Chest reduction / Gynaecomastia

Overview

Many men undergo chest reduction surgery, as it is a common operation to reduce the amount of chest tissue and if necessary skin covering the chest, improving its overall shape and size. The nipples are also moved into a new and higher position if required. This can lead to a reduction in nipple sensitivity, but not in all cases.

The vast majority of men who have chest reduction surgery are glad they have had it and are very pleased with the results.

Click here for Chest Reduction FAQs

Excision of tissue by a cut around the Nipple and liposuction note the nipple sits higher and the fullness had changed to a much flatter look

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Simple excision of excess tissue through a small cut around the nipple. Notice the fullness by the left nipple

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much more volume and skin (the pink scars will fade in time)

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Liposuction and peri-areolar (disc around the nipple) skin reduction. The correction needs to address the excess tissue and if present the excess skin. Note the improved position of the nipples.

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Liposuction and peri-areolar (disc around the nipple) skin reduction. The correction needs to address the excess tissue and if present the excess skin.

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Liposuction and peri-areolar (disc around the nipple) skin reduction. The correction needs to address the excess tissue and if present the excess skin. Notice the dramatic loss of the “breast” shape making the chest in proportion with the rest of the body.

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Liposuction and significant skin reduction. The correction needs to address the excess tissue and if present the excess skin. In this case the amount of excess skin could not be managed by a peri-areolar correction. The pink scarring will fade in time.

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Chest reduction FAQs

 

Different Types of Gynaecomastia Surgery.

There are several ways of performing gynaecomastia surgery. The ones I use are the; simple liposuction, liposuction and skin reduction, open Wise pattern reduction, vertical scar reduction and horizontal scar reduction. They are used widely and each has pros and cons.

The Operation and hospital stay Gynaecomastia

The surgery is performed under general anaesthetic and takes about two hours. When you wake up you should be comfortable as local anaesthetic is used in the wounds and you will remain on regular analgesia (painkillers) for several days until you are effectively pain free. There will be dressings on your chest. After the surgery you will stay in hospital overnight until it is safe to send you home. Surgical drains are sometimes used to prevent blood collection in the tissues and these are removed once they have settled.

What can go wrong with Gynaecomastia correction

I feel it is important that anyone having surgery with me is aware of the possible negative sides of surgery and understands the small but real risks. The following paragraphs cover what happens when things occasionally don’t go as expected.

Like all surgery there are risks of complications whoever does your surgery. It is important you are aware that many of the problems you may get after your surgery, if they are treated promptly, have no obvious effect on the final outcome.

It is unlikely your chest is symmetrical before surgery and there may be a small degree of asymmetry after the operation. (If it is a big difference then a surgical correction can be discussed). All operations have a risk of bleeding. In gynaecomastia surgery there is a small risk that a blood transfusion may be required (no more than 1%) or that there may be bleeding leading to a collection of blood (haematoma), which needs to be removed under an anaesthetic (less than 2%). Infection is rare and antibiotics are given around the time of surgery to reduce the risk. Some people form bad scars (about 2%) and these can be troubling for a while although often respond to treatment over several months.

There is a small risk of seroma (fluid collection under the skin) this is normally treated by removing the fluid with a syringe and needle in clinic; occasionally further surgery can be required. There may be some numbness of the skin, this will normally get better over a period of time but there is a small risk of small areas of permanent numbness.

Risks particular to gynaecomastia surgery are problems with nipple sensation which may be lost or significantly reduced and can be permanent. There is a very small risk of the nipple not surviving (less than 1%) in its new location and this can require a reconstruction which will not be a good match for the other side. There may be some contour irregularity once the swelling has settled. At the limit this can require a fat transfer procedure.

Other rare problems include some wound breakdown in the wound under the chest which mostly responds to a period with dressings and a problem termed fat necrosis where some of the internal fat loses its blood supply and causes inflammation and hardness and occasionally an oily discharge. Again this responds in the main to dressings and has little if any impact on the final result. All operations can result in long-term discomfort.

All operations have a small risk of Deep Vein Thrombosis (DVT), chest infection and Pulmonary embolism. Death following elective surgery is exceptionally rare (1:250,000 in fit and well people)

As this is a surgical procedure to deal with appearance no guarantee can be given to the final appearance, but if we agree it is an unsatisfactory result correction will be offered at no additional cost.

After Gynaecomastia correction

Expect to feel washed out for a few days after the surgery and to tire quickly although you will return to your normal energy levels in a few weeks.

The sutures are all dissolving, but a one week follow-up will be given to make sure everything is OK. You will be provided with two garments (one to wear and one for the wash) to wear for the first few weeks after the surgery. I will personally see you at 1, 4 and 12 weeks and 6 and 12 months following surgery and more if required.

What to expect from Gynaecomastia correction

Gynaecomastia surgery makes an immediate and dramatic difference. There may be some discomfort for a few days. Normally 4-6 weeks after the surgery, you are beginning to return to normal. It may even be quicker than this. As said above, expect to feel washed out for several weeks after the surgery and to tire quickly although you will gradually return to your normal energy levels.

If liposuction is a part of your treatment it can take up to 12 weeks for the swelling to settle.

The majority of people who undergo gynaecomastia surgery are very pleased with the result and feel it makes a very positive change to their lives.

Cost of Gynaecomastia Surgery

– from £5000

This includes all required follow-ups and in the unlikely event you require further treatment due to post-operative problems any further treatment is also included

(prices updated Feb 2018)

Post Operative Instructions for Gynaecomastia correction

What to bring to hospital

If you would like, bring a family member or friend. Bring some easy to put on bed wear, preferably with front buttons and your own clothes and toiletries and something to pass the time like books, puzzles or some music . The rooms have televisions and there is free Wi-fi.

What to look out for after you have gone home

Before you come into hospital, you will get a package that contains a set of post-operative instructions and a thermometer.

Watch out for redness, swelling, pain, discharge, opening of the wound, fevers, sweating and shaking. Whatch to see if your temperature is above 37.2C and you feel unwell or it is above 37.6C.

If any of the above are seen or any of the information of the instruction sheet call the numbers on the instruction sheet or the hospital you had your operation.

Things to Avoid

The following are medications or herbal medicines to avoid before surgery.

Please disclose all medications (including self prescribed and herbal and vitamin supplements) during the consultation. The following increase the risk of post operative problems.

Roacutane or other vitamin A skin preparations / aspirin / steroids / warfarin / clopidogrel / Brufen / alka-seltzer / Fish oil / Flagyl / anti-rheumatics-arthritics / blood thinners eg persantin / St John’s Wort / Aloe vera / Cimetidine / Vitamin E (>600mg/day) / Vitamin C (>1000mg/day) / alfalfa / arnica / bromelain / calendula / celery / chamomile / cloves / Evening primrose / garlic / ginger / ginko / goji berries / licorice / meadowsweet / diabetes medication / blood pressure medication / diuretics

Most fruit and pickles have aspirin like chemicals in them so avoid large quantities in the two weeks before surgery.

Please remember that if you have any questions or concerns to ask during one of your consultations. Writing questions down is sometimes helpful.

Driving

Normally you can re-start driving at around 2 weeks. You are fit to drive if you feel you are fit. I recommend you have someone take you to an industrial zone or supermarket car park late at night so you can attempt driving without risk to others. If you find you can drive without problems you are safe to go out on the road

Work

Depending on how physical the work you do is, you can start working from between 1 and 3 weeks.

If in doubt remember you can always ask for advice.

Exercise

At home rest is necessary for one week and any strenuous activity, bending, and lifting etc. is to be avoided. You can shower once your dressings are reduced after your first appointment.

Physical exercise more than a gentle walk should be avoided for the first least 3 weeks and then only undertaken if comfortable. After 3 weeks I allow swimming and cycling and more vigorous walking. After 6 weeks you can, if it is comfortable, return to full activities.