Overview of the Treatment of the Male Breast

What is Gynecomastia?

Gynecomastia is the formation of female breast tissue in men where the full breast squeezes through the clothes. Going to the gym, the swimming pool or the beach becomes a problem and not to mention intimate situations. Plastic surgery can now correct such a stressful body shape and help the man lead a normal life.

Cause of the “Male Breast”

Gynecomastia usually begins at puberty, Childhood fat, “baby fat”, does not regress during this stage of development, but remains on the breast after puberty.

There are two forms of gynecomastia:

One cause is that a man has a breast just like a woman. In other words, besides too much fat and too much skin, he has a proper mammary gland, female mammary gland tissue. This is called gynecomastia vera, “real” gynecomastia.

With the other cause, the man “only” has too much fat and too much skin and no mammary gland, this is called pseudogynecomastia or lipomastia.

The two types must be distinguished from each other before the operation because the treatment is different.

Is it Only pure Fat Accumulation or is Female Breast Tissue Present?

Both forms of gynecomastia look the same at first: The man has breasts of different sizes. It can range from slight fullness to cup size “B”.
How to distinguish between the two forms:

The easiest way to do this is as follows:

The surgeon physically examines the patient: Are the mammary glands present?

An ultrasound examination: In the ultrasound, a gland is easily recognizable and can also be measured.

If a mammary gland is present, it makes sense to have the hormones examined as there may be too few male hormones and too many female hormones, this is done by an endocrinologist.

Gynecomastia never completely disappears and Its extent can vary, i.e. it becomes larger with weight gain and smaller with weight loss.

It never disappears, there are no other, non-surgical treatments, the only way to fix the problem is through surgery.

Objective of Treatment in Gynecomastia Surgery

The aim of the operation is to remove the female upper body, the breasts, and to form a male upper body, the operation removes all the superfluous, unwanted tissue.

Treatment Procedure

Once the form of gynecomastia has been clarified, it is treated in two ways:

Pseudogynecomastia: The excess fatty tissue is usually removed in tumescence, i.e. a special form of local anaesthesia.

Gynecomastia: The excess fat is also aspirated. As a rule, the mammary gland must be surgically removed, this means that an incision is made at the edge of the nipple and from there the gland is removed.

What Happens to the Skin?

If this excess is small or moderate, it shrinks and adapts automatically to the new situation. If the excess of skin is large, it must be cut away.

Aftercare

After the operation, a compression girdle is worn that presses the inner wound surfaces together and supports the healing and shrinking of the skin. It will be applied 24 hours a day for the first two weeks and another four weeks either during the day or at night. Checks take place two days, two weeks and two months after the procedure. Exercise and physical exertion take one and a half weeks for the abdomen and legs and four weeks for the arms and chest.

Risks/Complications

In operative subjects there is no such thing as zero risk!!! With experienced, good surgeons it is small and although there is the minimal risk of wound infection, We have had no infection so far in our German practice.

What has Happened Before?

The relief of the breast is not completely smooth after healing. This is due to the fact that the internal scars, which always develop after an operation, exceptionally become bulging and push through the skin. Then we can remove these internal scars so that the bottom line is a beautiful male breast.

When is it not Advisable to Undergo Surgery?

In the case of serious basic diseases, e.g. cancer, surgery is contraindicated. If the breast is only enlarged on one side, the tissue on the changed side must first be removed and the fine tissue under laid.