Men are often overlooked when we think of being self-conscious about weight problems, but in reality, men can be just as concerned as women. Whether it’s competing for jobs, or just wanting to look good socially, the body area men are often very self-conscious about is the chest.
Male breast reductions in Melbourne
Enlarged male breasts, when caused by a hormonal imbalance, are a medical condition that results in what’s known as gynaecomastia: enlarged male breast tissue. This condition may require gynaecomastia removal surgery.
Breast tissue development or a fatty chest is one of the most common issues to affect how a man sees himself and it can affect the perception of masculinity, and in some cases cause debilitating problems of self-consciousness and shame.
What gynaecomastia is and is not
Frequently the breast/chest area in men can enlarge with weight gain, which is most commonly due to simple lifestyle changes. This situation is not gynaecomastia.
For a percentage of men, an increase in chest proportions can be affected by the amount of oestrogen in the body, causing an increase in glandular breast tissue combined with fat. This is gynaecomastia.
What causes gynaecomastia?
The specific causes of gynaecomastia remain uncertain, although it has generally been attributed to an imbalance of sex hormones or the tissue responsiveness to hormones, in particular oestrogen.
Frustratingly, the extra fat and duct tissue stored in the chest is not easily removed with healthy eating or exercise. In most cases, any fat and/or breast tissue is generally located outside the muscle wall and can be removed simply and quickly with liposuction.
In rare cases, a small excision may be required to remove glandular breast tissue.
*Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.
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Benefits of male breast reduction surgery – Melbourne clinic
- Remove ‘man boobs’ (gynaecomastia reduction)
- Improved muscle definition
- Fit into clothing better
- Have a slimmer profile
- Appear more youthful
- Look good, feel good
Recovery period after gynaecomastia surgery
You will be provided with compression garments after gynaecomastia chest reduction worn all the time, day and night, for at least a fortnight. The following two weeks also require compression garments, but only part time – so you can choose if you want them worn during the day or at night.
A binder will need to be worn for the first week after gynaecomastia surgery, which is simply to ensure all the tumescent fluid is drained from the chest area. These garments are generally very comfortable.
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You can expect to have some soreness and discomfort after the procedure. Discomfort isn’t any more or less than what you might feel after a hard session at the gym or doing physical labour for a day when you weren’t conditioned for it. It’ll hurt a bit, but the soreness will fade away quickly as you heal up, and be very manageable. Painkillers can be taken.
You can also expect some tumescent fluid to leak out of the tiny holes we’ve made to perform the procedure. This leakage is normal, until the skin closes over, which happens quite quickly. Expect bruising and swelling for many weeks.
The results will not be apparent for at least a month or two since all the swelling must go down completely to see results.
There may be some lumpiness and deep swelling for a few weeks post-surgery. We may request an ultrasound treatment every week, or even twice a week, to help with circulation and resolve bruising quickly. You may feel some numbness in the area, but this will resolve as the area heals and the swelling drains over a period of weeks or months.
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You are offered a phone line directly to a nurse, so if you have any issues, day or night, you can call for advice. You will be back in the clinic the following day to be checked.
What about post-male breast reduction surgery scarring?
The tiny incision marks fade away almost completely, and nobody will ever know you have had liposuction on your chest – scarring is not an issue.
Returning to work and exercise after a male breast reduction
You can usually get back to your job within a few days, but this will depend largely what sort of work you do. Talk to your surgeon about what time you should expect to take off work. You can get back to exercising usually when you feel able to do so, but a period of light exercise after the gynaecomastia procedure is recommended, such as a light walk the next day.
Male breast reduction surgery
When you are in the operating theatre, your chest area will be injected with the special tumescent fluid via a very small tube (a micro-cannula) through tiny incisions. This fluid numbs, softens, and evens out the fat, which can then be suctioned out very gently. The tumescent fluid not only acts as an antibacterial agent but also quells bleeding, so bruising and swelling is reduced. Enough fat is left in your chest so it always looks natural, and if you put on weight (or lose weight) later, your chest will remain in proportion with your body. Your chest will also feel natural.
The male breast reduction procedure is a day surgery at our Melbourne clinic.
Risks of gynaecomastia treatments
Gynaecomastia surgery is considered a very safe procedure with remarkable results. Liposuction is now more straightforward and the risks are lower than ever before. The risks – which exist but are lower with a great surgeon – include infection. Risk is mitigated by the special tumescent fluid Dr Rich uses to perform the procedure, plus antibiotics post-surgery.
Seroma remains another rare risk of gynaecomastia treatment. Seroma is where fluid remains in the skin, becoming infected. This fluid may need to be drained from the surgery area later but can be treated with antibiotics.
Every surgical procedure carries risks with it, and not everyone will be an appropriate candidate for liposuction in any area, particularly male breast surgery.
Why do men get ‘man boobs’?
Stubborn chest fat typically develops due to the effects of oestrogen. Why would a man have too much oestrogen? Well, it’s complicated, but in essence, oestrogens are in and around us all the time, and while men do have more testosterone than women, they also have normal amounts of oestrogen. Women also have normal amounts of testosterone. There are several ways that men can end up with too much oestrogen.
Too much fat
If a man is carrying a lot of fat, he will usually have a lot more oestrogen. This increase in oestrogen is due to fat cells having an enzyme in them called aromatase that converts testosterone to oestrogen. (Fat in women promotes female fertility this way. In men, this outcome is not so desirable, but it happens nonetheless when a man has more fat than can support his healthy testosterone levels.)
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Fat is not the only factor when it comes to male hormone levels, but it matters when it comes to male breast surgery.
The other way men end up with a lot of oestrogen in their body is xeno-oestrogens, or in plain English, oestrogens (or molecules that behave like oestrogen), in our environment. Xeno-oestrogens are all around us, but are prolific in plastics – how many plastic water or drink bottles have you used this week alone?
There has been a marked declination of male fertility and sperm quality globally in recent decades, but this decline has also been mirrored in animal life. Xeno-oestrogens affect everything, since they are also in our water supply. (Think of how many women are on the pill and how this is excreted – via urine, which then goes into the sewerage system, which is then filtrated back into the sea, as one example. Water filtration systems do not remove hormones.)
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We have many delighted patients, but in the unlikely event you are unhappy with your results, speak to Dr Rich. Dr Rich is very experienced in liposuction, leaving enough fat around the armpits and nipple to avoid irregularities. You can gain and lose some weight without results looking unnatural.
Environmental oestrogens
An excess of xeno-oestrogens can be due to a combination of factors. If you are of a healthy weight (without too much fat), but are finding your breast tissue increasing, it could pay to take a closer look at your environment for the cause.
Meat and dairy
We can absorb xeno-oestrogens from meat and dairy, from cows that are fed bovine growth hormones. Choosing quality meat sources is really important, including paying more for animals raised without added growth supplements. Finding great meat is easy to do in Australia with many options available at the supermarket. You can find a local butcher and ask about the source of their meat.
Insecticides or pesticides on fruit and vegetables
Anti-pest products can also have an oestrogenic effect. Thoroughly washing your produce can make a huge difference, and trying to buy products that are not sprayed with insecticides and pesticides is a good place to start.
Personal care products – shampoo, etc.
You can absorb xeno-oestrogens via the skin, so anything you use on your skin that contains paraben or phenoxyethanol (a preservative agent) is contributing to xeno-oestrogen levels.
Soft plastic
Plastics are one of the main contributors – think of how many things in a day are wrapped or stored in soft plastic. Food is stored in the fridge in plastic containers, we microwave food in plastic containers, drink liquids out of plastics, and get hot takeaways in plastic containers. A food wrapped in plastic heated in the microwave contains some of the highest levels of xeno-oestrogens you can find. Take your own containers to the takeaway store or opt for glass or cardboard/paper where you can.
Soy-based foods and drinks
Tofu, soy milk and soy protein contain high amounts of plant oestrogens (phyto-oestrogens). Each has differing amounts, so check levels of any soy-based foods you are consuming regularly.
FURTHER READING
Frequently Asked Questions
All surgery comes with risks, which Dr Rich will explain to you in detail before your surgery. Liposuction has a different risk profile to excision of glandular tissue in breast tissue. Modern liposuction is considered an effective treatment for excess fatty deposits, including in breast tissue. You can rest assured you are in the best hands with Dr Rich.
We do not expect adverse outcomes; however, sometimes, the human body doesn’t behave as expected. We check up on your regularly after your procedure to ensure everything is going according to plan and you are safe and comfortable.
If you’re in severe pain or don’t feel well, you can call our on-duty nurse 24/7 for advice.
We have many delighted patients, but in the unlikely event you are unhappy with your results, speak to Dr Rich. Dr Rich is very experienced in liposuction, leaving enough fat around the armpits and nipple to avoid irregularities. You can gain and lose some weight without results looking unnatural.
Reducing the impact of xeno- and phyto-oestrogens can and should be worked on at home if this is an issue for you. Oestrogens of all kinds drive the development of glandular tissue, so reducing your reliance on soft plastics for hot food and water is a substantial step. It can also pay to decrease intake of soy-based products as per your dietary needs.
Losing weight will also naturally reduce oestrogen levels in the body since testosterone converts to oestrogen inside fat cells. In most men, less fat means less oestrogen.
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There are risks with every surgery, including liposuction. We ensure you are aware of risks at your appointment. Additionally, we check up on you regularly and have a 24-hour nurse on duty to take any calls if something goes wrong.
While liposuction is considered a low-risk surgery, unexpected outcomes can occur. We are prepared for any eventuality and work hard to keep you safe and comfortable with thorough instructions and care.
You can expect to take a few days off work initially, but depending on your job, it may need to be longer. Very physical jobs are likely to require longer off work than a desk job. Dr Rich will help you work out what sort of tasks you can undertake while you heal.
Initially, we recommend light exercise, but you can build up to your regular routines over the next two weeks. Gradually reintroduce your regular exercise regime, and avoid going too hard too quickly. You can cause damage that way. Talk to Dr Rich about how to reintroduce exercise safely.
When you remove fat cells, they disappear for good; however, the same may not be true for glandular tissue or with significant weight gain down the track. After many decades of experience, we’ve found that typically recurrence is most often in those who use anabolic steroids after surgery.
In cases where glandular tissue existed, but an excision was not performed, some people later wished they’d done the full treatment.
We do a careful preop assessment, and we’ll give you all the information about your condition so you can make an informed decision about how you’d like to proceed. You can change your mind at any time.
There are tiny scars on either side of each breast, but they are only a few millimetres long. These scars fade naturally with skin and are barely visible to the naked eye due to their position. Nobody will know you’ve had liposuction.
Your body needs to rest and recover, including the delicate tissue that needs to re-establish itself in your chest. Working a very physical job may disrupt this process, so speak to Dr Rich about your work and how much time you’ll need to take off post-surgery.
You can expect to take a few days of home rest but typically can return to your regular activities reasonably soon after. Reintroduce exercise gradually to avoid tissue disruption.
Anyone dissatisfied with the shape of their chest due to fat or glandular tissue can have liposuction, with some caveats. Because liposuction is a surgery, you need anaesthetic which requires a healthy person.
It’s essential that healing isn’t impaired since your body has a lot on its plate after liposuction in terms of resolving inflammation and healing tissue. If you have any condition that impacts your ability to heal or are elderly, liposuction may not be right for you. We have other fat-reduction options, so speak to our clinic.
In some patients, the breast tissue will be fat and thus can be ‘lost’ with general weight loss. It depends on whether you have developed glandular tissue or not. If glandular tissue exists, you can’t just exercise or diet the problem away. Glands are here to stay.
If you are overweight, losing weight may reduce the amount of fat present. Losing weight can undoubtedly decrease the visual impact of a fatty chest, but having an assessment to see whether you have glandular tissue is necessary.
You will need an assessment to determine if glandular tissue exists in your chest, or if the mass is fat. If the weight is fat, then you do not need excision and liposuction is likely to be sufficient.
Yes, every liposuction procedure requires a local anaesthetic. We do not use a general anaesthetic for our procedures (usually only reserved for large-volume liposuction). The anaesthetic we use also works as an antibacterial and to constrict blood vessels to reduce bleeding and bruising
You will feel a little swollen and sore after liposuction. The swelling will go down with the use of your compression garments and with time, after which the results will become apparent. The greatest discomfort is the few days after your surgery, where bruising may also be visible. We recommend, if needed, over the counter pain medication, though most people find it quite tolerable.
The chest area is reasonably small, so the impacts of the treatment are manageable if we treated just one area. Your comfort is our highest priority, so if you are uncomfortable, let us know.
Compression garments are necessary for two weeks full-time after the treatment, then for another two weeks for either the day or the night. The compression garments help drain fluid from the area, reducing the swelling quicker than if you don’t wear them. You’ll see your results faster by wearing the garments, as well as keeping your body supported during recovery.
The first day you can’t shower or take a bath, as you’ll be wearing dressings that need to stay in place. Warm water causes changes to your blood vessels, which may result in fainting or bleeding, which is undesirable. After your first 24 hours, you can take a shower but have someone nearby.
You can’t drive until all the sedatives are out of your system. We give you a relaxant before your procedure to keep you relaxed – getting fat suctioned out of your body can be a little anxiety-inducing! Your comfort is our highest priority, but we also need you to be still and relaxed while the procedure is underway.
We don’t perform liposuction on teenagers or the elderly unless it is medically necessary. Young people haven’t stopped developing and growing, and enlarged breast tissue is common in teenage boys (much to their chagrin). As we age, our ability to heal slows significantly, so performing non-essential cosmetic surgery is inadvisable.
We don’t have age restrictions as much as stage-of-life guidelines. In Australia, surgery cannot be performed on under 18s without a three-month cooling-off period as mandatory. We may also request a psychological evaluation if necessary, to keep our patients safe and ensure treatments are not being undertaken under duress or for regretful reasons.
We respect everyone’s right to choose their pathway in life; however, it is our duty as medical practitioners to be diligent with patient care.
Yes, we can remove back, arm, flank, hip, thigh, belly and double chin fat in one procedure. We can do many areas at the same appointment – if you can pinch it, you lipo it, as Dr Rich says! Combining treatments saves on costs, and you can recover all at once without taking more time out of life.
We recommend that you have another adult in the house as you recover to undertake regular household tasks such as laundry, childcare and shopping. Lifting heavy groceries, picking up children (with flailing limbs and unpredictable movements) and doing household chores may be too much during the initial period of healing.
You’ll soon know when it’s safe to go about regular family life because your body will tell you – it won’t hurt or feel tender – and Dr Rich will let you know what you can and can’t do and for how long. Take it easy and stick with bedtime stories until you’ve had the all-clear for more strenuous activities.
