Gynaecomastia

Gynaecomastia should only be treated by operative means in adult patients as the body undergoes various hormonal changes during puberty. For younger men suffering from gynaecomastia, the first port of call should be to consult a specialist doctor for internal medicine. If a hormonal cause can be identified, it might be possible to treat the gynaecomastia with medication.

The term gynaecomastia denotes an enlargement of the male breast. Similar to women’s breasts, male breasts are made up of a combination of glands and fat tissue. Gynaecomastia can have various causes and also presents in different forms.

While some men are naturally predisposed to developing gynaecomastia, a hormone imbalance can also cause male breasts to become enlarged. In the first instance, it’s worth consulting a specialist endocrinologist (i.e. a doctor specialising in the body’s hormonal balance) who will be able to diagnose and then treat this. Gynaecomastia can also be caused by an excess of fat tissue or the consumption of certain medications, such as anabolic substances or steroids. The enlarged male breasts generally remain even after the patient stops taking such medication.

First of all, we determine the cause of the gynaecomastia in an in-depth consultation meeting and an initial examination. From there, we can develop a treatment plan together with the patient.

We carry out the operation ourselves on an outpatient basis under local anaesthetic – although, if the patient prefers, we can also combine this with twilight anaesthesia. The surgery itself is composed of two treatment stages. Fat is extracted from the breast by making as few incisions as possible to reduce the fat tissue in the breasts. The gland is then removed via the areola, which leaves behind no visible scars. Alternatively, the gland can also be removed via an incision at the lower edge of the areola. However, while this method is somewhat faster, it does result in scarring to the areola.

The gynaecomastia operation is suitable for men who suffer from enlarged breasts. Depending on the individual patient’s wishes, we can treat both minor and significant breast enlargement.

Following an operation to treat gynaecomastia, you will be ready to appear in public again the next day. Though patients may experience some muscle soreness or a feeling of tightness, they are by no means confined to bed rest.

They can resume sporting activities like cycling after about 2 weeks – though more strenuous exercise that strains the chest muscles more should be avoided for at least 4 weeks. After about 6 weeks, the patient can resume all their normal sporting activities.

After the procedure, the patient is bandaged and a compressive support applied. After a brief rest period, they’re allowed to leave the practice and can even shower again the same day. After 2 weeks, the patient can resume light exercise, but must wait around 4–6 weeks before taking more strenuous sporting activities up again. The sutures don’t need to be removed as they dissolve of their own accord in time.

That depends on the treatment method selected. If an incision is made through the areola, no scarring will be visible over time. However, if the doctor elects to make an incision at the lower edge of the areola, a small scar will likely be visible following the treatment.

An operation will be required to treat gynaecomastia if a gland is severely enlarged. The surrounding fat tissue can be reduced through appropriate nutritional changes and sufficient exercise – though this tissue is often rather hard to shift. If the gynaecomastia can be traced to a hormone imbalance, therapy with medication may be prescribed instead.

Gynaecomastia operations only result in complications in very rare cases. Standard operative risks apply, such as infections, inflammations and secondary haemorrhages. If parts of the gland remain in the breast after the operation and become problematic, a simple follow-up treatment can remove these.