Gynaecomastia Sydney

Male gynaecomastia is the medical term for the over development of breasts in men.

Gynaecomastia is characterised by excessive localised fat underneath the nipple, enlargement of glandular breast tissue, or a combination of both. Gynaecomastia may be present in one breast or both. It is a common condition which can be embarrassing to the individual, but is rarely malignant.

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What gynaecomastia technique is used?

Once all reversible causes for gynaecomastia have been sorted out, my preference for treatment is similar to my approach to female breast surgery; namely addressing the breast platform, the breast mound and lastly the skin envelope.

The breast platform is the footprint that the breast makes on the chest wall, analogous to the outline a house makes on a parcel of land. The platform forms the basis or foundation of the overlying three-dimensional structure of the breast and pectoralis muscle. Fortunately, in most men, there are no underlying chest wall or muscle abnormalities. The position of the male nipple on the chest platform may vary individually in height and width, but generally speaking it should reside on the vertical line drawn down from halfway across to the fifth rib space.

Unlike female breast surgery, where I try to create a breast mound, in male gynaecomastia surgery I try to achieve the opposite, and reduce the breast tissue.

Gynaecomastia is usually a combination of fatty and glandular tissue; therefore, different surgical modalities need to be implemented to deal with each component.

Liposuction is usually used to remove fatty tissue and the glandular tissue is usually excised through a semi-circular incision at the lower aspect of the areolar.

In the majority of cases, once the breast tissue has been removed, the elastic characteristics of the skin allow it to recoil to an appropriate position. This means that for most men, the only scars they will have will be the semi-circular ones at the base of their areolar. However, in severe cases and in those men with excess skin secondary to massive weight loss, a skin excision must be performed. This results in an inverted T-shaped scar, and in some rare cases the nipples are removed and grafted.

Why opt for male breast reduction?

Gynaecomastia is common in men of any age, particularly pubescent males. Whilst it is known that particular drugs, medical issues and obesity can seemingly contribute to male breast overdevelopment, there is no known cause for most cases.

With the boom in bariatric surgery and patients with massive weight loss, there is also a subgroup of male patients who come to see me with just excess breast skin, and no fatty or glandular component to their gynaecomastia. In this scenario, the principles of treatment are no different to standard gynaecomastia cases.

What are the potential risks and complications of gynaecomastia?

Potential complications and risks associated with gynaecomastia surgery include:

  • Slightly mismatched breasts or nipples, both in height and projection
  • Temporary numbness around the nipples
  • Recurrence of breast growth after surgery
  • Another procedure may be needed to remove excess skin, especially in males who are having the procedure as a result of massive weight loss
  • Permanent pigment changes around the nipple
  • Keloids and hypertrophic scars around the scars
  • Irregularities of the nipple and areolar complex

How much does a gynaecomastia cost?

Gynaecomastia surgery, in some circumstances, can be a reconstructive procedure and may be covered by private health insurance. Review your policy carefully to determine what is covered.

Costs associated with this procedure vary between $10,000-$14,000 depending on a number of factors such as:

  • Anaesthetist's fees
  • Private hospital or day surgical facility fees
  • Need for post-operative garments
  • Level of private insurance cover
  • Surgical assistant's fee

After our consultation my staff will give you an itemised account of the total cost.

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Frequently Asked Questions about Gynaecomastia

How do you prevent complications in gynaecomastia?

To try to mitigate risks in gynaecomastia Dr Moradi uses the meticulous technique during the surgery and also focuses on post-operative scar management which involves massage, silicone taping and/or light therapy. Regarding bleeding, Dr Moradi will ensure that the patient is not on any blood thinners and also ensure they are not taking any herbal substances such as fish oils krill oils, ginseng, gingko or garlic as all of these tablets make patients prone to bleeding more.

When it comes to contour irregularities, Dr Moradi believes that less is more. He tries to take less breast tissue out in order to avoid getting the scooped dish appearance. It is better to rather come back and do a revision if it appears as though not enough tissues has been removed, rather than taking too much and having the scalloping effect.

There are the classic, three patients that we see with gynaecomastia.

Firstly, there's adolescent boys about 16 to 18, who can't get rid of it and they may be a little bit chubby.

Secondly, there's the non-adolescent man who is overweight and therefore has breast tissue. The more they put on weight, the more they may get on their breast which will need to be removed.

Then there's patients who go the gym a lot and take anabolic steroids. These steroids are the causes of the increased breast tissue.

The primary cause of gynaecomastia is changes in hormone levels occurring both in adults and adolescents.  It can also occur due to anabolic steroid use or by taking different types of medication, for example heart failure medications. Marijuana use can also cause gynecomastia. So, you can have physiological causes such as age, pharmacological causes such as taking medication and pathological causes which are attributed to specific endocrine (hormonal) conditions. However, the vast majority of the time it'll be idiopathic. This means you simply just have it.

Yes, there are. The first is the classic or glandular type. This is just breast tissue and feels like a little nubbin of tissue under the skin. When removed, it looks like a white ball. They can range from the size of a ping pong ball to the size of a golf ball.

The second type is there's a lot of fatty breast is present. This is typically found in males who are a little bit overweight. Often, this extra fat can give the appearance of having an A cup or B cup female breast. This type is often a bit more complex to rectify, as there is both a glandular and fatty component to it.

The procedure takes about between one to two hours. It'll be around one hour if a patient has just the glandular type. This tissue can be removed through a small incision under the areola. The more complex procedures are when the patient is more overweight with a fatty breast. This can take longer, usually around two hours, as it is carried out using liposuction.

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Gynaecomastia is common in adolescent boys because of hormonal changes… and in men

Dr Pouria Moradi