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GYNAECOMASTIA


GYNAECOMASTIA

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GYNAECOMASTIA (Breast Enlargement in Men)

Gynaecomastia is an enlargement of breasts in men. The enlarged breast in gynaecomastia consists of two components, breast tissue and fatty tissue.

 

Causes of gynaecomastia:

1.    The commonest cause of gynaecomastia is increased breast sensitivity to the normal level circulating estrogen, causing the male breast to enlarge even though the hormonal status in the body is normal.

2.    Any condition that cause estrogen-androgen hormone imbalance:

a.    Physiological hormone changes e.g. during puberty and aging

b.    Certain types of medicine such as anti-androgens, anabolic steroids, diazepam, cimetidine, spironolactone etc.

c.    Health conditions such as liver problems, malnutrition, hypogonadism etc.

d.    Certain herb and supplements that have estrogenic activity.

 

Gynaecomastia by itself usually has no serious health implications. However, it can cause psychological and emotional distress because of its appearance that causes embarrassment to the male patients.

 

The treatment of gynaecomastia is surgical removal.

 

 

Preparation

1.    Inform the doctor of any pre-existing medical conditions and drug allergy. All medical conditions must be treated and stabilized before surgery.

2.    Stop smoking at least one week before surgery. Smoking negatively affects wound healing and increases the risks of other post-operation complications.

3.    Stop the following one week before surgery:

a.    All supplements that contain vitamin E, ginseng, ginkgo, garlic, fish oil and other ingredients that increase bleeding during surgery

b.    Medicine that increases bleeding during surgery such as aspirin, NSAIDs and warfarin. However, you may need to consult your physician who prescribed the medicine before you stop them.

4.    On the day of surgery, wear simple and comfortable clothing. Do not wear any jewelry and metal objects on the face and body.

 

 

Surgery

Duration: 2-3 hours

Anaesthesia: Usually local anaesthesia with general anaesthesia as an option

Hospitalization: Not required.

Recovery*: Back to work in 3-7 days, light exercise after one week, heavy exercise after 4 weeks.

 

*The speed of recovery and duration of rest may vary from person to person and also depends on the physical burden of the work and exercise the patient is going to resume.

Technique: Combination of liposuction and excision.

1.    Liposuction: Liposuction is performed through a small incision (around 3-5mm) made on the lower chest.

2.    Excision: Breast tissue and fat are excised and removed through incision around the lower border of the areola.

 

 

Post-operative Care**

1.    What to expect: Swelling usually peaks on second to third day after surgery and gradually subsides thereafter. Pain usually is minimal.

2.    General care

a.    Wear special supportive garment for at least one month to support the skin.

b.    Avoid smoking for at least one month. Smoking increases the risk of wound complications.

c.    Good rest and sleep can help the wound to heal faster.

d.    Be relaxed and calm, as unnecessary anxiety and worry will slow down recovery. Contact the clinic if there are any queries.

3.    Medicine: Finish the oral antibiotics as prescribed. Take the painkiller as prescribed when necessary.

4.    Wound care: Leave the wound dressing on until coming back for review after one week. Change the dressing if it gets dirty or soaked.  The compression pad can be removed after 3 days.

5.    Physical activity: Avoid heavy physical activity and exercise for at least one month.

6.    Follow-up: Come back one week after surgery for suture removal and review.

7.    Emergency: If there is heavy bleeding, rapid increase in swelling or severe pain, immediately contact the clinic/doctor for advice.

**The instructions in this section are not meant to be exhaustive and are only for general references. If you have any specific queries or concerns during the post-operative recovery, please contact the clinic for further advice.

 

 



 


 




 
 
 
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