The Most Frequently asked questions regarding Gynaecomastia correction
Gynaecomastia describes the condition in which a man has developed breast tissue creating an abnormal chest contour and this can be a source of embarrassment, low self esteem and cause patients to be very self aware in and out of clothing. This condition can be treated successfully with surgery and one of our most frequently performed operations at Mode Plastic Surgery.
Here we provide answers to some of the most frequently asked questions about gynaecomastia.
What is gynaecomastia?
Gynaecomastia is the medical name for male breast development. The tissue in the chest is usually composed of both fat as well as glandular tissue. It can be a source of embarrassment and reduced self confidence for many boys and men, contributing to reduced social interactions, changing clothing to hide the area and avoiding situations where the chest may be exposed such as swimming at the pool or beach.
What causes Gynaecomastia?
Around 50-70% of all boys develop the condition during puberty (which normally disappears as they grow older. It is also very common in older men with rates up to 30-40% in old age. These ‘natural’ causes are the most common cause but there are rarer causes such as hormonal disturbance, thyroid, kidney, or liver disease, problems with the testes, an unknown malignancy or a variety of medications including anabolic steroids. Being overweight can contribute to this also at it increases the fat content in the chest and elsewhere.
A consultation is therefore aimed at excluding some of the rarer causes, and your doctor may ask you to obtain a panel of blood tests to exclude any causes other than normal pubertal growth.
How is gynaecomastia diagnosed and what happens during a consultation for gynaecomastia?
Gynaecomastia is a clinical diagnosis and can be made by anyone with experience with
the condition such as general practitioner and most definitely a plastic surgeon.
At Mode, Dr Aggarwal commonly sees patients with gynaecomastia and during consultation it is established if gynacomastia developed during puberty or there is another (‘secondary’) cause. If the latter is suspected, further tests may be ordered such as a panel of blood tests to exclude underlying hormal disturbance. In some cases a referral to an endocrinologist (hormone specialist) will be requested. During consultation a physical examination is also conducted. This is to ensure there are no breast lumps or suspicion of cancer. Cancer is actually a very rare possibility with gynaecomastia as it is very uncommon – however patients with a certain syndrome called Klinefelter’s disease (a genetic condition), have high rates of breast cancer and also have gynaecomastia. The main purpose of the physical examination is to formulate an individualised plan for surgery – to determine how much fat, breast tissue and skin is present as each needs to be treated for the optimal result.
Does gynaecomastia cause breast cancer?
No, gynaecomastia does not cause breast cancer, and there is no association between the two. However there is one genetic condition called Klinefelter’s syndrome – where males are born with one or more X chromosomes – that is associated with gynaecomastia due to an abnormality of hormones, and these patients also have a dramatically higher risk of male breast cancer.
Does gynaecomastia hurt?
Glandular tissue in the chest can be tender especially when it is undergoing a period of active growth. Therefore during puberty the chest can be tender or hurt from time to time. This is similar to women experiencing breast tenderness during their menstrual cycle when the breast tissue is being affected by hormones. Longer term however gynaecomastia is not tender and should not be changing dramatically in size. If it does, one should seek medical attention, to exclude sinister causes like male breast cancer.
Can’t I just diet and workout to get rid of my “man boobs”?
Unfortunately not. Because gynaecomastia usually involves an excess of both breast tissue and fat it is only the fat that may shift with diet and exercise, but not the glandular component. Furthermore the longer the gynaecomastia has persisted the more fibrous or dense the tissue becomes making it harder to shift.
Therefore correction of the underlying cause is essential (if one is present), and surgical correction is warranted in order to remove the glandular (and fat) tissue.
Can taking hormones cure Gynaecomastia?
Usually not. While the cause of gynaecomastia is an imbalance between testosterone (being low) and oestrogen (being high) – most cases of gynaecomastia have persisted from puberty and are called idiopathic. This means that the underlying cause is not completely understood and simply taking excess testosterone will be of no benefit. If however patients have low testosterone in a condition called ‘hypogonadism’ then they may benefit from supplemental hormones. These patients have other signs of low testosterone such as reduced male physical features, reduced male hair growth, reduced sex drive/mood, low sperm counts and so on. This diagnosis would usually be made by an endocrinologist (hormone specialist), and the treatment would strictly be under prescription and with their supervision.
Does gynaecomastia go away? Will it improve with weight loss or exercise?
In the vast majority of patients where the gynaecomastia has developed during puberty, the tissue will subside after pubertal growth has finished. However a certain proportion of patients will retain the breast tissue developed during puberty and will therefore seek medical attention by visiting a plastic surgeon. In these patients the glandular tissue is quite firm and sits behind the nipple, while even the fat of the chest is quite fibrous and feels firmer than fat elsewhere in the body. The persistence of male chest tissue beyond puberty remains as the most common category amongst gynaecomastia patients. Unfortunately in these patients the tissue will not decline with exercise. It may certainly improve with weight loss – however this only reduces the fat content of the chest, while the glandular component of the chest will be unchanged with weight loss and exercise. Therefore patients often require surgical intervention if the gynaecomastia has peristed beyond puberty.
How is Gynaecomastia treated?
During consultation, an individualised treatment plan for surgery is made for each patient.
Gynaecomastia is firstly graded in its severity from 1 to 3 – this is a grading system that classifies patients based on the excess gland and fat component, as well as if they have excess skin on their chest.
Patients with excess gland and fat are usually treated with liposuction, and gland excision through an inconspicuous scar around the nipple. The surgery usually takes 2-3 hours and the patient stays in hospital overnight. Patients with more severe gynaecomastia have skin that needs to be removed in addition to the gland and fat tissue. These patients are treated with liposuction, gland removal as well as skin removal. The nipple may also be relocated higher on the chest. The latter requires additional scars which are discussed with the patient. The surgery in this case is longer, may require a drain and may require more post operative care. During consultation a discssion of the intraoperative steps, post operative recovery and a review of previous patients’ before and after photos will be undertaken. We always see patients twice before proceeding with surgery, and provide patients with a comprehensive quote after the first consultation.
Is gynaecomastia surgery covered by Medicare?
Gynaecomastia surgery is covered by Medicare under item number 31526 (as of September 2023). This combined with appropriate health fund cover, will dramatically reduce out of pocket costs for surgery, as this will allow coverage for hospital fees, theatre fees and provide rebates for surgeon and anaesthetist.
What does gynaecomastia surgery surgery cost?
The approximate out of pocket cost (as of September 2023) at Mode Plastic Surgery is $10800 with an appropriate health fund. This is inclusive of surgeon, assistant, anaesthetist, and follow up care.
The exact costs however will be quoted after consultation and will change for more complex surgery that could involve skin removal, nipple adjustment or nipple grafting, or extensive lateral chest wall liposuction.
How much time does it take to recover from male breast reduction surgery?
Recovery varies by patient and the scope of their procedure. Most patients return to work and socializing after about a week. Light exercise can be resumed two weeks after surgery. Patients need to wear a chest compression garment or binder for a total of 8 weeks, and need to refrain from heavy lifting over this time period.
Does gynaecomastia surgery leave scars?
Most patients require liposuction through minor scars and a gland excision via a scar hidden around the nipple. In these cases the scars are small and almost imperceptible long term. In the smaller group of patients who have very significant gynaecomastia with an abundance of skin that requires removal, the scars will be larger and more obvious. However in these patients the longer scars are often worth the dramatic improvement in their chest contour which can be difficult to hide even in clothing, and the scars fade over 12-18 months.
Can man boobs grow back after surgery?
In most cases, the results of Gynaecomastia surgery are long-term. However, weight gain, steroid or drug use and hormone fluctuations may lead to a recurrence of gynaecomastia. Dr. Aggarwal can provide more information about maintaining the results of surgery in a consultation.