Gynecomastia is a benign swelling of the male mammary glands. The disease is caused by an elevated level of oestrogens during normal physiological development. It is often seen in new-borns as a result of increased oestrogen levels that the new-born received through the placenta from his mother. The mammary gland in males is temporarily enlarged during puberty and in older age, when gynecomastia is probably caused by increased conversion of androgens to oestrogens in tissues. Enlargement of the breasts may also occur with the use of anabolic steroids. Sometimes this is merely an increase in fat tissue – then we talk about pseudogynecomastia.

Pre-operative preparation

The operation does not require any special preparation. There should be no signs of inflammatory illness on the skin and the evening before the operation it’s necessary to shave the chest. Because of the possibility of increased bleeding, we recommend that patients not to take medicines containing acetylsalicylic acid (aspirin) for 3 weeks before surgery. 

Course of the operation

In most cases the operation is performed under general anaesthesia. With smaller gynecomastia, the incision is made at the edge of the pigmented areola and skin in the lower half of the perimeter of the areola. A result of this surgical approach is a mostly invisible scar in the post-operative period. During the operation, the whole gland is surgically removed. If pseudogynecomastia is present, it is typically corrected during one operation using liposuction of the breast. Other surgical techniques are used in the surgical treatment of large gynecomastia.

Post-operative care

Depending on the extent and type of operation, bruising and swelling should be expected in the post-operative period; they usually disappear within 14 days. Generally speaking, it is recommended that stress and strain of the pectoral muscles be limited and that lifestyle needs be adapted to this. Drains are put into the surgical wound and removed on the day after the surgery. It is recommended that an elastic compression bandage (or elastic undergarments) be worn for at least 4 weeks after the operation. After this period, it is usually possible to take part in sports and more physical exertion.