Male Breast Reduction
Table of Contents
A male breast reduction is one of the most commonly performed cosmetic procedures for men in the UK. The procedure involves removing excess breast tissue and fat to reduce the size of the breast and create a firmer, more defined chest contour. The medical term for the procedure is gynaecomastia surgery. It is important to have a good understanding of the treatment before you have your surgery. This male breast reduction overview can give you a good starting introduction.
What is gynaecomastia?
Gynaecomastia is a common medical condition that is seen in men of varying ages. It is the enlargement of breast tissue in men. It is not always clear why this occurs. However, some causes can include obesity, hormonal changes, use of certain drugs or certain medical conditions.
Prior to having surgery, you should try and see if these causes may be the reason for your gynaecomastia. It is important to check because you may be able to reverse it by stopping taking certain medications and drugs. It is also important to try to lose weight first before having treatment, as this may also be the cause.
What can a male breast reduction achieve?
Enlarged breast tissue can have a negative impact on your self-esteem and be a source of emotional distress. You may feel that the excess breast tissue and excess skin in the area of your chest have given your chest more of a feminine look. As a result, you may consider a breast reduction. A male breast reduction procedure can help:
- Remove excess breast tissue.
- Remove excess skin in the chest area.
- Achieve a more masculine looking chest.
In addition to physical changes, this procedure can help boost your confidence.
Many men are unhappy with how their chest looks due to the presence of excess breast tissue. Male breast tissue enlargement, or gynaecomastia, is a common condition. The most suitable male breast reduction candidates include men who:
- Have had no response to previous medical treatment.
- Have seen little to no improvement in their breasts after weight loss.
- Feel self-conscious and insecure because of their breast enlargement.
- Currently, have a stable breast size.
- Want an effective solution that will give long-lasting results.
- Are not currently suffering from any serious medical conditions.
- Have realistic goals.
- Have a healthy BMI less than 30.
Both adult and adolescent men can develop breast enlargement. Adolescent men may also be suitable for this procedure, however, it is important to note that they are often at an age where the body is still developing. As a result, they may require a further procedure after their first surgery.
How is a male breast reduction procedure performed?
A male breast reduction procedure generally takes between 1 to 3 hours to perform. The use of general anesthetic will ensure you are asleep for the duration of your procedure. Your procedure could be a day case or you may need to stay in overnight.
1. Consent Form
You will first meet with your surgeon before the operation to sign a consent form. They will ask you to sign the form either at your preoperative assessment or on the day of your operation.
After you have given your consent, your surgeon will use a marker to draw lines on your chest and discuss the goals of your reduction. In addition, your surgeon may ask for permission to take before and after pictures of your chest for your medical records.
Before your procedure, your anaesthetist will have to give you an anaesthetic. The surgery can be done either using a general anaesthetic or a local anaesthetic with IV (intravenous) sedation. The choice of which anaesthetic to use will be made before you have your surgery.
The technique your surgeon chooses to use for your male breast reduction procedure will depend on the amount of fat, excess breast tissue and excess skin you have. Depending on the degree of breast enlargement, your surgeon may use liposuction, a breast tissue removal technique or a combination of both. If you have a small amount of breast enlargement, your surgeon may use liposuction alone to remove excess fat. If you have more severe breast enlargement, your surgeon may use both liposuction and a breast tissue removal technique to remove the excess breast tissue and/or skin. The greater the amount of excess breast tissue and skin you have, the bigger the incision will be.
If your surgeon chooses only to use liposuction, they will create various small incisions below the breast and under the armpit.
If you only have a small amount of breast tissue that your surgeon needs to remove, they may use a periareolar incision. Your surgeon will make the incision halfway around the circumference of the areola.
If you have a moderate amount of excess breast tissue and skin, your surgeon may use a vertical incision. This requires your surgeon to make a cut around the whole areola, and a cut vertically down to the breast fold.
If you have a large amount of excess breast tissue and skin, your surgeon may use an Anchor-T incision to perform the reduction. This is similar to a vertical incision but requires an extra cut to be made along the breast fold.
4. Closing of incisions
Next, your surgeon will use sutures to close the incisions and will apply a dressing over your chest. They may also place a drainage tube under the skin. This will help to reduce swelling and bruising in that area.
5. Return to the ward
Finally, once your surgery is complete you will return to the ward to recover from the anesthetic. You will be able to return home on that day or the next day. Despite being able to return home, be aware your breasts will remain sensitive and tender for the next several weeks.
What should I expect during my male breast reduction consultation?
Your surgeon will meet you for your initial male breast reduction consultation. This meeting can last between 15 minutes to an hour. Your surgeon will use this time to talk about your requirements and the treatment itself. They will discuss the following topics with you:
- The cause and degree of your gynaecomastia (male breast enlargement)
- The quantity and quality of the surrounding skin
- Your personal goals for surgery
- Which medications you are taking (this includes prescription, over-the-counter and herbal medications)
- How much alcohol you drink
- If you smoke or use recreational drugs
- Your past and current medical history
- Any personal or family history of breast cancer
- Any concerns or worries you may have.
After your surgeon has taken your medical history, they will then examine your breasts and take some confidential photographs of your breasts for your personal medical record.
What questions should I ask during my male breast reduction consultation?
This consultation is your opportunity to ask any questions you may have about the procedure. It is therefore important that you are as honest and candid as possible. This will help to ensure that your surgeon understands exactly what you wish to gain from the procedure. Clear communication is vital in achieving results that you are happy with. To help, we have thought of some questions you may like to ask your surgeon:
- Do you think my goals surgery are realistic?
- How can I help to get the best results?
- What surgical technique is appropriate for me?
- What will my final scars look like?
- Can I see before and after pictures of similar treatments you have done in the past?
- What are my options if I am not happy with the outcome of my surgery?
Although these are important questions to ask, we strongly recommend that you spend some time thinking of and writing down questions you have for your surgeon. This will help you feel prepared for your consultation. Furthermore, it will help ensure you get all the information you need to make a fully informed decision about your procedure.
Risks & complications
What are the main risks and complications of a male breast reduction?
It is vital for you to familiarise yourself with the potential male breast reduction risks and complications. Doing this will help you make a fully informed decision regarding your treatment. Your surgeon will be able to discuss all the male breast reduction risks and complications with you during your consultation. These include:
Bleeding & bruising
You should expect to see some minor bleeding and bruising after your operation. This is a common and normal thing to experience after surgery and it should settle down with time. In some cases, however, the bleeding can become more severe. You may notice that your chest will become very tight and swollen. If you notice any heavy bleeding, it is vital that you contact a doctor as soon as possible.
A male breast reduction is an invasive surgical procedure. As with any surgery, it comes with the risk of infection. Even though most infections are mild, wound infections, it is important that you take them seriously if they occur. Your surgeon will be able to treat the infection with some antibiotics.
In some rare cases, the infection may spread and become more severe if not treated early. You must, therefore, be aware of the signs of an infection which can include:
- A high temperature greater than 38°C
- Redness or swelling around the incision that is getting larger and beginning to spread
- Any foul-smelling discharge or pus that is coming from the drains or incision site
- An increasing amount of pain that is not going away when you take your painkillers.
If the there is a disruption to the blood supply around your nipples or breast, it may damage the skin, fat or tissue around it. If the disruption is large enough the blood supply can be lost. A loss of blood supply can lead to a condition called ‘necrosis’, whereby the affected area can die, leading to tissue death, nipple or skin loss. If this occurs, you will need to have a small operation to remove the dead skin or tissue. This complication is very rare but is much more likely to occur if you are a smoker. This is one of the reasons why you must stop smoking and using all nicotine products for at least 6 weeks before and after your surgery.
In some patients, there may be a build-up of fluid under the skin. The medical term for this is a seroma and it commonly occurs around the incision site. Your surgeon will often put in a drain to remove any excess fluid during your procedure. This reduces the risk of a seroma developing. If it does develop after you have had your surgery, your surgeon may need to drain the fluid out from the seroma.
General surgical risks
All surgical procedures come with a general risk of complications. These include, but are not limited to:
- Reactions to tape, sutures, glues or injected agents
- Anesthesia risks
- Blood clot formation
- Delayed wound healing
- Damage to underlying structures such as nerves or muscles.
Changes in sensation
It is common to experience some minor changes in sensation in the breasts and nipples after the procedure. This may be an increase, a decrease or a tingling sensation for example. This will often improve and resolve by itself over time, however, the changes may become permanent if there is significant damage to the nerves in that area. In some rare cases, these can result in complete loss of nipple sensation.
You should always keep in mind that you may be unhappy with the results of your treatment. You may be unhappy with the size, shape or symmetry of the breasts. This is one of the reasons why it is very important to choose your surgeon carefully. You should be honest and candid about what you would like to achieve. Choosing a highly experienced BAAPS/BAPRAS surgeon reduces the risk of this happening.
As gynaecomastia surgery requires your surgeon to use surgical incisions to be made, scars are unavoidable. If you are only having liposuction, then there will be very minimal scars that may not even be visible. If your surgeon also has to remove some breast tissue, the scarring will be greater. Your surgeon will tell you how best to look after your scars after surgery.
You will have the opportunity to discuss all of the above male breast reduction risks and complications with your surgeon during your consultation.
Preparing for your treatment
How can I prepare for a male breast reduction?
Preparing for a male breast reduction can be easy as it is an elective procedure. This, therefore, gives you time to get some things in order beforehand. Below you can find some tips that may help you with your male breast reduction preparation.
What can you do around the house before surgery?
As you will not be able to do any heavy lifting for a few weeks after surgery, make sure you do a big grocery shop before you go in to have your treatment. You may also want to cook some meals and put them in the freezer so that you do not have to worry about cooking during your recovery!
You do not want to strain yourself cleaning and tidying whilst you are recovering. It may, therefore, be a good idea to clean the house, take the bins out and get the laundry done before your operation.
Reaching for cupboard items may put strain on the incisions around your breasts after surgery. It would be handy to put items like mugs, crockery and dry food on a low kitchen counter, where they are easy to reach.
What can you organise before your surgery?
Pets & children
You should ask family members and friends to help you look after any young children or pets. You need time to put your feet up and relax!
Your surgeon will give you instructions on when you can start driving again. Usually, you must wait between 5 days to 2 weeks before you can resume driving again. In any case, you must arrange for someone to pick you up and take you home after your procedure.
What should you do after your surgery?
It is important to maintain a healthy diet after your surgery. You can do this by eating food that is high in protein and low in salt and sugar. Try to eat lots of fruits and vegetables and drink lots of water!
You may find it more comfortable to sleep propped up and on your back after the procedure. You should, therefore, make sure you have lots of extra pillows on your bed. Rest and sleep on your back for the first few days after surgery.
Make sure to follow all advice that your surgeon gives you.
What can I expect after a male breast reduction?
Knowing what is involved in your male breast reduction aftercare can help relieve any anxiety you may have. You will be able to return home on the same day of your procedure or the following day. Your surgeon will arrange a post-operative appointment before you leave the hospital. During this appointment, they will examine you, change any dressings and remove any non-dissolvable stitches.
You will be unable to drive for 5 days to 2 weeks after your surgery depending on your surgeon’s advice. It is therefore vital that you arrange for someone to take you home after your treatment.
What will the aftercare involve?
Male breast reduction aftercare has many aspects. We have listed some general advice below, but it is very important that you follow the specific advice that your surgeon gives you and follow the time-frames they provide.
You will be given an elastic pressure garment to wear after your procedure. You must wear this day and night for the first few weeks following surgery. Your surgeon will tell you exactly how long you need to keep this on for. Your breasts will be very sensitive for several weeks, and it may take a few months for them to settle completely.
Showering & bathing
You may not be able to shower or bathe for 24 hours to a few days after surgery. You will also need to avoid using hot tubs, saunas and swimming pools for two to three weeks. Your surgeon will give you specific time-frames for this.
Your surgeon may recommend some scar reducing techniques to help the healing of your scars. These can include:
Your surgeon may or may not recommend that you do a gentle scar massage after your incision has fully healed. You should wait until the scab completely disappears on its own, then use a light cream, oil or scar gel to massage all areas of the scar.
Silicone sheets, gels or creams
Silicone has been clinically proven to help reduce the appearance of scars. You can use a gel, cream or some silicone sheets to apply over your scar once the incision heals. If your surgeon advises you to use this, you must follow their specific instructions.
Protection from the sun
It is very important to keep your scars out of the sun. Exposing your scars to the sun may make them go darker.
Usually, scars tend to be red and raised in the first few weeks after surgery. They will then change to purple in the following 3 months. From that point onwards, they fade to light lines and may eventually fade completely.
Return to work
The type of job you have will affect how much time you need to take off to recover. If your job involves a lot of physical activity, e.g. childcare or waitressing, you will need to take at least 2 weeks off work. If you have a desk job or a job that requires less activity, you should take around 7 to 10 days off work.
In any case, you should avoid even light household duties for at least 2 to 4 weeks.
Although it is important for you to get plenty of rest after your procedure, you should take some short, like walks around the house as soon as possible. This helps reduce the risk of blood clots developing in your legs.
In regards to sports and exercise, you should avoid all sports and exercises for the first 3 weeks after your surgery. Even light, aerobic exercises might increase swelling in the breasts.
After 3 weeks, you can continue to do light exercises such as cycling, but you must not do any heavy lifting or contact sports. When 6 weeks have passed, you can resume all kinds of sports and exercise.
As soon as your procedure is over, you will be able to see a difference in the size and shape of your chest. You should keep in mind, however, that it may take up 6 months before you can appreciate the full results.
Remeber to follow all the specific instructions your surgeon gives you in regards to your male breast reduction aftercare. This will help you achieve the best results possible from your surgery.
Male breast reduction FAQs
The most common male breast reduction FAQs (frequently asked questions) can be found below.
Will the results of my gynaecomastia surgery be permanent?
The results of your gynaecomastia surgery should last a very long time. However, any major weight gain may reverse your results of the procedure and increase your breast size again. It is therefore important that you lead a healthy lifestyle after you have had your reduction. This will help you avoid gaining fat in your breasts. You should also be aware that certain drugs, medications and diseases can increase the risk of the breasts growing again.
Which surgical technique is best for me?
During your consultation, your surgeon will discuss which surgical technique will work best for you. They will determine if you will need liposuction alone or a combination of liposuction and breast tissue removal. Your final scar will depend on which technique your surgeon chooses to do.
How does drinking alcohol, using recreational drugs, and smoking affect my surgery?
Smoking, drinking alcohol and using recreational drugs are all things that can have a negative impact on your surgery and your recovery. Smoking, in particular, is harmful as it reduces the time it takes your wounds to heal. This puts you at a greater risk of developing an infection. You should, therefore, stop smoking and using all nicotine products at least 6 weeks before and after your surgery. It may also be helpful for you to reduce your alcohol consumption before your surgery.