Male Breast Reduction

Enlargement of the male breast is known as gynaecomastia. It has a number of causes but in most cases there is no obvious reason for the development of gynaecomastia.

It is a relatively common condition. It is particularly common in adolescence and usually settles by itself in about 10% of cases though it can persist into adult life. Gynaecomastia is also relatively common in old age.  With more and more patients losing significant amounts of weight, there has been an increase in a type of gynaecomastia, where excess skin is the main issue (pseudogynaecomastia).

If you think you have this condition and have not seen a doctor about it before,  It is important that you see your own GP to check your chest and to confirm that no further tests are required. A testicular examination to exclude lumps may be required. Sometimes referral to a NHS breast clinic is needed if there is a particular lump that needs to be evaluated. It should be appreciated though that in most cases gynaecomastia is not caused by anything sinister.

Why do patients seek surgery for gynaecomastia?

Why do patients seek surgery for gynaecomastia?

  • Embarrassment in clothing – unable to wear snug-fitting t tops such as T-shirts
  • Lack of confidence when not wearing a top – when swimming, on the beach.
  • Rarely the problem can cause physical symptoms, such as discomfort when exercising.
  • Asymmetry – a small group of patients have difference between the two breasts that can cause cosmetic concerns.
What happens during the consultation?
Mr Chester will take a detailed medical history from you. He will assess your suitability for surgery. Your height and weight will be measured. Mr Chester will examine your chest, take measurements and check you for lumps in the chest and armpits. He will offer you a testicular examination if this has not already been performed. Mr Chester will then present you with surgical options and recommendations based on your problem. There are different types of gynaecomastia surgery, each with their own advantages and disadvantages. The degree of breast tissue and skin excess will dictate the procedures that are recommended.
How long will I be in hospital ?
You will come into hospital on the day of surgery.  Patients are normally in hospital for 1 night after gynaecomastia surgery.
What happens during the operation?
Gynaecomastia is usually performed with patients asleep under general anaesthetic. The length of the procedure varies from approximately 1 to 2.5 hours, depending on how extensive the gynaecomastia is.  Excess skin is removed where necessary and underlying breast tissue is removed. Some tissue has to be left immediately behind the nipples and areolas to help keep them alive and to reduce the risk of an indentation forming. Liposuction is sometimes performed. The scarring varies from a semi-circular or circular scar around each areola to anchor-shaped scars on each side, depending on the amount of skin that needs to be removed and whether the nipples need to be moved upwards significantly. To reduce the risk of the scars around the areolas stretching, Mr Chester will often use a permanent Goretex suture, particularly for those who require skin tightening around the areolas. Mr Chester routinely uses drains, which are narrow plastic tubes that come out the skin on each side of the chest and are designed to take away any excess blood or fluid. Drains are usually removed before patients go home.
What is the recovery period following surgery?
It is generally 6 weeks before patients can return to most normal activities. Most patients require at least 2 weeks off work, although this can be nearer 6 weeks for those with heavier occupations. Driving should be avoided for 2-3 weeks. Exercise can be commenced from 4 weeks, depending on the extent of surgery, but heavy upper body weight lifting may need to be avoided for longer than this. Mr Chester will advise you on the likely recovery period.

Mr Chester recommends that patients wear snug-fitting “skin” or T-shirt for 3 weeks after the operation, to apply gentle pressure.

Follow-up

Mr Chester normally sees patients following gynaecomastia surgery at around 1 -2 weeks, 6 weeks and 3-6 months post-operatively, although this is only a guide and sometimes patients can require additional appointments for dressings etc. Mr Chester provides most, if not all, of the aftercare himself to provide reassurance throughout the patient journey.

Before and after photographs

Case 1

19 year old gentleman with moderate gynaecomastia treated with surgery to remove a donut shape of skin around the areolas and underlying breast tissue. Scars are located around the areolas. Post-operative photographs have been taken at around 6 months.

Before surgery
After surgery
Case 2

57 year old gentleman with moderate gynaecomastia. Excess breast tissue and donut shape of skin taken from around areolas. Post-operative photographs taken at around 3 months. Scars are located around the areolas.

Before surgery
After surgery
Case 3

28 year old gentleman with significant gynaecomastia following weight loss. Excess skin and breast tissue removed. Anchor-shaped scars result due to the amount of skin that requires removal. The nipple positions are elevated and the areolas are reduced as part of the procedure. Asymmetry is corrected. Post-operative photographs are taken at 9 months. Scars are beginning to fade out and will continue to fade further over the next 6 months.

Before surgery
After surgery
For any enquiries or to book an appointment with Mr Chester please get in touch with his secretary
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