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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.
THE PROCESS OF PLANNING YOUR SURGERY 
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.
WHAT TO EXPECT AFTER YOUR 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. 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.
Frequently Asked Questions
Most commonly this operation is performed under general anaesthetic or on occasion deep sedation depending on the extent of surgery required.
There is some discomfort associated with surgery. Most patients report a ‘tightness’, rather than pain, due to the excellent pain control regime we use, which includes local anaesthetic for the immediate postoperative period as well as powerful analgesics. However, its worth noting pain perception varies between individuals
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. Recovery varies between individuals.
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.
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.
1. There are some general risks associated with ANY operation, which include:
a) Infection in surgical wound(s) with resultant redness, pain and possible discharge. In severe cases, wound(s) could break open and need to be re-sutured.
b) Possible bleeding in surgical wound(s) with swelling or bruising.
c) Secretions may accumulate in the lungs and cause a chest infection.
d) Deep vein thrombosis.
e) Death is possible during or after an operation following severe complications.
f) Smoking significantly increases the risk of complications. Therefore, you should completely stop smoking at least 4 weeks prior to surgery, and refrain from smoking for at least 4 weeks.
2. The following facts, risks and complications apply specifically to THIS operation:
a) Antibiotics are given during and after the operation, to minimise the risk of infection. If infection was to occur, it would be treated with the usual techniques. In severe cases, treatment may involve being admitted to hospital for intravenous antibiotics; and further surgery may be required.
b) Antibiotics are given during and after the operation, to minimise the risk of infection. If infection was to occur, it would be treated with the usual techniques. In severe cases, treatment may involve being admitted to hospital for intravenous antibiotics; and further surgery may be required.
c) Bruising and swelling is normal, but the severity can vary with each patient. If bleeding occurs after surgery, a clot (haematoma) may occur and this often needs to be removed surgically. The risk of this occurring within the first few days after surgery is about 0.5%. The risk of increased bruising or bleeding can be reduced by abstaining from medications such as aspirin, anti-inflammatory drugs, or other blood thinning agents, for at least 2 weeks prior to surgery. (See Medication Information sheet)
d) The incisions will result in scar formation. Dr Farhadieh will endeavour to keep the incisions as minimal as possible, and these scars will soften and fade with time. I will be instructed as to how best care for scars to optimise results.
e) Postoperative pain experience varies from very mild to significant discomfort. I will be given plenty of analgesic medication following your surgery and this should keep me comfortable, no matter what my level of discomfort
f) It is common to have intermittent mild discomfort, or sometimes, intermittent sharp pains in the first few weeks after surgery, as the swelling resolves and the nerves recover.
g) Numbness of parts of the breasts and nipples is common following surgery and is generally temporary. I may experience a change in the sensitivity of the nipples and the skin of the breast. Permanent loss of nipple sensation can occur after a gynaecomastia correction surgery.
h) The sutures used to close the incisions on my breasts are completely dissolvable, but they may be felt through the skin for up to 6-9 months after surgery.
i) Breasts may feel irregular (lumpy), firm, and uncomfortable following gynaecomastia correction surgery; however, this will subside with time. Some contour changes may be permanent.
j) Most patients will need to take at least few days off work. Heavy lifting and vigorous upper body exercise should be avoided for 4-6 weeks. See Pre and Postoperative Instructions for more details.
k) It is almost impossible to get the breasts looking identical with surgery, the reason for this is that breasts are living tissues and will change to whatever they are genetically programmed to do with time. Dr Farhadieh however, will make them as symmetrical as possible with the procedure.
The aim of gynaecomastia correction surgery is improvement rather than perfection. Further operations may occasionally be required to improve the results. This is particularly true if any of the above mentioned complications develop. You may not be satisfied with the final outcome.
