What is a gynecomastia surgery?

Gynecomastia is the development of breast tissue in men.  It occurs during puberty in many men as a result of hormonal changes and spontaneously resolves in many people.  However, in some men this breast tissue may persist beyond puberty and may be worsened by medications including anabolic steroids, marijuana, alcohol and a number of prescription medications.  In addition to true gynecomastia (breast tissue), excess fat tissue due to weight gain can also give the appearance of gynecomastia.

Who is a suitable candidate for gynecomastia surgery?

Patients who have excess breast tissue without an underlying medical cause and who are otherwise in good health are good candidates for the surgery.

What are the goals of the gynecomastia surgery?

The goals of gynecomastia surgery are to reduce the volume of breast tissue and improve the contour of the chest wall while minimizing visible scars. Removal of fat may also be required to achieve a cosmetically attractive appearance of the chest.

What is done during surgery?

The surgery for gynecomastia involves a general anesthetic with incisions around the chest to allow removal of the excess tissue. This breast tissue and fat may be removed with special instruments or with liposuction. The resulting scars depend on a number of factors but are most commonly hidden along the edge of the pigmented skin around the nipple or other inconspicuous areas of the chest.  In cases with severe sagginess of the breast skin, longer scars may be required to achieve the appropriate contour of the chest.

Where is the surgery performed?

All surgeries are performed at Women’s College Hospital as day surgery by the plastic surgery senior resident under the supervision of a faculty plastic surgeon.

What to expect in the recovery? How long will I be off work? When can I resume exercise?

The procedure itself can take from 1 to 3 hours depending on how much work is required. For the best results, you should plan on resting and taking it easy after surgery. For the first few days after surgery, most patients experience some discomfort at the surgical site. After which you will starting feeling better and returning to your normal self. Recovery from the surgery varies between individuals and the specific procedure performed.  Swelling and bruising in the area of the surgery will be present and generally begins to improve about 1 week after surgery.  For most patients, we recommend a compression vest for the first couple of weeks after surgery to help with swelling and bruising. You should plan on being off work for 1 week. During your recovery, you should refrain from strenuous physical activity including lifting and pulling for 6 weeks following surgery.

Where are the scars?

As plastic surgeons, we realize the importance of the cosmetic outcome.  We will make every effort to optimize the scar size and conceal it in the least visible area of the chest. In many cases, it is possible to improve the appearance with very little scarring. Where the sagginess of the chest skin is severe, the length and placement of the incision will vary based on location and extent of excess tissue to be removed. It is important to realize that scar formation varies between individuals and is highly dependent on a person’s genetic predisposition.  Scars typically fade over time but their final dimensions and colour are difficult to predict.  At the consultation, the plastic surgeon will talk to you about this.

What are some common complications of surgery?

Complications of gynecomastia surgery, like those of other cosmetic procedures, are uncommon but may include unfavorable scarring, asymmetries, bleeding, infection, swelling and numbness. Specific to gynecomastia surgery, risks include overresection or underresection of the tissue and the rare possibility of loss of feeling or skin loss around the nipple.

When will I see the final results of the surgery?

The results of surgery will be immediately apparent and will continue to improve postoperatively as the swelling decreases.  It should be realized that minor amounts of swelling may persist up to 12 months after the surgery.  Final results in contour as well as scar quality will take at least 6 to 12 months after surgery.