Gynecomastia Procedure

What Do Enlarged Male Breasts Look Like?

There are many different sizes and variations to gynecomastia. It may be worth looking at our before and after photography section on this website, which can give you many examples of how enlarged male breasts look like.

Some enlarged male breasts are pendulous, while others are very large and round. Some can be small and pointy. Sometimes the gynecomastia is just from fat, in which case the problem could be solved through liposuction. Other times, the gynecomastia is due to actual breast tissue or glandular tissue which is fibrous, white, and hard. The size of the fibrous tissue can vary from a small marble to almost a handful. When this tissue is present, an excision of the tissue is also required. In some cases, the gynaecomastia also involves a large amount of excess fat on the sides of the breast. Dr Lanzer usually advises to treat both simultaneously.

What Causes Gynecomastia in Men?

There is a strong genetic tendency with gynecomastia. Often, we see it running in families. Of course, there can be factors other than genetics contributing to gynecomastia. A prime example is overweight, which can cause an excessive build-up of fat in the male breasts. Subsequently, this factor could be tackled with weight loss and an active lifestyle. There are also cases of gynaecomastia that are caused by hormonal imbalances, causing an increase in fatty tissue and glandular tissue, giving the male patient a more feminine looking chest.

Some cases of gynecomastia are caused by drug abuse, this includes long-term use of anabolic steroids. Even when the person in question stopped the use of these illegal substances years ago, the effects can linger in the form of gynecomastia. 

There are some patients who are concerned that breast cancer can cause gynecomastia, and this can be the case in a small percentage of men. To rule out this potential cause, patients are submitted to a number of tests including blood tests and tissue sample tests before the procedure can take place. 

Older men are also more likely to develop enlarged breasts, this due to the changes in hormone levels that accompanies the ageing process. 

It is a fact that some medical conditions and health problems are common causes of gynaecomastia. Some of these conditions include but are liver disease, kidney failure, kidney disease, prostate cancer or cancer of the testicles (testicular cancer), male breast cancer, a problem with the adrenal glands, elevated estrogen levels, Klinefelter syndrome, irregular hormone levels in general, hormonal changes linked to the ageing process, elevated levels of human chorionic gonadotropin, reduced testosterone levels, hypogonadism, hyperthyroidism, can all be possible causes of gynecomastia. 

The use of certain medications has also shown to have an effect on gynaecomastia. Medications that have been linked to the development of gynaecomastia include Tamoxifen, Calcium Channel Blockers, Finasteride, Flutamide, Ketoconazole, Diazepam, Spironolactone, Metronidazole, tricyclic antidepressants, antiandrogen medications, and Cimetidine. Evidently, this list of non-exhaustive. On top of that, the medications in question can also be used for conditions that are known to increase male breast tissue or lead to breast enlargement. As a result, the effects of these medications can enhance the side-effect of breast enlargement.

For many patients, it is vital to determine the underlying cause of breast enlargement before choosing the surgical removal of fat and breast tissue. To determine the cause, a health professional may need to adopt endocrinology tests, mammography, and even blood tests to look at testosterone production and other hormones. As a medical treatment can also be the cause of enlarged male breasts, an alternative may need to be found before surgical treatment options can be considered. 

Men who have enlarged breasts due to fat accumulation have so-called pseudogynecomastia, a condition characterised by excess fat in the breasts. While this condition could improve with weight loss if the patient is overweight, some patients on their target weight fail to shift the excess fat and therefore need surgical intervention. 

There is also so-called pubertal gynecomastia. This type of gynecomastia is often characterised by rubbery fat and is only temporary in nature. However, a very small percentage of men may be left with enlarged breasts in adulthood.

Proper health care and advice before and after your procedure is vital. To determine the best treatment for gynecomastia, you must be examined by an experienced cosmetic surgery. Once the cause of enlarged male breasts is known, more effective treatments can be put forward for your consideration.

What Happens During a Gynecomastia Consultation at the Dr Lanzer Clinic?

The procedure starts with the assessment by Dr Lanzer. Firstly, Dr Lanzer will take photographs. These photographs will be used as a reference point for your treatment, but they can also be your “before” photos after your treatment has taken place.

Before the procedure is executed, Dr Lanzer will mark the areas of fat. Markings will be subject to the most prominent amount of tissue that must be removed. Different concentric circles are drawn, which will aid in the understanding of what needs to be removed during the procedure.

The procedure can be done under local anaesthetic or general anaesthetic. When the gynecomastia surgery is done under local anaesthetic, patients will feel a small sting as the local anaesthetic is infiltrated into the breast tissue; this takes about five or ten minutes. After the initial sting, the breast becomes numb. Often, we will wait thirty – ninety minutes to help the anaesthetic work. The anaesthetic also contains adrenaline. The adrenaline causes closure of blood vessels. It is for this reason that after 15,000 liposculptures, Dr Lanzer has not had to give a blood transfusion on any occasion; this breakthrough method was also described by dermatologist, Dr Jeffry Klein, in America.

Once the breast is tight, firm, and numb, Dr Lanzer will commence the suction process. There are usually two small keyhole incisions around the breast. Then, Dr Lanzer attaches a very powerful suction device to a cannula. Dr Lanzer uses a specialised device called “MicroAire”. MicroAire is a vibrating cannula, allowing Dr Lanzer to pass easily between the fibrous tissues of a male breast. In some cases, he will also use the Vaser ultrasound to help soften the fat and tissue as well. It is important that Dr Lanzer removes the fat on multiple layers and levels, so that all the fat is removed; this will enhance the skin contraction. Once the tunnels have been created, the skin will contract, so that the skin collapses down and tightens down to the muscle.

A significant amount of tissue between the skin and the muscle is removed during this surgical treatment. If there is breast tissue present while the cosmetic surgery takes place, then Dr Lanzer will make a small incision under the nipple and remove the breast tissue. Sometimes, the breast tissue removed will be minor, approximately the size of a little pebble underneath the nipple. Other times, it can be as large as almost a tennis ball. In the large majority of cases, excess skin does not need to be removed. However, patients with a significant enlargement of the male breast may need excess skin removal as well as moving the areola to a more suitable location, as the latter can be situated lower on the male breast due to the enlargement. 

Breast tissue has a white thickened appearance. Excess breast tissue sometimes occurs for no reason other than genetics. Other times, it can be caused by hormones and drugs. Once the tissue has been removed, Dr Lanzer will put some stitches along the edge of the nipple to close the area where he removed the tissue from. No stitches are placed on the actual liposculpture incision. Padding is applied onto the breast and a compression garment is worn; this will reduce the amount of bruising and swelling. Ice is sometimes beneficial in the recovery period.

In conclusion, the surgical technique used for gynaecomastia depends heavily on the cause of the enlargement, but also the ratio of gland tissue compared to fatty tissue. This is why it is so important for a surgical procedure such as this to be completely tailored towards the patient’s body. The treatment of gynecomastia envelops numerous factors, which is why a thorough physical examination by an experienced cosmetic surgery is advised for all patients. 

Shortly after your procedure, you will be required to attend a follow-up appointment; this enables your cosmetic surgery to check the results as well as your progress.

Will I Get Medication Before and During My Recovery from Breast Reduction?

Dr Lanzer always gives pre-operative antibiotics. He usually starts a cephalosporin derivative the night before orally and gives an intramuscular injection just before surgery. Infection is extremely rare, but it is still worthwhile taking prophylaxis prevention antibiotics. Dr Lanzer also recommends anti-septic washes to be applied the night before surgery. Pain is not a major issue with gynecomastia surgery. Basic panadeine tablets are prescribed following the surgery.

What Signs of Complications Should I Look Out for After Surgery?

As we mentioned briefly already, the chances of complications are rare at the Dr Lanzer Clinic, but that does not mean patients should rule them out all-together. We usually tell patients to look out for specific symptoms of complications, so they can contact the Dr Lanzer Clinic as soon as possible.

Common signs that may indicate complications include fever, excessive swelling, excessive bruising, and breathing difficulties. If you notice anything abnormal during your recovery, contact the Dr Lanzer Clinic for an emergency appointment.

Do you have any additional questions about recovering from a breast reduction? Contact the Dr Lanzer Clinic today for more information.