gynaecomastia

Treatment for Gynaecomastia

Gynaecomastia is a common benign condition resulting in enlargement of male breast tissue. Surgery offers an effective means of treating gynaecomastia. The best results are attained in patients with good skin tone and smaller breast enlargements, and weight stabilization and diet are essential in preparing for surgery. The surgery seeks to treat the breast tissue primarily, with the hope that the skin envelope will retract to an aesthetically normal position following surgery.

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Gynaecomastia is estimated to affect almost half of the male population at some time or another during life. Although organic causes, including normal physiological development during adolescence, hormonal imbalance, some medications and other medical conditions may be implicated, the vast majority of cases are labelled ‘idiopathic’, meaning that a cause cannot be found. Affected breast tissues, as well as the nipple–areola complex, become prominent and this may cause embarrassment and self-consciousness.

 

During your initial consultation Dr Farhadieh will note a detailed medical, drug and family history, including investigations you may have had in search of a cause. Your chief areas of concern, along with your expectations from surgery, will be discussed. The surgical procedure can be undertaken as a day procedure under general anaesthetic or sedation depending on the case, your preference and your surgeon’s recommendation. The actual operation generally takes between 1 and 2 hours.

 

Surgery usually involves liposuction of the excess breast tissue, and most often entails a small resection of the breast tissue through an incision near the nipple–areola complex. In extreme cases the entire breast tissue may need to be surgically resected, including part of the skin envelope. Most surgeons, including Dr Farhadieh, prefer to take a conservative approach, resecting less rather than more tissues, and, if need be, performing smaller revisions later on.

 

For smokers, cessation of smoking 3–6 weeks prior to surgery and abstention for at least 3–6 weeks after the operation is recommended. Medications and herbal supplements that may increase the risk of bleeding should be stopped at least 2 weeks prior to surgery; they may be recommenced 1 week after surgery.

 

After your surgery, you will be taken to the recovery area and your chest will be dressed tightly. The dressings remain intact until you see your surgeon during a follow-up consultation in 10–14 days. Application of local anaesthetic will reduce immediate postoperative discomfort and small amounts of pain relief medication will be prescribed on discharge. These are often only necessary during the first few days postoperatively. Depending on your occupation you may be off work for 1–2 weeks. Your chest will be bruised for at least 1–2 weeks.

 

As with all surgery, there are potential complications, but fortunately these are not common. Dr Farhadieh will discuss these with you in detail during your consultation.

 

Your relationship with your surgeon is the most important part of the process. At any stage prior to or after your operation Dr Farhadieh and his staff will be available for advice and support. We are dedicated to being there for every step of your journey.

‘Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.’

Frequently Asked Questions

Will I require a general anaesthetic for the procedure?

Most commonly this operation is performed under general anaesthetic or on occasion deep sedation depending on the extent of surgery required.

Is the surgery painful?

There is some discomfort associated with surgery. Most patients report a ‘tightness’, rather than pain, due to the excellent pain control regime we uise, which includes local anaesthetic for the immediate postoperative period as well as powerful analgesics.

When will I be able to resume normal activity?

Most of the swelling will settle in the first 7–10 days. You will be able to return to work after this time and resume most normal activities. Depending on the extent of surgery, all bruising should resolve within 2–3 weeks.

Where will the scars be placed?

This depends on the extent of surgery required. Where it is only liposuction/liposculpture, multiple peripheral stab incisions are strategically placed which often heal without any significant residual marks. Where an incision to remove breast tissues around the nipple is necessary, this often heals and fades over the coming months. Although uncommon, when more extensive surgery is required that includes removal of breast skin envelope, these scars are often vertical from the nipple down the chest wall and more noticeable before they fade over time.

What will my follow up include?

Dr Farhadieh believes that the relationship between doctor and patient is sacred and privileged. Our practice is based on compassion, honesty, transparency and, above all, patient welfare. We pride ourselves on making sure that you feel supported at all times. We will be available during all stages of your journey and will schedule short-, medium- and long-term follow-up appointments as part of our overall practice.

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