Gynaecomastia is the abnormal enlargement of the male breast.
It occurs most frequently in the teenage years when a temporary disturbance in the hormonal balance can lead to breast development in males.
A similar disturbance can occur in the older age group, but in both age groups it can also occur as a consequence of significant weight gain.
More commonly these days we are seeing Gynaecomastia as a consequence of the use of performance enhancing anabolic steroids. These drugs directly stimulate the male breast gland and lead to overgrowth.
Treatment of Gynaecomastia may vary from liposuction to a breast reduction procedure similar to that of which is done for women with large breasts. If the reason for the breast enlargement is mostly due to accumulation of fat then liposuction can work well. This procedure leaves small scars and is usually done under a general anaesthetic as a day patient. Bruising commonly results for two to three weeks. A garment is usually worn after the operation to reduce the swelling and to encourage shrinking of the skin to smooth out the contour.
If there is an excessive amount of skin the resulting contour may not be good with dimpling or folds or hanging of the empty skin. In this circumstance a skin reduction procedure much like a female breast reduction may be required. This leaves substantially larger scars and is really something of a last resort for Gynaecomastia. This is because the scars can be as inhibiting and disfiguring as the over growth of the breast gland itself.
Where the enlargement of the breast is due to the over growth of the gland, liposuction is unlikely to be effective. In these cases direct excision of the breast gland itself is required and this can usually be done by fairly inconspicuous incision around the border of the areolar. However if there is skin excess, uneven contour and laxity of the skin may result. Again a skin reduction procedure with significantly larger scars may be required.
Appropriate excision of the breast gland can be difficult to judge. Insufficient excisions will, of course leave too much gland there, whilst over excision can leave a depression which can also be disfiguring. For most men the relatively mild depression is a lesser evil than persistence of the breast gland itself. However the aim of surgery is to leave a smooth natural contour there.
If anabolic steroids are used again recurrence of the gland may well be accepted. This is because the small amount of residual gland can again be stimulated by these hormones. If you have had Gynaecomastia it is most unwise to recommence the use of these drugs. These drugs are also associated with death due to heart disease in young males so their use is not to be encouraged in any circumstance.
Treatment of Gynaecomastia will require a careful assessment of your particular condition and an outline of the treatment options available. Not uncommonly there is a mixture of fat and gland in the Gynaecomastia. In some cases reduction of the fat component by liposuction alone through small inconspicuous scars can give a reasonable contour without the larger scars of direct excision. In other circumstances the glandular component of the Gynaecomastia is too great and a second procedure to excise the residual gland is required.
So due to the variations in the natures of different Gynaecomastia it is wise to get a careful assessment and discussion of the treatment options which may be available to you.
Dr Scamp will explain the surgical procedure, risks, recovery time and answer all of your questions at your initial consultation at his Gold Coast clinic.