Gynecomastia alert: Do's and don'ts before male breast reduction surgery

Significant gynecomastia can be removed via surgical treatment that involves liposuction and gland incision. Here's all you need to know about the male breast reduction surgery

Hormonal imbalances sometimes develop female-like breasts in men. This condition is known as gynecomastia or commonly referred to as ‘man-boobs’ that is caused by the swelling of breast tissues in males. While regular exercise expanding several months will marginally reduce this swelling, in order to have a chiselled body, one needs to be patient to see that result naturally. However, if you want to see quick results, you can opt for gynecomastia male breast reduction surgery.

But will it be safe? Will it have a long-term health implication? Will there be any side effects? Does it have a 100 per cent success rate? Business Standard asked Prashant Yadav, a plastic and cosmetic surgeon at Dezire clinic, the procedural details about this surgery. Here are the answers:

1. What is gynecomastia? What are the problems that cause gynecomastia?

Gynecomastia or breast hypertrophy in men is a condition of having abnormal enlarged breasts like a woman. Gynecomastia is a jumbled derivation from Latin and Greek language: Gyneco – ’woman’ + Latinised form of Greek mazos – ‘breast’ which is a variant of mastos.

It more commonly occurs on both sides of the chest in 70 per cent of the cases.
 

There are two types of gynecomastia —True gynecomastia in which major component is enlarged glandular tissues and Pseudogynecomastia, where breasts develop due to deposition of fat in the breast area.

2. Reasons for developing gynecomastia:

Dr Prashant Yadav

In the majority of the cases, there is no obvious reason found and this is known as idiopathic gynecomastia. But certain factors can increase the probability of gynecomastia. Due to increasing cases of obesity, increased use of anabolic steroids and environmental contamination with estrogen-like substances, the number of patients in India with gynecomastia are increasing.

It is usually caused by an increase in the ratio of estrogens (female hormone) to testosterones (male hormone). Estrogen, the “female” hormone, makes breast tissue grow, while testosterone, the “male” hormone, has inhibitory effects on the breast tissue (it stops estrogen from making breast tissue grow).

3. Here are the four types of clinical gynecomastia based on severity: 

• Grade 1 small enlargement, but without excess skin over the chest
• Grade 2 moderate enlargement, but without excess skin over the chest
• Grade 3 moderate enlargement with extra skin over the chest
• Grade 4 marked enlargement with extra skin over the chest

4) How to get rid of gynecomastia?

Non-surgical alternatives like dieting, Ayurvedic medicines, gym and even pills can help to a certain extent in a few cases in mild gynecomastia. 

Pre-pubertal or pubertal gynecomastia in boys needs no treatment usually as it resolves on its own once hormone levels return to normal. 

However, significant and discernible gynecomastia can be removed via surgical treatment that involves liposuction and gland incision. It is a surgery done by a highly advanced technique performed by a specialised gynecomastia plastic surgeon. The breast gland is also removed so that there is no recurrence after the surgery.

5. Who can opt for the surgery? What should be the age group of the person?

Any male who is above 18 years and is medically fit can opt for this surgery.

6) How should one prepare for the surgery?

• Get a complete medical evaluation done

• Avoid smoking, taking anti-inflammatory drugs and herbal supplements

• Apprise your surgeon about any medication that you have been taking

• Procedure time and duration of stay in the clinic.

The surgery needs around two hours and it’s only a one-time treatment.  One needs to stay in the clinic three-four hours and after the surgery. It does not require admission or staying in a hospital.

8) What are the steps of a Gynecomastia procedure? What type of anaesthesia is used for the procedure?

• Marking of pectoral (chest) muscles and glandular tissue for chest reshaping is done

• Administration of anaesthesia - local anaesthesia with light sedation is preferred.

• Tumescent solution infiltration

• VASER Liposuction to remove extra fat deposited in the chest area

• Complete removal of excess glandular breast tissue is done with an intention to eliminate any chances of re-occurrence.

9.Precautions before surgery:

• All pre-operative mandated tests should be completed. 

• Chest and under-arms completely shaved. 

• Do not eat/drink 6 hours before surgery. 

• Wear comfortable clothes. 

• Have a responsible person accompany you. 

10. Precautions after surgery:

After surgery, a small dressing is put. A pressure garment is applied to minimise swelling and support the fresh chest contour as it heals. 

You can take bath next day after surgery & no dressing is needed. 

Seven days of Antibiotics are prescribed and sutures are removed 10-14 days after the surgery. 

You need to avoid driving for the first 24 hours, but can resume normal life after one-two days and start exercising after one-two weeks when you feel comfortable.

11) What are the risks of gynecomastia surgery? 

The side effects include:

• Swelling

• Bruising at some part of the chest

• Pain and discomfort

• Numbness

These are temporary and subside within seven to 14 days after the surgery.

12) Is this surgery a permanent solution for the male breast reduction?

As the fat and the glandular tissues, which are the root causes are removed, there are no chances of recurrence, but it is imperative for the patient to follow the surgeon’s post-surgery recommendations. 

13) Will gynecomastia surgery leaves post-surgery scars? 

The surgery scar is very small surrounding the nipple region that will blend with the surrounding colour change on the skin in this area.

14) What is the cost of gynecomastia surgery?

In India the cost ranges from Rs 65,000 to Rs 95,000 depending on the amount of fat to be removed, sculpting needed, the technology used, and other miscellaneous expenses.

In most cases, correction of gynecomastia is not eligible for insurance coverage but various finance agencies provide easy EMI facility as well.

15) What results should be expected after the Gynecomastia surgery? 

Results are instantaneous and long-lasting. Scars are not easily visible and fade away in six months. After 10 days, there is an appreciable change in shape.