What is Gynecomastia?
Gynecomastia is also known as man boobs or man breasts. This is when the chest wall of a male increases in size, volume, and starts to resemble more like the female breast. It can occur to one or both sides. Very often you can feel it as soft fatty tissue or a firmer breast gland. Sometimes the firmer breast gland may even feel tender on touch. You may also notice that the size of your areola (the dark pigmented area around your nipple) has increased in size. Sometimes man boobs can only appear to you solely as puffy nipples. These changes can often lead to feelings of embarrassment, especially when participating in activities without a shirt.
Having man boobs is a condition that emotionally disturbs many boys and men alike, making one self-conscious. There are various causes of gynecomastia developing. Most commonly, it occurs physiologically during certain periods of life when the hormonal levels of testosterone and estrogen are imbalanced, namely:
At birth when there is increased maternal estrogen, this generally goes away after several weeks.
During puberty and the adolescent growth phase when fluctuating hormone levels cause the breast tissue to grow. This can start anytime from the ages of 10 to 12 and continue till the ages of 16 to 20. Most of the time, the breast tissue remains and causes disturbances psychologically.
Lastly, when one grows old, usually after 50s, the body produces lower testosterone levels.
Being overweight can also cause excess fat to accumulate over the chest wall region, causing them to enlarge and become man boobs. Some medications taken on a long term basis can also cause gynecomastia to develop, like anabolic steroids, certain anti-depressants, certain traditional and herbal medications, alcohol, certain heart medication, certain antibiotics and more.
Who is suitable for Gynecomastia Surgery?
Generally, any men who are bothered by their man boobs are suitable to opt for gynecomastia surgery. However, for a small group of men whose gynecomastia is a result of abnormal hormone levels, we will first have to assess and manage the cause of the hormonal imbalance.
Consultation and Planning
An in-depth discussion will be done at the initial consultation, to understand your general health, regarding the symptoms from the gynecomastia, followed by a thorough examination and evaluation of the size, volume and nature of the gynecomastia. This assessment will determine the nature of your gynecomastia. Is it due to excessive fatty tissue, an underlying breast gland, a combination of both breast gland and fatty tissue, excessive loose skin and an enlarged areola.
During this visit, 3D pictures using Quantificare 3D camera will be taken to aid with the evaluation and discussion.
Following this, we will arrange for blood test to assess your hormone levels. An ultrasound study of your man boobs will also be performed to evaluate and to rule out any suspicious lesions.
The presence of breast glands in your man boobs will likely allow for the surgery to be Medisave and likely insurance claimable, depending on your insurance coverage.
It would be helpful to bring along any previous imaging scans, reports and blood test.
How is the Surgery done?
The surgery for man boobs is generally performed under general anaesthesia. This can be done as a day surgery procedure or an overnight stay if you prefer. The incisions are carefully placed around the areola (dark pigmented area around the nipples) to ensure that the resultant scar is well-camouflaged as no man wants the stigmata of having man boobs as well as the stigmata of having undergone surgery. The scars are very well hidden.
A combination of treatments will be used during the surgery. If there is a significant amount of fatty components, liposuction will be first performed to remove these fats. The firmer breast gland will be removed subsequently. Very often, both fatty and glandular components are present and a combined approach will be taken to completely get rid of the man boobs.
Are there any other methods to treat man boobs?
For breast glandular tissue, there is no other non-surgical method to remove them. For the fatty tissue, they may potentially respond to multiple repeated sessions of external lipolysis.
What is the recovery like?
The recovery period for man boobs removal is generally about 2 weeks.
By about one week, the wounds would have healed. However, the swelling and bruising may take a few more weeks to gradually settle down. You will have to take it easy for the first week after surgery but you can comfortably resume normal daily low-impact activities after 2-3 days. You should avoid upper body work outs and sporting activities for six weeks. The final results of the surgery will generally start looking more natural after 3 months.
We will review you in the clinic within the week after surgery and again after several weeks.
Is it Medisave / insurance claimable?
Generally, if there is breast gland removed, we will send it for histological testing to determine if it is indeed gynecomastia. These cases generally should not have any issues with Medisave / insurance claims. However, do check with your insurance agent for your coverage.
Frequently Asked Questions about Gynecomastia and Man Boobs Removal
Gynecomastia surgery risk and complications can include:
- Anaesthesia related risk. Our anaesthetist will assess and address them prior to the surgery.
- Bleeding possibility and haematoma formation
- Fluid or seroma accumulation. If the extent of the gynecomastia removal is significant, drain bottles will be placed to reduce this risk
- Temporary nipple sensory disturbances
- Chest wall asymmetry, with the possible need for revision surgery
- Scars are generally well camouflaged, however there may be the risk of hypertrophic or keloidal scars if you are genetically prone to them
If liposuction is performed at the same time to remove the fatty component of your man boobs, you may feel sorer over the chest wall region following surgery. This generally settles after 2 to 3 days.
The analgesia and compression garment will help reduce the discomfort and provide additional support.
All surgery leaves scar, but rest assured, the scar from gynecomastia surgery is designed to be well camouflaged at the junction of your areolar and the skin. So, once it has fully healed, it will be barely visible. You will not have any obvious stigmata of having undergone surgery.
Yes, you can. However, we advise avoiding doing upper body exercises for about 6 weeks following surgery to allow the wounds to heal and strengthen.
Unfortunately, most of them do not. If your man boobs persist for over six months, it would be advisable for it to be assessed by a medical professional.
There is a small potential for this occurring if the initial development of your gynecomastia is a result of medical conditions that causes hormonal imbalances or if you continue to take medications that causes man boobs to develop.