Gynaecomastia can be diagnosed by a family physician, but requires treatment by a plastic surgeon, explains Dr Terence Goh, Consultant, Department of Plastic, Reconstructive & Aesthetic Surgery, Singapore General Hospital.
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Although gynaecomastia (man boobs) is not a serious problem, surgery is an option for men who find it difficult to cope with their condition.
Reasons for gynaecomastia surgery
- Pain and tenderness in the chest region
- Swelling of the chest causing embarrassment and affecting self confidence
- Limitation from physical activities due to enlarged breasts
- Stigma causing psychological stress, depression and anxiety
- Body builders who require a flat chest contour
Surgical options to treat gynaecomastia
“At Singapore General Hospital (SGH), we have devised and evolved a combination modality for treating gynaecomastia. This technique, called MELT (a microdebrider excision and liposuction technique) involves making a well-hidden and sub-centimetre cut within the area surrounding the nipple,” says
Dr Terence Goh, Consultant,
Department of Plastic, Reconstructive & Aesthetic Surgery,
Singapore General Hospital (SGH), a member of the
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A review of the results over a 15-year period has proven that MELT is superior to other treatments such as liposuction or direct excision, resulting in lesser bleeding, scarring and asymmetry for the patient.
“This is especially useful for patients who are thin and have a prominent breast disc (a button-like growth under the nipple),” added Dr Goh.
Risks associated with gynaecomastia surgery
Gynaecomastia surgery is relatively safe with few complications. As the procedure is performed under general anesthesia, there are standard risks associated with the use of general anesthesia.
In a study conducted by the American college of Surgeons on 204 paediatric and 1,583 adult patients who have undergone gynaecomastia surgery, there was a low surgical (3.9 and 1.9 per cent) and medical (0.0 and 0.3 per cent) complications within the standardised 30-day post-operative period respectively.
Potential risks associated with gynaecomastia surgery include:
- Haematoma (blood clot) formation
- Asymmetrical chest wall contour
- Under or over-correction
- Residual breast disc
Patients with cardiovascular risk factors whom are at high risk of major intra-operative stroke or heart attacks may not be the best candidates for the surgery. Hence it is important for comprehensive clinical evaluation and assessments to be done prior to surgery.
FAQs about gynaecomastia treatment
1. What is the post-surgery care required?
- After surgery, compression dressings are applied immediately and patients are fitted with pressure garments from the first day after the operation. The garments are worn for at least six weeks.
- Patients are reviewed at the clinic five days later where the dressings are removed.
- A subsequent follow-up appointment will be scheduled a month later. During the follow-up session patients will be advised to avoid strenuous activity involving the chest and arms. Exercises such as walking, jogging and static cycling can be resumed after two weeks.
2. How long do I have to stay in the hospital for?
Whilst the procedure can be done as a day procedure, patients are advised to stay overnight for pain control and to watch out for complications such as bleeding. Alternatively, they can be discharged after surgery and be reviewed in the outpatient clinic the next day.
3. Aside from surgery what are the other treatments available?
If there is a distinct cause for the condition, it would be treated based on the underlying cause. In cases where there is no underlying cause of the disease, surgical removal is usually performed. Apart from surgery, it is possible to opt for a conservative approach if the patient is able to cope with the burden of the disease.
4. Will the breasts grow back?
Recurrence is uncommon but can occur during weight gain or if the cause of the condition is due to the continued use of certain medications. Even then, the recurrence due to weight gain can be resolved by weight loss. The fibrous breast disc component removed during gynaecomastia surgery does not recur.