Gynecomastia is the medical term for the development of abnormally large breasts in males. The problem is usually caused by a combination of excess breast glandular and fatty tissue. It may affect only one breast or both and most of the time, there is no known cause. Although not commonly talked about, this condition is relatively common. It affects around 40 to 60% of all males. Gynecomastia (also called “gyno”, “man boobs, or “puffy nipples”) is often a source of emotional distress. Feelings of embarrassment, shame, anxiety and humiliation are common and many men resort to wearing thick shirts and avoiding activities which would expose their chests.
In adolescent boys, symptoms of gynecomastia often disappear within a year. If you are struggling with this condition and feel self-conscious about your appearance, breast-reduction surgery (either liposuction, gland excision, reduction mammoplasty, or a combination of these surgical techniques) can be of great help to enhance your appearance and your self-confidence. The procedure removes glandular and fatty tissue from the breasts, resulting in a chest that is flatter, firmer, and better contoured. At times, it may also be necessary to remove excess skin.
If your breast enlargement is largely due to fat accumulation (also referred to as pseudogynecomastia), your surgeon is likely to use liposuction to remove the excess fat. After a small incision is made in the skin, a slim hollow tube called a cannula is inserted. The cannula is attached to a vacuum pump which allows for the surgical suctioning or vacuuming of fat from beneath the surface of the skin.
In the tumescent technique, the surgeon first injects large amounts of fluid into fatty areas before performing liposuction. The fluid contains a local anesthetic to alleviate pain and blood vessel constricting drugs to minimize blood loss. This fluid causes the sections of fat to become tumesced, or swollen or firm. These expanded sections of fat allow the liposuction cannula to travel smoothly beneath the skin as the fat is suctioned out. You may feel some friction during the procedure, but generally the procedure is not painful.
If your breast enlargement is largely due to the proliferation of the glandular component of the breast, your surgeon may do either surgical excision of excess breast tissue with a scalpel, liposuction, or a combination of excision and liposuction. There are newer liposuction cannulas that are designed to break up the denser breast tissues into smaller pieces so that they can be suctioned out. For major breast reductions, or in cases where excess skin also has to be removed, the procedure may require larger incisions that result in larger scars.
As with any surgery, there are risks involved in male breast-reduction surgery. However, when the procedure is performed by a qualified plastic surgeon, complications are infrequent and usually minor. Some risks which may result include infection, hematoma, contour irregularities, excessive pain or bleeding, adverse reaction to anesthesia, skin injury, scarring, permanent pigment changes in the breast area, or assymmetrical breasts or nipples. Gynecomastia corrective surgery may also result in the temporary loss of breast sensation or numbness, which may last up to a year.
Surgery to correct gynecomastia is usually done on an outpatient basis. The procedure takes around 1 to 2 hours and may be done under general anesthesia or under local anesthesia plus sedation. If done under general anesthesia, you will be able to sleep throughout the whole operation. If under local anesthesia plus sedation, you’ll be awake, but in a relaxed state.