Mammaplasty: a solution for gynaecomastia (enlarged male breasts)
Written by:
Plastic surgeon
Published: 04/05/2020
Edited by: Robert Smith
Gynaecomastia usually isn’t a serious problem, but it can be tough to cope with the condition.
Sometimes referred to as "man boobs", gynaecomastia is a common condition that causes boys' and men's breasts to swell and become larger than normal. We spoke to Dr Gary Horn, a renowned plastic surgeon based in London and Brussels. He let us know how to distinguish if you have gynaecomastia and talked us through the procedure used to treat the condition.
How can you distinguish that you have gynaecomastia?
Gynaecomastia or adipo gynaecomastia is a condition where men have an enlarged breast and sometimes enlarged areolar nipple complex. Either it starts during puberty when your body reacts to unbalanced levels of hormones, and the result is an enlarged breast gland.
Or it appears much later, generally after the age of 50, and it involves excess fat lumps and skin sagginess on your chest.
Who is most likely to get gynaecomastia?
Again, gynaecomastia affects either young men (mostly a gland problem), or it affects over 50 year old men (mostly fat excess and loose skin).
There is also a third group of patients: bodybuilders who are taking steroids for a long time and that can affect patients at any age.
Finally, there is a fourth group: patients who have had a massive weight loss after surgery (gastric bypass etc.) or a very strict diet. These patients do not have true gynaecomastia, but they do sometimes have loose skin affecting their chest.
Is gynaecomastia always symmetrical and does it have to occur on both sides?
Gynaecomastia is mostly affecting both sides, but it can be asymmetrical, and less often affects only one side. Adipo gynaecomastia affects both sides.
What are the non-surgical options?
The only real treatment option is surgery. Building up pectoral muscles can help, but the real problem is not muscular: it is glandular or affects fat and skin.
What are the latest surgical techniques being used for gynaecomastia?
It is a double treatment:
1) When needed, subtotal excision of the breast gland through an inferior areolar incision. That means that most of the gland is removed but it is important to leave a thin layer of gland under the areola to avoid getting a dip.
2) Vaser liposuction to contour the chest.
That means that not only the chest area is treated, but also the axillary area and the area underneath the inframammary fold.
The ultrasound energy of the vaser probe will melt the fat making it easier to be extracted and will amplify the skin tightening. Then the fat is liposuctioned using vibrating handle cannulas that allow an easier and more complete extraction of the fat.
3) For some patients, we can give more volume to the top of the chest either by fat transfer or by using a submuscular silicone gel pectoral implants for more definition.
How successful is surgery for gynaecomastia?
For 95% of patients the results are excellent and patients are over the moon.
For patients who had massive weight loss, or are obese, we can give them a good result but they also need to either have a chest uplift (after massive weight loss) or to lose weight (if obese).
If you require a consultation about plastic surgery or treatment for gynaecomastia, you may want to book an appointment with one of our expert plastic surgeons such as Dr Gary Horn.