Gynaecomastia

Boys hormone levels vary and in teenage boys there is frequently a hormone imbalance or change that leads to breast growth, breast pain and swollen breast tissue or puffy nipples. The breasts may be tender.  This so-called physiological gynaecomastia usually does not last, and the breast tissue goes away or flattens on its own as the hormone imbalance rights itself. The breast pain caused by the male breast tissue usually fades away too as the enlarged breasts get smaller. In up to one third, though, there is some residual breast gland that causes embarrassment in later years.

Usually gynaecomastia occurs in pubertal boys when they are teenagers. However, in later years, male breast enlargement is common when the male hormone testosterone naturally drops and oestrogen levels are relatively higher. Men of all ages can build up fatty tissue in the chest due to weight gain—this is not true gynecomastia, but referred to as pseudogynecomastia. Of course overweight men also develop gynecomastia and when they do, the excess breast tissue growth  together with the fat or adipose tissue is termed mixed gynaecomastia. 

The normal male breast area consists of skin, a thin layer of fat, a small disc of glandular tissue, loose connective tissue and muscle.  When the gland enlarges, the area behind the nipple and areola feels firm.  In men with more body fat who have gynaecomastia, the area might be feel softer but still protrude.

During the consultation, our surgeon will take a history before examining you. This includes a conversation about risk factors for developing the condition as well as those related to fixing gynecomastia for you.  Breast examination includes an evaluation of the surface of your chest, presence of body hair, appearance of the nipples and contour of your chest and breasts.  Clinical features of gynecomastia range from puffy nipples only to large breasts that droop.  An assessment of breast asymmetry and overall body fat and body mass index is made, including an examination of fat that extends towards the armpits which is very common.

Male breast cancer is rare, accounting for only 1% of diagnosed breast cancers. The risk of breast cancer in men is higher in men who have significant hormone imbalances, and may be higher in men who have an altered male hormone to female hormone ratio; however, male breast enlargement when it is deemed gynaecomastia after clinical evaluation is not dangerous.  Gynecomastia is a benign condition and is extremely common.  Although gynaecomastia can affect one or both breasts, when there is enlarged male breast tissue  that is recent, on one side, or forming a lump, you may be sent for imaging and any breast tissue that is removed will be examined in the lab. Long standing swelling of both breasts in men is not a feature of breast cancer.

Breast tissue growth during puberty often goes away on its own.  However, in one in three men, some degree of persistent breast tissue remains.  If this persists for a year or two, it is very unlikely to shrink and disappear without intervention.  For men with an underlying medical condition, hormone therapy or other medical treatment may halt the growth of breast glandular tissue.  For men with unchanging male breasts that are bothersome, surgical treatment is usually the only definitive treatment that completely resolves the issue.

If you are bothered by the appearance of your chest and want to treat gynecomastia, we are here to help you remove this problem safely and efficiently.  Lots of men develop gynecomastia and it is not something to be ashamed or worried about.  In our experience of over 16 years in male breast reduction, we have hundreds of guys who only wish they had addressed it sooner.  We use VASER liposuction and frequently combine this with gland excision or surgical removal, all under local anaesthesia. This delivers best results for a flatter, more contoured chest.

VASER liposuction is a form of ultrasound-assisted liposuction. Using VASER liposuction, our surgeons are able to remove fat cells and destroy glandular tissue that causes gyno. Special probes are used through tiny incisions that not only liquefy the unwanted tissue, but also help skin tightening.  VASER liposuction allows a smooth, natural-looking result in expert hands and also deals with fat in the upper chest and toward the armpit.  Of all cases of gynecomastia diagnosed at our clinic, we use a combination approach of gland excision in about 80% of cases.  This means that whatever small but stubborn lump of gland remains after liposuction, we also remove.  This type of gynecomastia surgery, combining VASER liposuction with subcutaneous mastectomy through a small hidden incision around the nipple gives best results.

We have extensive experience and expertise performing male breast reduction under local anaesthesia.  Before surgery you will receive relaxing tablets so you are comfortable.  You must be collected by a friend or family member.  The procedure itself takes only about 90 minutes and you can return home straight away.  Because there is no recovery from general anaesthesia, most men feel very good with minimal discomfort over the first few days. You will be given a binder to wear, some instructions and antibiotics for the first week.  You will see instant results that continue to get even better as swelling subsides. 

If there is a very large overhang of tissue and skin, you will be advised of options such as formal breast reduction surgery.  However, in nearly all cases, we can deliver excellent skin retraction and tightening using VASER liposuction.  If skin is loose, we also employ BodyTite, an internal radiofrequency device that heats underneath the dermis in a controlled way, further tightening skin.  This can be performed during the same procedure.

No.  We remove the male breast tissue which does not regenerate.  Fat cells also do not return after definitive liposuction.  Therefore, our technique treating gynaecomastia under local anaesthesia is a way to get a lasting result that does not require further surgery.  A thin layer of fat cells is deliberately left behind to make sure there are no irregularities or asymmetries.  Therefore, maintaining a healthy weight is important so these remaining fat cells do not enlarge.  Only very large fluctuations in weight would make the remaining fat swell significantly. Regular exercise will help overall results by keeping you toned and preventing more body fat accumulation. 

The cost of permanent gynecomastia removal at Venus Medical depends on whether we use VASER liposuction alone, VASER combined with gland excision, or also add BodyTite to tighten skin when breast enlargement has caused excessive skin that sags. Please contact us for more information and quotes.  We also partner with Humm for financing options if you wish to pay monthly over time. Excess breast tissue growth in men is very common and we look forward to speaking with you.