Male Breast
Surgery

Pre-operatively, you will be seen by the pre-assessment team who will advise you if any changes to your medications are required before surgery. “Practice” sleeping on your back – If you’re a side/stomach sleeper, train yourself pre-surgery to avoid accidental strain post-op. Use a V pillow for support.

After surgery, there are lots of ways to invest in your recovery to optimise your surgery outcome. We have written an article with our advice in the Information Hub section which covers the strategies that we would recommend to you.

Normally for men undergoing breast reduction surgery we would recommend a mammogram for if you are aged over 40 or for those who have other risk factors, such as a family history of breast cancer. It is rare to find anything wrong in the breast tissue removed at the time of a routine breast reduction. For this reason, it is not usual to send the tissue to a laboratory for examination under the microscope. However, if there is a strong family history of breast cancer or a previous history of breast disease, then we are likely to advise that the tissue be examined further.

Yes, the breasts do not always enlarge symmetrically. Whether your gynaecomastia affects both sides or is unilateral, Mr McLean can treat the problem. It is common for pseudo-gynaecomastia to affect both sides.

In the majority of patients, Male Breast Reduction is a one-off procedure. There is a small chance of recurrence of gynaecomastia if all the glandular breast tissue is not removed. If gynaecomastia does come back, revision surgery may be required after you have been checked for an underlying hormonal or medication driver of the regrowth. Fatty tissue may return with changes in weight, and we would recommend that you achieve a stable weight preoperatively and work to maintain this in the long-term to avoid fatty chest regrowth.

Male breast reduction surgery is a safe and commonly performed procedure, but like all surgeries, it carries some risks. Mr McLean leads efforts to reduce complications and improve the safety of male breast reduction surgery by ‘stacking marginal gains’. This has resulted in excellent outcomes following surgery for his patients.

The overall complication rate for routine male breast reduction is less than 10% and most of these are minor problems. While serious complications are rare, it is important to be fully informed before making your decision. Below are some possible risks and how they are managed.

• Scar – this will depend on the type of surgery that you have and will be discussed with you at your consultation
• Haematoma (bleeding)– a collection of blood may cause swelling and pain. Small haematomas resolve on their own, but large ones may need a second operation to remove the blood clot and stop bleeding.
• Seroma (fluid accumulation)– a small amount of fluid may collect in the breast post-surgery. Most resolve naturally, but symptomatic cases may require needle aspiration.
• Infection– some minor wound infections may require antibiotic treatment.
• Wound healing problems – occasionally, there may be areas that take a bit longer to heal due to either infection or impaired blood supply.
• Abnormal scarring – in very young and/or darker skinned patients the scars can thicken, become raised and itchy after surgery (scar hypertrophy) and in severe cases become keloid scars. This is very rare and can be treated.
• Loss of nipple sensation – temporary numbness in the first few months is common, with permanent numbness seen rarely (more common in very large breasted patients.
• Nipple blood supply issues – very rarely the blood supply can be interrupted, which can lead to a range of outcomes from skin scabbing and discolouration to partial nipple necrosis or complete loss.
• Chest asymmetry– there may be minor asymmetry in size, volume or shape between the two breasts and in particular in the shape of the nipple areolar complex. It is important to realise that any asymmetry in the nipple areolar complex prior to surgery will remain. Adjustment may occasionally be necessary.
• Fat necrosis – if the breast tissue is very fatty, then when it is cut, some areas of fat may lose their blood supply and die. This will become evident in the postoperative period with an area of hardness in the chest. This can occasionally lead to contour irregularities in the chest shape. In most cases it resolves, without treatment, over a 3-6 month period.

It is important that your chest and wounds are held in place firmly for the first few weeks after the surgery and a well-fitted surgical compression vest helps. At Enova Surgery, we have included a resource to assist you in selecting your postoperative vest. Please bring one of the vests to theatre with you so that it can be put on at the end of the operation whilst you are still asleep.

These compression vests need to be worn for six weeks following the surgery, both during the night for sleeping and during the day.

The Department of Health give advice on protecting patients who are considering cosmetic surgery.

Specific advice regarding male breast reduction can be obtained from:

• Read more about Male Breast Surgery