Gynecomastia means large breasts in men, which is caused by an imbalance between the estrogen and testosterone hormone.  It is common in adolescent boys and in 90% of cases the symptoms subside within 6 months to 2 years later.  There are several possible reasons for gynecomastia such as obesity, puberty, steroid abuse, tumors, genetic disorders, castration, chronic liver disease, Klinefelter Syndrome, Gilbert’s Syndrome, aging, and as a side effect to certain medicines.  Gynecomastia may be due to excess in fat cells in the breast (known as pseudogynecomastia) or due to an increase in the glandular tissue of the breast.

Surgical treatment is through liposuction which removes the breast fat or excision (Mastectomy) which removes the glandular tissue. A pre-operative physical examination will determine which procedure is required.  A mammogram may be recommended to determine the proportion of fat to glandular tissue within the breast.  The procedure can be done under local anesthesia with sedation or general anesthesia.  Prior to the procedure you will be requested to stop smoking for at least 2 weeks, as well as after the surgery.  The surgeon will also explain to you which vitamins and medications to take and not take.

The procedure involves making an incision in a hidden area such as in the underarm area or on the edge of the areola (the dark skin surrounding the nipple).  Through this incision the liposuction cannula can be inserted to suction the fat cells (liposuction procedure), or the surgeon uses the incision to remove the excess glandular tissue, fat and skin (excision).  Note both procedures can be performed if necessary during the same surgery.  If a large reduction is required, then the incision will need to be a little larger which may result in visible scars.

After the surgery a small drain will be inserted to allow for drainage of excess fluids, the incisions will be covered with a dressing and the chest area will be wrapped to hold the skin firmly.  The stitches will be removed within the first three weeks if not dissolvable.

The pain after the surgery is mild; you will be given pills for the pain.  There will be swelling and bruising which will take a few weeks to go.  You must wear a compression vest 24hrs a day for a month at least.

You should resume gentle activity from day one, especially walking, and within two to three days you should be able to go back to work.  Sexual activity and strenuous activity should be avoided for the first three weeks.  You should also stay away from any activity that has a risk of you getting a blow to the chest during the first month at least.  Another thing you should avoid for the first 6 months is exposure of the scars to the sun as this will darken the scars.

The final result of the operation can be seen after 6 to 12 months.

Risks like any other surgery are infection and bleeding.  Scars usually fade although in some cases may remain.  There is a possibility of asymmetry or contour irregularity and return of gynecomastia.

The cost of the procedure is around US$3000 – US$3500.