Male Breast Reduction

The Male Breast

Liposuction of the male breast is one of the most common areas treated by liposuction. In men other areas commonly treated in my practice include the neck, abdomen and flank.

The Normal Male Breast

Both male and female breasts contain a mixture of fat and fibrous glandular tissue (the breast tissue). Liposuction will remove the fat component of the breast, and sometimes a small excision is made to surgically remove the ‘nubbin’ of breast tissue under the nipple. It is important to note that the amount of fat in the breast varies from individual to individual. There are no investigations which can categorically tell how much fat there is in the breast. The only way to do this is by liposuction of the breast, extracting as much fat as we are able. If, at consultation, I believe we can reduce the breast by liposuction we are almost always able to do this. We do refund part of the fee if we are unable to obtain a significant reduction.

The majority of males with enlarged breasts have what is termed ‘Pseudo-Gynecomastia’. This is particularly so if the man carries excess body fat. Fortunately, Pseudo-Gynecomastia is usually very amenable to reduction by tumescent liposuction.

True Gynecomastia

True Gynecomastia is increased breast size, caused not by an increase in fat, but an increase in glandular tissue. It is not common and is usually not responsive to liposuction. It is usually caused by medical conditions or by some medications.

Treatment

As mentioned previously, most men with enlarged breasts should respond very well to Tumescent Liposuction. In cases of true Gynecomastia a more extensive surgical procedure may be required.

Tumescent Liposuction of the Male Breast

This is well documented to be the safest form of breast reduction. It will achieve results equivalent to what can be achieved under general anaesthetic or intravenous (IV) sedation. It is a very comfortable, easy procedure to have done. I can perform the procedure under IV sedation, or with a general anaesthetic in selected cases (e.g. in patients who are reluctant to have the procedure done while awake).

Breast reduction using Tumescent Liposuction is now available at our Wellington Clinic, Wakefield Hospital, Newtown, as well as at our Christchurch Clinic

Background

Breast reduction has traditionally been performed with surgical intervention called mammoplasty. The procedure involves cutting out sections of the breast and elevating the nipple/areola and loose skin.

Mammoplasty is an effective and well-proven procedure. However, it does have a high reported rate of complications (10-50%) and involves a number of hours in theatre under general anaesthetic. Complications can include unsatisfactory scarring, altered sensation of the nipple, difficulty or inability to breast-feed as well as others. Recovery from this procedure is slow compared with the now available option of Tumescent Liposuction, which has a reported low complication rate (about 1%).

Technique

Liposuction underwent a dramatic change in 1987 when an American Dermatologist discovered the tumescent technique. This involves filling the fat with a very dilute form of local anaesthetic and adrenalin, which numbs, softens and prepares the fat. The adrenalin causes temporary shrinkage of small blood vessels so there is minimal bleeding.

Using very small and thin microcannulae, the fat can be removed smoothly and evenly through tiny 1-2mm incisions. These heal with no, or at most minimal scars.

Procedure

Following the procedure, a compression garment is applied and worn for the next 3-6 days. Post-operatively there may be some tenderness and bruising and there may be weeping of fluid through the small incisions during the next 24 hours. Most patients can return to ordinary duties after 48 hours; however, there may be variation between patients.

Results

A very noticeable, significant reduction in breast size is usually possible with Tumescent Liposuction

Dermatologists proficient at the procedure of Tumescent Liposuction for Breast Reduction believe it should be the procedure of choice for most people considering Breast Reduction.

Complications

Some bruising, swelling and pain can be expected. In most patients the pain is almost always only mild to moderate and controlled with oral pain relief. Infection is also possible. The Tumescent technique reduces the infection rate, due to the fact that the fluid is antibacterial. The procedure is performed under high sterility with pre-operative antibiotics.

Significant scarring does not occur with Tumescent Liposuction, as there are only lmm-2mm necks on the skin, which normally heal exceptionally well with minimal to no marking.

There have been no long-term studies to ascertain the effect of liposuction on the ability to breast feed, although groups overseas report that patients can.

Individual results will vary. Medical, diagnostic and surgical procedures have benefits and risks.

Talk to Dr Bellaney or your GP about your individual situation in advance of Tumescent Liposuction.

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