase the risk of complications, such as infection or bleeding. It may also make the procedure more difficult or less effective, as the breasts may become larger or more difficult to shape.
2. More Breast Tissue Growth: Gynaecomastia may continue to progress if surgery is delayed. It leads to further enlargement of the breast tissue.
3. Continued Physical Discomfort: Prolonged physical discomfort, such as chafing, skin irritation, and pain in the chest area, affecting one's daily comfort and quality of life.
4. Prolonged Emotional Distress: It can extend the emotional distress associated with having enlarged male breasts. This may lead to prolonged self-consciousness and lowered self-esteem, impacting mental well-being. 
5. Reduced Participation in Physical Activities: Some men with enlarged breasts may feel self-conscious about participating in physical activities or may even avoid them altogether.

Generally, gynaecomastia surgery can cost between ₹ 40,000 to ₹ 1,00,000. It can vary depending on several factors:

1. Consultation Fee: This is the cost associated with the initial meeting with the surgeon to discuss the surgery and assess your condition.
2. Patient's Condition Severity: The extent to which gynaecomastia affects you can impact the cost; more severe cases may require more extensive procedures.
3. Clinic or Hospital Type: The choice of where the surgery is performed can influence costs. Larger or more prestigious clinics or hospitals may charge more.
4. Location or City: The geographical location plays a role as the cost of living and healthcare expenses can vary significantly between cities and regions.
5. Patient's Age: Younger patients might have different physiological considerations, which can affect the complexity and cost of surgery.
6. Surgical Technique: The surgical approach used, such as liposuction, direct tissue excision, or a combination, can impact the cost. The more complex techniques, the more expensive.
7. Post-Surgery Complications: Any issues that arise after the surgery, which may necessitate additional treatment, can add to the overall cost.

Click to know in detail the Gynaecomastia Surgery Cost in India

Men may experience breast tissue enlargement due to hormonal imbalances or supplements. It usually resolves on its own and isn't typically a severe medical concern. But for cosmetic and medical reasons, gynaecomastia surgery is recommended.

If you're worried about gynaecomastia, HexaHealth experts can offer guidance and discuss potential treatment plans. We will guide you from the beginning to the end of your surgical journey. Book your appointment now!

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