Your chest may be reduced by either liposuction (sucking out the fat and breast tissue through small incisions) or by opening up the skin around and near the nipple to cut out the breast tissue, or a combination of these techniques. The specific technique used will depend on your individual situation.
What does it involve?
Gynaecomastia surgery is usually performed under a general anaesthetic (with you asleep), however, for smaller cases of gynaecomastia (a sub-areolar button) it can also be performed under local anaesthetic (with you awake). For larger cases, you will wake up with surgical tapes along the wounds and a surgical drain (tube) coming out of each side (unless you have had liposuction alone in which case drains are not used). No drains are used for smaller cases. You will need to go into a firm-fitting compression garment or running top the following day. This will need to be worn day and night for 6-weeks. If you are interested in seeing a video of me performing gynaecomastia surgery, please click here ›
What are the benefits?
Gynaecomastia surgery addresses the excess breast tissue, any excess skin you may have as well as reducing the size of your nipples if appropriate in your case.
How long does the surgery take?
The surgery takes from an hour to two and a half hours, depending upon what procedure, or combination of procedures is required.
What is the recovery period?
For liposuction alone you are likely to have your surgery as a day case procedure (in and out the same day). Otherwise, you will stay in hospital overnight after the surgery, or occasionally for 2-nights. This is to ensure that there is only minimal fluid coming into your drains, which may then be removed. After the surgery the wounds will be dressed with medical tape. This is splash-proof and shower-proof (but not bath-proof!). You will be able to shower from the day after surgery, and dab the tape dry with a clean towel, kitchen towel or alternatively use a hair-dryer on a cold setting to dry the tapes.
How long before daily activities may be resumed?
Strenuous activity should be avoided for at least 2-weeks. You may be able to drive after this period, but remember that you need to be comfortable in performing an emergency stop or similar manoeuvre. If you drive too early and you need to do an emergency stop, the wounds may come apart from pressure of the seatbelt.
What are the success rates?
Gynaecomastia surgery has a high success rate, but frequently small revision procedures are needed. The philosophy is always to be conservative with the surgery – it is better to need a minor further procedure to improve things than to have overdone the first operation (taken too much away) and have to correct it.
What are the possible complications?
- Wound infection & wound breakdown
- Bleeding or haematoma (a collection of blood in the wound that would mean that you would need to be taken back to theatre to stop the bleeding)
- Lumpy scarring (hypertrophic or keloid scarring) – these can be difficult to treat
- Change in nipple sensation (usually less sensitive, but occasionally more)
- Complete or partial loss of your nipple (a rare but important complication)
- Fat necrosis (dying of some areas of fat within the breast) – this either shows as an oily discharge from the wound or as the formation of lumps within the breast. It may mean you need to go back to the operating theatre, but can usually be treated as an outpatient with dressings (if the wound has opened) or with massage of any lumps
- Asymmetry – no chest is perfectly symmetrical, and although Mr Pacifico strives to make both sides as equal as possible, there will be differences between them
- Deep vein thrombosis (DVT) and pulmonary embolus (PE) – these are blood clots that may occur in the leg (DVT) and travel to the lung (PE) which may be very serious – fortunately they are rare in gynaecomastia surgery.
- Further surgery may be needed to make adjustments to correct for imperfections or significant differences between the two sides (rates may be up to 15%)
