Treating Gynaecomastia

Sydney cosmetic plastic surgeon Dr Hodgkinson explains how gynaecomastia, a common problem for men, can be resolved. Louise Conville reports.

One of the main complaints among men suffering from gynaecomastia is the effect it can have on their self-esteem and, subsequently, their social life. This male condition is a result of excess tissue or fat in the upper chest that gives an appearance similar to that of a female breast.

‘Gynaecomastia can occur in teenage boys, young males and the elderly,’ says Sydney cosmetic plastic surgeon Dr Hodgkinson. ‘It has a number of causes including an over-activity of hormones. In this instance, the breast is made up of an excess of true glandular tissue. For elderly gentlemen, it is often a side effect of certain drugs. Body builders can develop the extra tissue from overuse of steroids and, more recently, excessive use of marijuana has been cited as a possible cause.

The breast tissue can either form similarly to a female symmetrical shape or one breast can differ in size compared to the other. For teenagers it can be both embarrassing and confusing at the height of adolescence, particularly if they receive negative comments. ‘In some cases, it can be so detrimental to their selfconfidence that it stops them from participating in activities like going to the beach,’ says Dr Hodgkinson. ‘For many grown men it’s embarrassing too and can lead to social preclusion. Some males lose the courage to socialize with women because it has damaged their self-esteem.’

Gynaecomastia may be a genetic condition and Dr Hodgkinson has encountered father and son patients with similar appearances. ‘The surgical approach is to remove the glandular tissue and fat. Liposuction removes the fat but not the mammary gland,’ he explains. ‘For patients who require gland reduction, the surgeon makes a small incision between the skin and the areola, or nipple. A sample is then sent to the pathologist because breast cancer can occur in a small number of men today.

In Dr Hodgkinson’s opinion, liposuction creates the best contour and establishes a good shape and definition of the pectoralis muscle. For some small-framed men, an implant can be placed in the pectoral to retain shape in the area and avoid a ‘thumb print’ effect underneath the areola.

The operation is performed as day surgery without any overnight stay. A firm dressing is placed around the upper chest and back for seven to ten days and the same period should act as downtime from work or school. There are very few complications associated with such procedures if the patients are relatively healthy. Scars usually fade over a period of 12 months.

‘One side benefit of this procedure is that it gives men more confidence and self-esteem,’ says Dr Hodgkinson. ‘They feel comfortable enough to wear tighter fitting T-shirts and partake in a variety of sports and activities.’acsm