Updated: Nov 4
What is gynaecomastia?
Some call it "mans boob". It is a condition where male's breast is larger than normal, resembling a women's breast. Gynae = female, mastia = breast. It can occur in one breast, or both.
Is gynaecomastia dangerous?
In most cases, they are benign. However, since it is made of breast tissue, there is still slightly increased risk of breast cancer.
What causes gynaecomastia?
Patient who came to my clinic, mostly had a history of steroid intake, to bulk up their muscles. Teenage male in their late teens who are going through hormone changes are quite common too. However, a lot of things can cause gynaecomastia. A complete cause of gynaecomastia can be divided into idiopathic, physiological, pharmacological can pathological.
It means, the cause of gynaecomastia is unknown. It may arise spontaneously after all other causes have been excluded.
Gynaecomastia can results due to side effect of certain medications. The list of drugs are endless, but here are some examples:
Certain underlying diseases may cause gynaecomastia due to hormone imbalance (mainly due to increase level of estrogen and reduce level of testosterone.
How big can gynaecomastia grow?
It can grow from mild to significantly large. A clinical classification (called Simon's Classification) is made, based on how large the breast is and how redundant the skin is (in layman term - how saggy the breast is).
Small visible breast enlargement
No skin redundancy
Moderate breast enlargement
No skin redundancy
Moderate breast enlargement
Has skin redundancy
Marked breast enlargement
Marked skin redundancy - (Like a pendulous female breast)
What is that firm nodule that I felt under my gynaecomastia breast?
The breast tissue of a person with gynaecomastia can be made of fatty (usually soft), glandular (usually firm) or mixed. In most cases, these are not breast tumor, but rather different consistency of breast tissue due to different breast tissue type.
What is the treatment of gynaecomastia?
First and foremost, if there is a primary case that causes the symptoms, that need to be treated first. A full body examination including your genitalia, several blood test and imaging investigation needs to be done to rule out any underlying cause of it. If any of it is identified, then it will be treated accordingly. Sometimes, you may need to be referred to other doctor of different specialty.
Once all has been excluded and treated, a surgery can be done to remove the excess breast tissue and sometimes together with some of the redundant skin. It can be done by liposuction, surgical excision or both.
How is the scar going to be like after surgery?
Depending of the severity of gynaecomastia, it may be a almost scarless procedure through only liposuction, to fine incision line around your nipple. In an extremely large breast, the whole breast may need to be removed via larger excision leading to longer scar line, with the need of free nipple grafting to achieve a flat contour.
How long is the downtime after a surgery?
2-3 Days After Surgery
Pain and swelling
Pain medication is necessary
Compression garment needs to be worn
Rest with light activity
You can be discharged after your first wound inspection and removal of drain
1 Week After Sugery
Pain and swelling will start to reduce
Return to work with light activity
Never do strenuous chest exercise
Sleep by lying at your back
Wear your compression garments
2 Weeks After Surgery
Return to normal daily activities as tolerated
Avoid strenuous exercise
You may sleep on your sides
Wear your compression garment
3-4 Weeks After Surgery
Swelling and bruising usually disappear by now
Return to normal exercise except chest exercise
Compression garment can be removed after 1 month
6 Weeks After Surgery
Return to normal
Some slight swelling and bruises will gradually resolves over time.
What can go wrong with gynaecomastia surgery?
Generally, gynaecomastia removal is a low risk surgery but nothing is guaranteed as any invasive procedure comes with risk. Common complications include:
fluid accumulation as part of healing (seroma)
unsymmetrical breast due to over or under resection
reduced nipple sensation
loss of nipple tissue due to compromised blood supply
Gynaecomastia surgery is an invasive treatment that needs to be done by a qualified plastic surgeon in a licensed healthcare centre. In all my cases, it is done under general anaesthesia, backed up by anaesthetist specialist in a well established hospital. It is important for your surgery to be done by board certified plastic surgeon who has been extensively trained through years of comprehensive plastic surgery postgraduate program to minimize risk of complications.
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