Gynaecomastia is the benign enlargement of the breast tissue in men. All males have breast tissue beneath the nipple and areola.
It is likely a very subtle hormonal imbalance or increased sensitivity of the breast tissue accounts for its increase in size. In some cases, an identifiable cause may be found such as a hormonal imbalance, or the use of some medications or ‘recreational’ drugs that are known to increase the likelihood of developing gynaecomastia.
Please note that individual results will vary depending on the individual, their genetics and lifestyle factors, and all surgeries have associated risks. Before proceeding with any surgery, it is advisable to seek a second opinion from an appropriately qualified medical practitioner such as a Plastic Surgeon. Dr. Gary Avery (MED0001633092) a registered medical practitioner, with specialist registration in Surgery – Plastic Surgery. Dr Avery is also a member of the two leading professional associations for plastic surgeons in Australia, Australasian Society of Aesthetic Plastic Surgeons (ASAPS) and Australian Society of Plastic Surgeons (ASPS). Their websites provide additional information regarding plastic surgery in Australia that you might find useful, please visit ASAPS and ASPS.
Medications may be effective in reducing gynecomastia in the early stages. In cases in which medication has not been effective, another option is to undergo surgery to treat it. The surgery for gynaecomastia aims to create a relatively flat appearance to the chest that can take on the shape of the underlying chest muscle.
Gynaecomastia is not associated with severe health problems. Nevertheless, it is important for the patient to be examined by a physician to disregard any potential chronic conditions (e.g., cirrhosis, hypogonadism, renal insufficiency).
Patients considering any form of breast surgery will need to come in for a consultation with Dr Avery to discuss your expectations, along with the surgical options for how these can be achieved. During your consultation with the Avery team, we will ensure that the surgery you are considering is the appropriate choice for you.
At Avery, we welcome the opportunity to have an open conversation with you to understand the changes you are looking for with surgery. Our patients’ stories matter a great deal to us.
Wherever you are on your personal journey, we would like to assist you. Your reasons for having surgery and your expectations from surgery are important conversations to have before undergoing surgery. Dr Avery will also assess your health and medical history to ensure any surgical procedure you are considering is a safe and appropriate choice for you.
Your Gynaecomastia Surgery
Your GP or another specialist that knows you well must make a referral to Dr Avery. The decision to have a consultation may be made after talking with family or friends or following your own research into plastic surgery and Dr Avery.
The purpose of your initial consultation with Dr Avery is to discuss your motivations for surgery and expectations from surgery. It is an opportunity to openly communicate what you want to change, alleviate or remove. We will discuss any concerns you may have about your potential surgery and its outcome. We will also collect information that is specific and tailored to you, to add to the knowledge you acquired through your research outside of the consultation process.
When you arrive at Avery, you will check in with our Care Team and complete a medical history form, if not already completed. We encourage you to bring a supportive family member or friend who can remain with you throughout the consultation if you like, and be a sounding board during your decision-making process following the consultation.
The consultation with Dr Avery will include an examination of the area of your body that you are concerned with and considering changing. Our aim will be to determine if plastic surgery can achieve what you hope it will, and if so, what specific plastic surgery procedures will address your concerns and meet your expectations in a realistic way.
Plastic surgery procedures can impact physical appearance and there may be a psychological response to the changes in your body after surgery. Besides the reasons for having plastic surgery, it is important to be fully aware of any potential limitations of the operation and how they apply to your unique situation. This includes the risks of having surgery and all of the possible complications that can occur after surgery, and what can be done if these occur.
We will discuss what the surgery involves, how it relates to you specifically given your uniqueness and current state of health, what the possible risks of the surgery are, and then decide if having the surgery is a safe and appropriate choice for you as an individual.
Your consultation will also include a discussion of the estimated financial implications of having this surgery or surgeries that were discussed with Dr Avery.
After your consultation, our Care Team will be there to talk through any further questions you have, including the cost of the surgery.
At Avery, our goal is to ensure you are equipped with the knowledge needed for you to feel empowered throughout the decision-making process, surgery and post-surgery.
Correction of gynaecomastia removes fat and excess glandular tissue from the chest area using liposuction. A small incision is made around the outside edge of each areola, where scarring should be minimally visible.
In some cases, an excision technique may be required in addition to liposuction, to remove large amounts of glandular tissue and excess skin. Several incision options are available, and the surgeon will discuss each in detail with the patient.
The surgical technique used will be determined by the patient’s:
- Breast anatomy
- Amount of reduction desired
All male breast procedures are performed under general anaesthetic in an accredited hospital, with appropriately trained support staff.
As with all surgical procedures, male breast reduction surgery does have risks, despite the highest standards of practice. It is not usual for any surgeon to outline every possible side effect or rare complication of a surgical procedure. However, it is important that you have enough information about the most common risks to fully weigh up the benefits, risks, and limitations of surgery.
The following possible complications are listed to inform and not to alarm you. There may be other complications that are not listed. Smoking, obesity, and other significant medical problems will cause greater risk of complications.
Some general risks and possible complications of surgery include, but are not limited to the following:
- Heavy bleeding from an operated site. This may require a blood transfusion.
- Infection that may require treatment with antibiotics or further surgery in some cases.
- Allergic reaction to sutures, dressings or antiseptic solutions.
- The formation of a large blood clot (haematoma) beneath an incision site may require further surgery.
- Complications such as heart attack, pulmonary embolism or stroke may be caused by a blood clot, which can be life threatening.
- Pain, bruising and swelling around the operated site(s).
- Slow healing, often related to smoking or diabetes.
- Short-term nausea following general anaesthesia and other risks related to anaesthesia.
- Tissue cannot heal without scarring and that how one scars is dependent on individual genetic characteristics. Dr Avery will do his best to minimise scarring but cannot control its ultimate appearance.
- Smoking or using nicotine products during the 3–4-week pre-operative and post-operative periods is prohibited as these could dramatically increase the chances of complications.
- All medications I am currently taking, including prescriptions, over the counter remedies, herbal therapies and supplements, aspirin, and any other recreational drug or alcohol use can affect the safety of my surgery.
- There can be no guarantees about the results of any surgery.
Some specific risks for male breast reduction surgery include, but are not limited to the following:
- Bleeding / haematoma requiring surgery
- Asymmetry of breasts and/or nipples
- Delayed healing
- Discoloration / swelling
- Different size than expected
- Change in nipple and skin sensation
- Discomfort (pain/sensitivity)
- Further surgery required
- Disappointment/unsatisfactory result
- Further recovery time if further surgery is required
- Wound separation
- Nipple retraction / contour irregularity
- Restricted activity
- Skin or nipple loss requiring further treatment
- Unfavourable scar appearance
- DVT (deep vein thrombosis) – clot in legs or PE (pulmonary embolus) – clot in lungs
- Allergic reactions to tape, suture material, topical preparations, medications
The Australasian Society of Aesthetic Plastic Surgeons (ASAPS) has further information about male breast reduction surgery including the possible risks for this surgery.
Generally, this can be performed as either a day procedure or with one overnight stay post-surgery to aid with recovery. Depending on the complexity of the surgery, up to two weeks off work may also be recommended.
If you have undergone another surgery in addition to the male breast reduction, a longer stay in hospital might also be necessary for recovery. As with any operation, you will need to organise somebody to drive you home. We encourage our patients to have another adult stay with them during the first night after surgery.
After male breast reduction or gynaecomastia, you will be required to wear a compression garment for 2–6 weeks to provide support and reduce post-operative pain or swelling, which generally subsides about two weeks after the surgery.
A customised pain relief program will be created for you and issued before you leave the hospital. If circumstances change at any stage during the recovery period, we can adjust the pain medication accordingly.
The financial aspects of your surgery are as important as the medical elements when planning for surgery. At Avery, the surgeries we offer fall into three different financial categories: Self-funded – aesthetic surgery; self-funded – plastic and reconstructive surgery; and health insured – plastic and reconstructive surgery.
To make sense of these three financial categories, we have created a detailed price guide to help you understand what may or may not be covered by your health insurer/Medicare and your out of pocket expenses.
For more information or to book a consultation, please contact our team on 02 4002 4150.
Gynaecomastia Surgery FAQ's
Gynaecomastia is a benign condition. Breast cancer although uncommon in men is possible. Both gynecomastia and breast cancer can be seen as a change in the appearance and size of the breast or nipple and areola and therefore, it is important to have any lumps checked by a doctor.
Prior to considering any surgical interventions, a medical evaluation should be performed by your GP. Any suspicion for an existing malignant breast tumour must be addressed before your consultation with a plastic surgeon.
Scarring will vary between patients. The size and location will depend on the type of surgery had, as well as your skin type. Usually, the scar will be red at first, but fades over time, finishing a little lighter or darker than the surrounding skin after 12-18 months.
The aim of gynaecomastia surgery is to create a flat chest. The majority of the breast tissue is removed to achieve the desired contoured chest shape, but given that men who do not have gynaecomastia also have a percentage of breast tissue, some will be left attached to the areola to recreate a natural male chest appearance.
Generally, the chance that there will be a change in nipple sensation increases with the extensiveness of the surgery. Some men may experience a reduced sensation in the nipples that can be temporary or permanent. They may also find their nipples become hypersensitive for a short time after surgery. For further risks associated with this surgery, please visit the risks section on this service page.
Simply walking is advised and is recommended during the first 2 weeks after surgery. An increase in activity is encouraged between 2-6 weeks, limiting this increase based on how your body feels and responds. From 6 weeks you can be mostly unrestricted with exercise but it may not be until 12 weeks following surgery that you feel you are back to pre-surgery fitness, or even improved from your pre-surgery fitness if physical symptoms and restrictions have been addressed with surgery.
Pain following surgery will vary depending on the extent of surgery. Pain immediately after surgery may be reduced by the use of local anaesthetic at the surgical site given during the surgery. The pain will also be managed with tablets or injections as required. Physical measures such as the dressings and supportive garments as well as limited movement and possibly ice packs will all help minimise any pain. Pain is usually well tolerated within a few days after surgery with all these measures. If your pain is increasing following surgery this is usually a sign that you may need a review to ensure your recovery is proceeding as expected.
Dressings and supportive garments will offer support to the wounds and the areas of your body that are still recovering. You will be also be advised to restrict excessive movement of the surgical area in the first two weeks after surgery. A good general rule throughout your recovery is if an increase in movement or activity does not increase any discomfort or swelling, then it is probably safe and this gradual progression back to ‘normal’ will be encouraged.
Typically, if your surgery is considered cosmetic in nature and does not have a related item number, private health insurance does not cover this surgery. If the surgery is being considered to address significant developmental differences, changes from previous trauma, or to relieve nasal obstruction, then a Medicare item number may apply to the surgery and there may be some cover of this procedure through private health insurance.
Sun exposure can adversely impact early wound healing and have an adverse effect on the pigmentation and long-term quality of you scar(s). All scars should be protected from sun until they are mature, which may not be until one-year post-surgery. A spray tan is okay after a few weeks (once the wound is healed).
Nipple Correction / Reshaping
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Your initial consultation
During your initial consultation we welcome the opportunity to have an open conversation with you to understand the changes you are looking for with your surgery and talk through any concerns or specific goals you may have.
Your initial consultation will include an examination of the area of concern and we'll work with you to determine if plastic surgery can achieve what you hope it will, and which specific plastic surgery procedures will address your concerns and meet your expectations in a realistic way.