A proportion of men develop enlargement of the breast disc at some point in time in their life and this can be a cause for concern and embarrassment. The chance of developing gynaecomastia increases with age with around 1 in 3 men developing it when they get to 60years of age.
There are various reasons why the breast disc may enlarge and the main reason being a reduction in the level of testosterone or increase in oestrogen levels in the body, the other common reason is medications such as water tablet – spironolactone and tablets to treat enlargement of prostate gland. In vast majority the reason is unknown.
Essentially gynaecomastia can be classified into three groups
True gynaecomastia – in this condition the breast tissue mainly the ductal component is enlarged and the breast feels firm in consistency and this requires formal surgical excision if bigger than grade 1 or 2.
Psuedo-gynaecomastia is where there is just build up fatty tissue with little or no breast tissue and this tends to develop in men who are over weight and can be treated with liposuction reduction alone.
Composite gynaecomastia is where the patients has elements of both true and pseudo gynaecomastia and this tends to be the commonest of the three types. This condition can be treated with liposuction first and with an interval of 6months either with a further liposuction or a formal excision of Breast tissue may be required.
In very large gynaecomastia – (grade 4) in addition to removing fat and breast tissue the excess skin may have to reduced.
Liposuction reduction of gynaecomastia
This procedure will require a general anaesthesia and is usually carried out as a day case operation. Liposuction is performed using telescopic cannula with tiny incisions. The procedure lasts between 40mins to an hour depending on the amount of tissue to be liposuctioned. Following the procedure a tight chest vest is fitted to reduce the risk of bruising and bleeding.
Complications of Liposuction to breast procedure
Bruising – usually settles with few weeks.
Fat necrosis – these can be felt as hardened areas with the breast and chest wall and usually settles down in few months.
Residual gynaecomastia – in most cases a second procedure is required which may be in the form of repeat liposuction +/- excision of breast tissue.
Residual asymmetry- the two breasts may look different like before and it is best to wait for a minimum of 6 months to reassess and may require a second procedure.
General complication of anaesthesia including chest infection, pulmonary embolism and Deep vein thrombosis.