Some men experience overdevelopment of their breast tissue - known medically as gynaecomastia. An estimated 40-60% of men are affected by this condition at various ages, including in newborn boys with a relative excess of maternal oestrogen influencing the breast, at puberty with a hormone imbalance as sex hormone production surges, or later in life with a decrease in testosterone production. Sometimes an identifiable cause can be found including an endocrine system disorder, resulting in a problematic imbalance of the hormones estrogen and testosterone; certain cancers; and metabolic dysfunction including liver disease. Gynaecomastia can also be aggravated by weight gain and drugs such as anabolic steroids and marijuana. Most commonly there is no identifiable reason for the increase in breast tissue in men.
Gynaecomastia can occur in one or both breasts and can cause the breast(s) to sag and also stretch the areola. The condition can cause pain in the breast(s). Moreover, having excess breast tissue can negatively affect the self-confidence of men, which is exacerbated by derogatory terms such as ‘man boobs’ or ‘moobs’ being used to describe the condition within the public domain.
How is gynaecomastia treated? In cases of mild or temporary hormonal imbalance, gynaecomastia may resolve spontaneously. Improvement may also occur if an identifiable cause is found and treated, or a causative medication is identified and stopped. In many cases, particularly when no cause is found and spontaneous improvement does not occur, surgery to remove the excess breast tissue is the most effective or only option.
Breast reduction surgery or reduction mammoplasty can be performed once breast development has stabilised (after adolescence) and can be performed by a Specialist Reconstructive and Plastic Surgeon in an accredited hospital. During your consultation, your Surgeon will go through your medical history and what you are hoping to achieve to ensure breast reduction surgery is the appropriate choice for you. Your surgeon will work with you to establish an individualised surgical plan to address your specific concerns. It is important to remember, as with any surgery, there are the risks associated with surgery to take into consideration during your decision-making process. These can include infection, contour irregularities of the chest skin, and problematic scarring. Generally, the scar that results from gynaecomastia treatment can be well hidden in the natural contours of the breast at the border of the areolae (the outer margin of the nipple).
What does surgery for gynaecomastia involve? Breast reduction surgery involves removing the excess breast tissue and fat from the chest area often using a combination of surgical excision and liposuction techniques. For surgical excision, generally, a small incision is made around the outer edge of the lower half of each areola where scarring is usually minimally visible. If liposuction is used an even smaller incision (approximately 5mm in length) is used and a small hollow tube is inserted and moved around in a controlled motion to loosen the fat, which is then sucked out. In some cases, excess skin removal is also necessary, often combined with the reduction, or removal and reattachment, of the nipple.
Male reduction mammoplasty usually takes between one and two hours and is typically performed as a day procedure, although occasionally an overnight stay in hospital is required. Recovery is an individualised process and also depends on what technique was used for your surgery. Most people return to work after 1-2 weeks and exercise after 2-6 weeks. It is important to think about when surgery will best fit in with your life and allow the time required for rest and full recovery.