Mrs Dalia V Nield FRCS(Ed)   FRCS(Eng)

CONSULTANT PLASTIC AND RECONSTRUCTIVE SURGEON

Formerly Consultant at
St Bartholemew´s and Homerton Hospitals

  5 Devonshire Place   London W1G 6HL   Telephone 020 7616 7693


Gynaecomastia is the development of female-like breasts in men and boys. It can occur as an isolated element during puberty, as part of a genetic condition like Klinefelter's Syndrome, as a consequence of hormonal treatment for Prostate and Testicular Cancer or in adult obesity.
Gynaecomastia in puberty occurs during the years when hormonal changes are taking place and the teenager is at his most vulnerable psychologically, and is most exposed to teasing at school.
A man or boy with gynaecomastia feels he is male but he has breasts. He can't understand why and is too embarrassed to ask. This can be devastating psychologically and limit his social and intimate activities.
The best, definitive treatment is surgery. Here, the role of liposuction is to minimize telltale scars and to achieve normal contours on the chest.
Many a man suffers with Gynaecomastia without realizing that help is at hand. Discuss it with your GP and he or she will refer you to a Consultant Plastic Surgeon.
I could show you photographs of some of my gynaecomastia patients, many of who would be happy to talk to you about this distressing condition.


Preoperative


Postoperative


1 years later
What to do?
The patient or relatives should consult their GP or Specialist who will refer him to a Consultant Plastic and Reconstructive Surgeon.
The initial consultation involves taking a full clinical history and examining the patient, to make a diagnosis of Gynaecomastia. At this point the surgical treatment is discussed explaining the possible complications in order to allow the patient to make an informed decision whether to undergo surgical treatment.
Surgery involves an admission to Hospital or Clinic for a minimum of one night and General Anaesthesia.
The operation involves liposuction and the removal (excision) of the gland's 'disc” which is the firm part of the breast under the nipple.
For the liposuction a fine metal tube (canula) is introduced through a small cut in the skin and the fatty part of the breast is removed by suction to achieve a normal looking male chest. The 'disc” can not be removed by suction and has to be excised (cut away). For this a skin incision is necessary and this is made on the edge of the lower half of the areola (the pigmented area of skin around the nipple), the disc is excised and the wound closed with external sutures (stitches).
In most cases a small drain is left in the cavity to avoid collection of blood after surgery. The drain is removed the next day and the patient is discharged home. The disk of breast tissue is checked under the microscope to exclude cancer.
After Surgery
It is important to wear an elastic garment or vest for 3 weeks to reduce swelling and help the excess skin retract without wrinkling.
There will be bruising and tenderness in the area for 3 weeks and physical exercise is limited.
The sutures are removed around 1 week or 10 days after surgery as an out-patient.
The nipple-areolar complex gradually 'shrinks' and the resulting scar is barely noticeable as it is camouflaged by the different colour between the areola and the surrounding skin.
Your surgeon will see you after surgery before discharging you.