What are the treatment options for gynecomasti?
Correction of the enlarged male breast is one of the most common plastic surgeries for men. Choosing the right surgical technique is crucial for a good result. On this page you will find all information about the surgical treatment of gynecomastia. If you would like to find out more about the causes of the disease (medication, hormonal causes, etc.), the symptoms and alternative forms of treatment, please visit the gynecomastia page.
There are different forms of gynecomastia. To find out what is behind the term pseudo-gynecomastia (lipomastia) and what the difference is, visit our corresponding parallel page on this topic.
As a rule, a combination of several surgical procedures makes sense. Liposuction is best done using the vibration method (SAFELipo technique). The specialist in plastic and aesthetic surgery can remove the man’s enlarged, solid glandular body through an inconspicuous, small incision on the lower edge of the areola. If there is very little breast glandular tissue, an attempt can be made to bypass the incision on the edge of the male areola. Experience shows that in real gynecomastia, the combination of removing the enlarged mammary gland and liposuction produces harmonious and very satisfactory results, so that the breasts no longer look feminine. After liposuction with the vibration method, the skin shrinks in the months after the gynecomastia operation. The extent to which the skin regresses depends, among other things, on the following factors: age, constant exposure to the sun, tobacco smoking, predisposition, concomitant diseases, certain medications and the extent of the enlarged breast. In young healthy men, an attempt can be made to forego the additional scar of the tightening. If you still suffer from excess skin after six months, a moderate tightening can be carried out easily, on an outpatient basis and under local anesthesia. Partial regression of the skin also offers the advantage that a smaller skin incision is sufficient for correction. There are various techniques for removing excess skin, depending on the severity. Some excess skin can be removed from around the man’s areola. If the breast is drooping and large and may look feminine, the nipple needs to be relocated or transplanted.
Are there scars after gynecomastia surgery?
The scars that a correction of the man’s breast leaves afterwards are usually very inconspicuous. As part of liposuction, a three millimeter short skin incision on the side of the chest is required to remove excess fatty tissue. Access is slightly offset to the right and left. Even small and barely visible scars do not give the impression of a planned operation. The tissue of the male mammary gland is removed through an arched skin incision on the edge of the areola. The scar between the areola and the breast skin is usually barely visible. If the skin is moderately tightened, a circular scar will remain around the areola. Removing sagging and sagging skin after significant weight loss requires nipple relocation or grafting. Here, the aesthetic units of the male breast and the skin tension lines must be taken into account. The transverse scars fade after six to nine months.
What Are The Eight Benefits Of Gynecomastia Correction?
- Correcting gynecomastia can restore a normal body image to affected men, so that they can then do without wearing extra wide clothing such as oversized T-shirts.
- The correction of gynecomastia usually leaves hardly any scars afterwards.
- Removing the mammary gland will improve or eliminate the chest pain.
- Correcting gynecomastia can significantly improve the general quality of life (Davanco RA, et al. 2009, Aesthet Plast Surg).
- Correction of gynecomastia delivers faster, more effective and aesthetically better results than drug treatment (Zavlin D, et al. 2017. Aesthetic Plast Surg).
- Most male breast reductions are performed on an outpatient basis.
- Gynecomastia surgery is associated with a small absence from training or work.
- There is no risk of the man’s breast coming back, so the suffering can be effectively put to an end. An effective and sustainable before-and-after change.
What does gynecomastia removal cost?
An experienced specialist can restore the male contours of the breast in a surgical procedure. You can get an initial cost estimate on our cost page. The techniques and the effort differ according to the severity of the gynecomastia, the type of excess tissue (tissue of the mammary gland, fatty tissue, skin) and the state of health of the man to be treated. We will be happy to give you an exact price quotation after a consultation. Whether the health insurance company pays for gynecomastia treatment through plastic surgery depends on the case. For more information on gynecomastia, please visit the following page. There you can also find out whether you can expect to be covered in your case.
How can I prepare for gynecomastia surgery?
The correction of gynecomastia is an elective procedure and should be carried out under the best possible conditions, i.e. without avoidable risks, in order to keep the swelling low and to ensure optimal healing. Frequent questions are answered in the run-up to the aesthetic plastic surgery in the case of an established breast enlargement (female breast). In addition to answering questions asked, a good doctor also provides comprehensive information and preparation for the plastic-surgical correction by the aesthetic surgeon.
- To clarify the causes, a blood test and a presentation to a specialist in endocrinology as well as an ultrasound examination of the breast and testicles are recommended.
- All your questions about possible complications and alternative treatments should be answered by a plastic surgery specialist before the appointment.
- The cosmetic surgery for gynecomastia takes place on an outpatient basis in the practice. An inpatient stay in a clinic is not necessary.
- In smokers, wound healing is delayed and the cosmetic results can be significantly worse. Therefore, if possible, refrain from smoking two weeks before to four weeks after the planned breast reduction surgery.
- Blood-thinning medication (e.g. ASA, Thomapyrin®) must be discontinued at least ten days before the operation after consulting your doctor.
- Vitamin preparations (A, E) and food supplements (omega-3 fatty acids, St. John’s wort preparations, etc.) must be discontinued at least four weeks before the operation.
- Follow-up cost insurance should be taken out before aesthetic interventions are carried out.
- You can help to keep the surgical risk of inflammation low by cleaning your breast on the day of the surgery with a disinfecting soap (for example HiBiScrub® Plus from Mölnlycke, Octenisan® Wash Lotion from Schülke, Prontoderm® Shower Gel B. Braun).
- Operations limit the ability to travel by air. You should therefore not plan any air travel, either professionally or privately, in the six weeks after the operation.
What is the procedure of a gynecomastia operation?
Every operation is prepared with the greatest care by the plastic surgeon. This means that several security checks are routinely carried out to ensure that the surgical breast reduction in men takes place under the best possible conditions. The surgeon will double-check that all of your questions have been answered. On the undressed upper body, the doctor marks the area of skin to be treated with a waterproof pen. The marked operation plan is used for control and better orientation during the operation in order to restore the planned natural shape. You will then be taken to the operating room. There, the team consisting of your plastic surgeon, a surgical assistant, the anesthetist, an operating room nurse and a technical assistant will take care of your well-being. Care is taken to ensure that you are lying comfortably on a specially padded operating table. A bit of background music can take away your fear and reduce the feeling of pain. You will be given medication that will put you into light or deep sleep (general anesthesia). During general anesthesia, the operating area is thoroughly disinfected several times. Sterile, pathogen-proof drapes are stuck to the skin in order to protect the surgical field extensively on all sides. So that you do not feel any physical pain after the procedure, the specialist anesthetist will administer a long-lasting anesthetic to you. The water solution that is injected into the subcutaneous tissue contains adrenaline. This will reduce blood loss and prevent bruising. Excess fatty tissue is suctioned off with very fine cannulas. The firm glandular tissue of the male breast is removed through an arched skin incision on the edge of the areola. Small vessels are deserted. If necessary, the excess skin is removed. The wounds are sutured with self-dissolving skin threads. The specialist in aesthetic surgery then critically checks again whether the result is beautiful and symmetrical. Finally, after the plastic treatment, a sterile bandage is applied and the compression girdle is adjusted. The duration of the operation for the surgical breast reduction is one and a half to two and a half hours, depending on the severity of the real gynecomastia. You will then be taken to a relaxation room where your wellbeing will be continuously monitored. If you are fine, you can have a drink or a bite to eat. As a rule, you can be picked up four to six hours after the operation. The doctor gives the approval for this after control. Before you are brought home, there will be a personal conversation: The surgeon will tell you how the operation to reduce the size of the enlarged breast went in detail. You will also be given a detailed report. The behavioral measures are listed in detail and the dates of the check-ups are noted. The report also contains the personal telephone number of the aesthetic surgery specialist, who is available to you around the clock. In the evening after the operation, the surgeon will contact you to find out how you are and to rule out any unusual swelling or pain.
What are the risks of gynecomastia surgery?
Surgical correction of the male breast is a safe method of treatment. However, there is no surgical gynecomastia treatment without the risks that may arise. In the first 30 days after surgical correction, the complication rate is 2.1 percent. The most common complications include inflammation in 1.3 percent, divergence of the wound edges in 0.3 percent, or bleeding that requires a blood transfer in 0.1 percent of cases. Diabetes, diseases of the heart or the liver increase the risk of complications (Zavlin D et al., 2017, Aesthetic Plast Surg). In general, smokers, overweight, or the elderly are at higher risk for surgery than non-smokers, normal-weight, or younger men.
Afterwards, every wound represents a possible entry point for germs. An inflammation can require medical or surgical treatment. Cigarette smoking, even if it is stopped four weeks before surgery, has been shown to be linked to a higher risk of inflammation.
In order to minimize the risk of secondary bleeding, the doctor discusses the use of blood-thinning medication, vitamins and food supplements in detail and asks about the status. Surgical gynecomastia treatment is possible if blood-thinning agents can be temporarily stopped. Normal laboratory coagulation values do not rule out a bleeding tendency. To reduce the risk of bruising, adrenaline is injected into the surgical area. Fluctuations in blood pressure can cause bruises to develop in the first few days or several days after the breast operation. Physical exertion should therefore be avoided for the first fourteen days.
In the form of gentle surgical and suturing techniques, the surgeon can help the tissue to heal quickly and well. Other factors such as old age, cigarette smoking, obesity, chronic diabetes, vascular calcification, medication (cortisone, Marcumar), shear forces and the effects of pressure can promote wound healing disorders. If there are serious illnesses, we advise against male breast surgery.
The aim of a good skin suture is precise, tension-free and gentle closure of the wound. The formation of new structural proteins as well as the alignment and networking of the fiber structure takes up to a year. In the first few weeks, scars are slightly hardened, red, possibly painful or itchy and sometimes slightly raised above the skin level. Usually after a year, scars become pale, soft, painless, and flat. A scar overgrowth describes scar tissue that grows beyond the wound edges. With certain predispositions, scar growths tend to develop on the ears, on the sternum or on the shoulders. Scar growths are characterized by a tendency to recur and can be treated with cortisone injections, compression and silicone or radiation.
Correcting the man’s chest may cause irritation of skin nerves. This affects the nerves of the nipple and the cutaneous nerves of the breast skin. This can cause temporary numbness.
Despite all precautionary measures, side differences and contour irregularities cannot be ruled out. Pre-existing inequalities, pronounced skin tightening or breast reduction make it difficult to produce results on both sides. A loss of elasticity in the skin and individually different scar healing processes can lead to an asymmetry of the scar. A correction is usually possible after the scar has matured. After the correction of a man’s breast, there may be an increased excess volume on the abdomen. Your goals will be discussed in detail in advance in order to create an individual treatment plan that takes your body into account holistically.
With sufficient elasticity, the skin shrinks and adapts to the new body contours. If the natural shrinkage is insufficient for sagging skin, excess skin folds can result. Skin tightening procedures can remove these wrinkles by reducing the size of the skin.
What should you do after gynecomastia surgery?
Optimal follow-up treatment is required for a perfect result.
- Immediately after the surgical procedure, which takes place on an outpatient basis in a special operating room in the practice, regular controls of your well-being and the results of the operation are arranged.
- Elevation of the upper body of about thirty degrees (also when sleeping) for five days is beneficial for decongestion and wound healing.
- Previously adapted compression girdles (compression vests) should be worn continuously three to six weeks after the operation.
- Showering is possible immediately before the wound inspection from the third postoperative day.
- As a rule, you can go back to your usual daily activities after five to seven days.
- Scar care (scar massage, sun protection, silicone pad) from the third postoperative week helps to create inconspicuous scars.
- Sports activities, saunas, swimming, hard work and sunbathing should be avoided for at least three weeks.
- From the third postoperative week, massage the scar several times a day for a few minutes. Use a greasy cream such as Bepanthen® ointment or Linola® fat. Pay attention to circular movements as well as lengthways and crossways to the scar. These measures help to create an inconspicuous scar that can only be seen by looking closely at the part of the body.
- Smoking increases the risk of inflammation and thrombosis. Avoid tobacco smoking and e-cigarettes after surgery.
How long should you not do sports after gynecomastia surgery?
Cardio training and muscle building should not be resumed until after three to six weeks at the earliest. Short walks stimulate the circulation and are therefore quite helpful. In rare cases, pain medication may still be required after the third day of surgery. You can find out more by talking to the doctor. Since the external wounds are very inconspicuous, the temptation can be great to resume the usual strength training after a few days. The body needs at least two weeks of rest. Depending on the state of swelling, a longer period of rest may be necessary.
Gynecomastia surgery experience at Centerplast
Patients these days place great value in reporting on other patients’ experiences and looking at a doctor’s average rating in order to select them for their surgery. If you would like to get an idea of the satisfaction of our patients and to read more about the experiences of gynecomastia surgery by our aesthetic surgeons, visit our testimonials page now.
Gynecomastia before after pictures
In addition to testimonials, men who are interested in gynecomastia surgery also value before and after photos. Such may not be shown on the Internet in Germany. However, it is possible to do this in a personal consultation. This is of course done in compliance with the data protection guidelines. To learn more about the possibilities of an illustrated before and after comparison, you can have a look at the following page.
Author: Stéphane Stahl, MD, PhD. There are no financial relationships with the pharmaceutical or medical device industries that could have influenced the above text. Any reproduction, even partial, is permitted for personal use only. All texts used on this website are protected by copyright.