Male breast – for a well-defined, masculine chest

Surgical correction of gynecomastia is advisable if other treatable causes can be excluded and if one or more of the following criteria are met:

• The size and shape of your breasts are a major stress factor for you.
• One side is significantly larger than the other.
• The gynecomastia affects your sense of well-being and self-esteem.
• You feel that the gynecomastia limits your physical activities (work, sport, etc.).
• Your general state of physical and emotional health is sound.

Given medically adequate diagnosis and performance of breast surgery, complications such as infections, wound healing disorders or circulatory disorders of the breast skin (e.g. loss of the nipple) rarely occur. Extended follow-up treatment and even a second operation may be required in individual cases.

Bruises (hematomas), wound fluid accumulations (seromas) and swellings are among the milder complications that generally heal without sequelae. Severe bruises sometimes even have to be surgically removed. Although sensitivity disorders of the breast skin and nipples sometimes occur, they tend to be temporary.

• Gynecomastia surgery includes the following risks:
• Hematomas (bruises), bleeding and swelling
• Seromas (accumulations of wound secretion)
• Wound healing disorders or wound infection
• Suture dehiscence (divergence of the sutures)
• Injury to nerves or blood vessels
• Numbness (mostly temporary, in rare cases permanent) in the surgically treated area
• Circulatory disorders of the breast skin or nipple
• Scars
• Minor asymmetry
• Correction surgery
• Thrombosis, possibly embolism

When performed by a competent and experienced plastic surgeon, breast reduction for gynecomastia is one of the safest, low-complication operations and results in high patient satisfaction.

Successful gynecomastia surgery is preceded by careful planning. A personal consultation with a medical specialist is the first step. Discuss your wishes, ideas and expectations regarding the operation with the surgeon. The specialists at Aesthea need this important information to help you understand the options and limitations of the procedure.

Your attending physician will take measurements and digital photographs of your breasts during the physical examination. They facilitate an objective analysis of the initial situation and careful planning of the operation. 

Breast size and shape, the position and size of the nipples, existing asymmetries of the breast or breast wall, as well as the skin quality and any scars are taken into account during planning. The appropriate surgical technique as well as the position of the skin incisions and the resulting scars can be determined on the basis of these individual factors and your personal wishes. You and your attending physician will work out the most suitable treatment plan for you. Your physician will inform you in detail about all risks and possible complications of the procedure and the agreed operation will be documented accordingly.

To prepare for the operation, we need information about your medical history (previous illnesses and previous operations), any current illnesses (high blood pressure, diabetes, thyroid dysfunction), allergies or intolerances as well as detailed information about any medication you are taking. This information is used to evaluate the risk of surgery and anesthesia. 

If you are planning to lose a lot of weight in the foreseeable future, please take this into account when planning a breast correction. It may be advisable to postpone surgery until your weight stabilizes.

Depending on the local findings as well as familial and personal risk factors, it is advisable to have a mammogram (X-ray examination of the breast) or a breast ultrasound before the procedure. A preoperative examination by the urologist may also be necessary under certain circumstances.

You can contribute significantly to the ideal preparation for surgery by following a few conduct guidelines.

We recommend that smokers avoid smoking two weeks before and after the operation so as not to impair the wound healing process. You should also stop taking certain medications causing an increased risk of bleeding (e.g. aspirin, non-steroidal anti-inflammatory drugs, certain vitamin preparations and homeopathic remedies) two weeks before the operation. 

Although gynecomastia surgery is generally performed on an inpatient basis with overnight stay at the clinic, sometimes the procedure can also be performed on an outpatient basis under anesthesia. In this case, please make sure someone comes to pick you up after the operation and takes care of you at home for the next 24 hours. 

Various medications contribute to your well-being during the operation. Your blood pressure, pulse and blood oxygen content as well as other vital signs are continuously monitored for your safety.

A special chest bandage or compression vest is put on as soon as the operation is over. You will then be taken to the recovery room, where you will be monitored until you are fully awake and able to stand up. Only a few hours later, you will be discharged and can go home (accompanied). If the operation is performed on an inpatient basis at the clinic, you will be transferred from the recovery room to your room, where you will stay until the next day. You can already get up regularly and walk around for a few minutes on the day of surgery. Doing so reduces the risk of thrombosis to a minimum. Post-operative pain is usually described as mild and compared with a severe muscle ache. Light painkillers that reduce the swelling make the discomfort quite tolerable. You can continue taking painkillers at home for the first few days after the operation.

If the operation is performed on an outpatient basis, you should be taken home and given continuous care for the following 24 hours. Your trusted person will receive all the important information from us to ensure optimal follow-up care, including some conduct guidelines in case there are complications or something unexpected happens. 

If the male breast consists mainly of adipose rather than glandular tissue, it can be treated with liposuction. What is referred to as ultrasound-assisted liposuction (UAL) is particularly effective in removing the often dense fatty tissue of the male breast. As the mammary gland tissue cannot simply be suctioned off, it must be removed surgically through a short incision at the edge of the areola. If the breast is very large or has reduced skin elasticity, it may be necessary to remove excess skin. It is usually possible to perform a skin lift around the nipple (periareolar lift) that results in inconspicuous scarring. At Aesthea, we usually perform minimally invasive vibration-assisted liposuction (UAL) using the MicroAire system. If necessary, the remaining breast gland tissue and/or excess skin is then removed. This procedure makes it possible to keep scar length to an absolute minimum.

At Aesthea, breast reduction for gynecomastia is performed under general anesthesia, either on an outpatient basis or during a short inpatient stay. The operation takes about two hours. If (in addition to liposuction) glandular tissue or skin is removed, drainage tubes are usually inserted at the end of the procedure. They drain blood and wound secretion from the wound and are removed after a few days.

Please note that the recovery time following an operation can vary greatly from person to person. Please take it easy on your body and do not lift your arms above shoulder height in the first few days after the procedure. Please also avoid carrying or lifting heavy loads. You should sleep on your back for the first few days after surgery. You must only take the painkillers prescribed for you. Please do not take any medication containing aspirin or other anticoagulants. Please always wear your tailor-made compression vest and follow our recommendations for the first four to six weeks. Please also avoid engaging in any physically strenuous and sporting activities in the weeks following the operation.

You may experience a feeling of tension and slight pain in the chest area for the first two to five days after the operation. You may also experience a – usually only temporary – numbness or hypersensitivity of the breast skin and nipples for a certain time. Although the feeling of numbness tends to be temporary, it can take weeks to months, and in some cases even longer, before sensitivity normalizes. Minor swelling and bruising around the breast generally disappear within two to three weeks. 

You will likely be back on your feet again and able to resume most of your daily activities within one to two days after surgery. The bandages and any wound drainage will then be removed and you will be able to take a normal shower.

We also advise you to avoid full baths and excessive heat (e.g. sauna) for several weeks until the swelling subsides. Skin sutures tend to dissolve on their own and do not have to be removed. If non-dissolvable sutures are used, they are removed after about a week. Although most patients can already go back to work a week after the breast correction, this depends on the activities your profession requires. 

Once skin sutures have been removed, skin and scar care begin with refatting ointments and light massage. Sometimes special follow-up treatment with silicone gel or silicone patches for two to three months is used. Please protect fresh scars from direct UV radiation for at least six months to prevent increased pigmentation.

You will be examined at Aesthea periodically after the operation to evaluate the progress of your recovery until the final result.

Your breasts will remain swollen for a certain time after the operation. It can also take a few weeks for the bruises and swellings to completely disappear. Although the scars at the edge of the areola will look reddened or somewhat darker for several months, they do fade over time and are hardly visible later on.

After gynecomastia surgery, your chest will be flatter, firmer and better contoured, giving you a distinctly masculine silhouette that will boost your self-confidence. Although the results of the procedure are usually permanent, severe weight gain can have a gynecomastia-like effect even after breast correction (pseudo-gynecomastia).