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Gynaecomastia comes from the Greek meaning 'female-like-breasts'. This medical condition occurs when firm breast tissue forms in males. It is often referred to as 'man boobs' or 'moobs'. It is important to distinguish between real gynaecomastia and pseudo- or false- gynaecomastia. In real gynaecomastia the enlarged male breast actually contains breast tissue. This is unaltered by vigorous exercise or weight loss, and it cannot be reduced other than by surgery. In pseudo- or false- gynaecomastia on the other hand, the enlarged male breast contains no breast tissue but is simply a fatty enlargement, which often arises in very overweight or obese men and does reduce when there is an overall weight loss. Male breast reduction surgery is usually performed under local anaesthetic combined with a sedative to make you drowsy so that you remain awake but feel very little discomfort during the operation. Some people may be up and about in a day or two after the operation, but you shouldn't plan on returning to (non-strenuous work) for 3 to 7 days. Private costs for a male breast reduction can range from approximately £3,000 to £5,000.
Gynaecomastia is a medical term that comes from the Greek meaning “female-like- breasts". This condition occurs when firm breast tissue forms in males. The media have recently termed this as 'man boobs' or 'moobs'.
The tissue is usually less than 1-1/2 inches across and grows directly under the nipple. Gynaecomastia can be present on one side or on both sides. The condition may also make the breasts tender.
Before talking about treatment for this condition, it is important to distinguish between real gynaecomastia and pseudo- or false- gynaecomastia. In real gynaecomastia the enlarged male breast actually contains breast tissue. This is unaltered by vigorous exercises or weight loss and it cannot be reduced other than by surgery.
In pseudo gynaecomastia on the other hand, the enlarged male breast contains no breast tissue but is simply a fatty enlargement of the male breast. This problem often arises in very overweight or obese men.
Pseudo gynaecomastia does reduce when there is an overall weight loss.
Although gynaecomastia is usually a benign condition, that is one which will not cause you any harm, anyone suffering from breast enlargement should first see his or her General Practitioner before considering any form of cosmetic surgery treatment. There are a number of medical reasons why this can occur and all need to be treated differently.
Many boys or young men will experience a temporary enlargement of their breasts while going through puberty, which does tend to disappear as the youth passes from puberty into full manhood. But this does not always happen. A small minority of men do not lose this breast tissue. These men will need to be checked out for the rare congenital condition called Klinefelter's syndrome.
Certain prescription drugs are known to cause gynaecomastia as a side effect, but this happens only rarely. There are also some illegal drugs, including anabolic steroids used by bodybuilders, which can cause excessive breast tissue growth in men. In many of these cases, no treatment is needed as usually the problem can be solved if you stop taking a medicine or drug that is causing the gynaecomastia.
There are a number of medical conditions that may also rarely cause male breast enlargement. These include hormone imbalances, tumours on the testicles or in the pituitary gland in the brain, breast cancer and chronic liver diseases such as alcoholic cirrhosis.
Occasionally, medicines may be used to treat gynaecomastia, especially if tenderness of the breasts is a problem. These medications may make the extra breast tissue go away.
If your doctor decides that surgery is needed to reduce the size of your breasts, the procedure will remove fat and or glandular tissue from the breasts, resulting in a chest that is flatter, firmer, and better toned and shaped.
Statistics from the American Society for Aesthetic Plastic Surgery (ASAPS) report that 24,672 male breast reduction procedures were performed in 2018 in the U.S., an increase of 22.3% on 2017 figures and a 47.9% increase against 2014 figures. No official figures are yet available for the UK, but we do know that these operations are being carried out successfully in this country too, with the British Association of Aesthetic Plastic Surgeons (BAAPS) reporting an 80% increase in the number of these operations performed by its member from 2008 to 2009.
If you are considering a breast reduction procedure, the following information will give you a basic understanding about what's involved. It can't answer all your questions, since a lot depends on the individual patient and the surgeon.
Please ask your surgeon about anything you don't understand.
Your first consultation with a surgeon should clearly set out your expectations and whether this surgery can achieve the results that you want.
Careful and detailed discussions and exchange of information regarding your medical history are very important at this stage. You should have already discussed this with your G.P. to make sure that there is no possible cause of your Gynaecomastia, which could be treated before surgery.
The surgeon will examine your chest to discover the exact surgical procedure that may be best for you.
The surgeon should discuss where he or she is likely to make the incisions in your chest, and how the excess tissue will be removed. They will also check to make sure that there are no other medical reasons why you shouldn’t undertake this procedure. You would normally also be asked to sign a consent form which means that you have understood the potential benefits and risks associated with breast reduction surgery.
Photographs may also be taken by the practitioner for a “before and after” comparison at a later date.
The surgeon may wish to write to your GP giving details of the operation so that if there are any problems associated with surgery in the short- or long-term, the GP is aware of the procedure and can help with your recovery.
Male breast reduction surgery is usually performed under local anaesthetic combined with a sedative to make you drowsy so that you remain awake but feel very little discomfort during the operation.
Depending on your health and the extent of the procedure, your surgeon may advise having the operation under a general anaesthetic.
Remember that any general anaesthetic has its own small risks attached to it and your surgeon should discuss them with you before any decisions about the operation are made.
The procedure is usually performed in an outpatient surgical centre, either independently operated by your surgeon, or as part of a hospital. The procedure usually takes about 1½ - 2 hours but, depending on the extent of the procedure, it could take longer.
The technique used is dictated by the amount of excess skin present in the enlarged breast. Sometimes, however, the techniques are combined. These techniques are described below.
Liposuction is the preferred treatment when there is not much excess skin and where fatty tissue is the main cause of enlargement.
For liposuction procedures, several quarter-inch cuts are made in either the armpit or areola (the dark skin surrounding the nipples). Fluid is then injected to begin the process of tissue removal. A thin metal rod (or cannula) attached to a syringe or vacuum pump is then inserted to remove the tissue and the fatty tissue is sucked out through the cannula. When the fatty tissue is very thick, Ultrasound Assisted Lipoplasty (UAL), which uses ultrasound energy, may be needed to help break up the tissue
For more information on this procedure, please visit the liposuction section of our site.
If there is a great deal of excess skin and glandular tissue, a more extensive procedure is required.
Your surgeon will make the first incision around the dark pigmented area around the nipple so that it can be moved higher up the breast, but the nipple itself is usually not removed. A second incision is made horizontally in the crease line under the breast. The third cut runs down from the nipple to the crease line. Excess breast and fatty tissue is removed and the skin is trimmed away to reduce, tighten, and reshape the breasts. The cuts are then closed with stitches.
A small drain tube may also be inserted to draw off blood and fluids for the first day or two.
Healing depends on both the individual patient and the extent of the surgery required.
Some patients may be up and about in a day or two after the operation, but you shouldn’t plan on returning to (non-strenuous work) for 3 to 7 days.
Side Effects and Risks
Your chest will be tender and swollen after this procedure. The extent of the swelling and bruising is dependent on whether you tend to bruise or swell easily.
Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before things settle into their new shape.
Risks or side effects following the procedure can include infection, a reaction to the anaesthetic, bleeding and nerve damage.
Bleeding and infection following a breast reduction are rare, but if you have had skin removed as part of the more extensive procedure, it can cause scars to widen.
This procedure does leave scars that gradually fade over time. If you have only had liposuction, these may become relatively unnoticeable. However, if tissue and skin reduction is required, the scars will be larger and more evident, and you may also find that you are left with slightly lop-sided nipples or a permanent loss of feeling in your nipples.
It is very important that you follow the advice of your surgeon carefully after your operation.
Post-surgery advice may include:
There are few reasons why someone should not undergo breast reduction surgery as long as they have had all the possible medical causes of the condition first ruled out by a doctor, are in good general health, and have realistic expectations of what the operation can achieve for them.
If you are prone to keloid (red, angry, raised) scars, or have a history of problems with wound healing your surgeon may not recommend this procedure or may caution you that scars could be raised and very visible.
Who Can Do It
Only fully trained and qualified surgeons should perform a breast reduction operation on men.
For more information about practitioner training, qualifications and relevant medical organisations please view the information contained within the Legislation section of the Consulting Room.
Some insurance companies and/or NHS hospitals may pay for male breast reduction surgery if it is considered to be medically necessary by your doctor.
You will need to see your General Practitioner for a referral to a surgeon in the National Health Service, or check your policy details to see if you are covered for this type of procedure if you have a private health plan.
The NHS has set out the following guidelines on how to get cosmetic surgery through the NHS:
"To qualify for surgery on the NHS you must meet specific criteria as set out by your local health authority. The NHS will not pay for surgery for cosmetic reasons alone. Reconstructive and cosmetic surgery to correct, or improve, congenital abnormalities and injuries will usually be carried out free of charge.
NHS reconstructive surgery is performed by plastic surgeons who have had extensive training and belong to the British Association of Plastic Reconstructive and Aesthetic Surgeons. Surgeons who carry out cosmetic surgery through the NHS also belong to the British Association of Aesthetic Plastic Surgeons.
To receive cosmetic surgery from the NHS, you will normally need a referral from your GP. You will have a consultation with a plastic surgeon and an assessment by a psychiatrist, or psychologist. It will then be decided whether there is enough social, psychological, or physical benefit to be gained to justify surgery."
Prices for private treatment for male breast reduction may vary from £3,000 to £5,000.
Male breast enlargement, 'man boobs' or 'moobs' can be a very embarrassing condition, and although it is not often talked about, there are some estimates that it may affect up to 10% of men to some extent.
True gynaecomastia with the production of firm breast tissue is much rarer. That is why it is very important with all forms of breast enlargement to visit your G.P. first to rule out any possible medical causes.
Surgical treatment options using either liposuction or surgical resection of skin and tissue (or a combination of the two procedures) can effectively and, usually permanently, reduce the enlargement, leaving a flatter male chest.
Remember, however, that you may need to be patient as swelling and scarring following this procedure can take many months to settle down.
Before and After Pictures
Please note that results of cosmetic surgery vary enormously, depending upon both the patient and the skill of the individual surgeon, so outcomes for procedures will always be more variable than those for less invasive non-surgical treatments.
(All before and after photographs featured are real patients treated by highly experienced surgeons, your results may differ).
Gynaecomastia (Man Boobs) before treatment and 8 weeks after treatment with VASER Liposuction
Male breasts, (Man Boobs / "Moobs") before treatment and 8 weeks after treatment with VASER Liposuction
Photographs provided courtesy of The Private Clinic