What is Mastectomy for Gynaecomastia: Overview, Benefits, and Expected Results

Definition & Overview

A mastectomy for gynaecomastia is a medical procedure used to treat male patients with abnormally enlarged breasts. The condition usually begins during the early stages of male development, such as puberty or adolescence. It is believed to be caused by hormonal changes that occur during this time. However, it can also be due to medications that disrupt the balance between the hormones androgen and oestrogen. In some patients, the condition resolves without treatment. In some, however, the condition causes severe and prolonged enlargement that causes embarrassment and low self-esteem. Thus, some patients choose to undergo a mastectomy.

Who Should Undergo and Expected Results

A mastectomy is for males who suffer from gynaecomastia, which is considered as the most common benign (noncancerous) disorder that affects the male breast. It most commonly affects newborns, adolescents, and older men. However, most newborn and adolescent cases are temporary and resolve without treatment.

Gynaecomastia is characterised by excess glandular tissue in the chest area. It can affect one breast or both. Its symptoms include:

• Dimpling of the skin
• Nipple retraction
• Milky discharge from the nipple
• Enlarged areola
• Asymmetric breasts

Although it is benign, gynaecomastia can cause psychosocial problems for those affected.

Gynaecomastia can be caused by several factors, such as:

• Hormonal imbalances
• Ageing, which causes a natural decline in testosterone production
• Underlying medical conditions, such as:

1. Klinefelter syndrome
2. Cancer, such as testicular cancer
3. Testicular tumours, such as Leydig cell tumours or Sertoli cell tumours
4. Endocrine disorders
5. Chronic liver disease
6. Aromatase excess syndrome
7. Peutz-Jeghers syndrome

• Obesity
• Medications
• Ketoconazole
• Cimetidine
• Human growth hormone

• Human chorionic gonadotropin

• Excess fatty tissue

Individual cases of gynaecomastia are categorised based on severity:

• Grade I – There is minor breast enlargement with no excess skin
• Grade II – There is moderate breast enlargement with no excess skin
• Grade III – There is moderate breast enlargement with excess skin
• Grade IV – There is a highly noticeable enlargement of the breast with excess skin

Mild cases of gynaecomastia can usually be managed with medical treatment, lifestyle changes, proper diet, and exercise. Unfortunately, cases persisting beyond two years are often unresponsive to non-surgical medical treatment, making surgery the only available option.

Hormonal imbalances and existing medical conditions are considered as valid medical reasons for undergoing surgical treatment for gynaecomastia. On the other hand, mastectomies used to treat gynaecomastia caused by obesity, medications (that can be discontinued), and excess fatty tissue are considered as a cosmetic treatment.

Furthermore, since some cases of gynaecomastia are temporary and do not require treatment, patients need to meet certain criteria before they are considered as a good candidate for a mastectomy. These include the following:

• The condition has persisted longer than three years after the initial evaluation.
• The enlargement is severe, or greater than 4 cm in diameter.
• The condition causes the patient emotional disturbance.
• The tissue that needs to be removed is glandular and not fatty tissue.

The goals of a mastectomy include the following:

• To restore the normal size of the patient’s breast
• To correct breast deformities

How is the Procedure Performed?

A mastectomy for gynaecomastia works by surgically removing glandular breast tissue. If only fatty tissue has to be removed, surgeons may perform liposuction-assisted mastectomy. However, if the breast gland itself has to be removed, a subcutaneous mastectomy is required.

The following steps are taken to perform a mastectomy:

• The patient is placed under general anaesthesia.
• The surgeon cuts into the patient’s skin. He may use:
• an inferior periareolar incision
• a periareolar circular incision
• an inferior periareolar incision with lateral, superior, and medial extensions
• a periareolar circular incision with transverse lateral extension

• a circular incision with inferior, medial, lateral, and superior extensions

• The surgeon accesses the glandular tissue underneath the areola. For massive enlargements, the surgeon may need to remove more skin and make a deeper excision.

• The tissue is then excised.
• The surgeon may place a surgical drain if necessary. This helps remove the blood and liquefied fat that may leak from the incision during the first 24 hours after the procedure.
• The surgeon puts all subcutaneous tissues back and closes the skin incision with sutures.

Since the surgery removes the tissue causing the enlargement, its effects are visible right after. Patients have to wear compression garments for at least four weeks. The appearance of the breasts will continue to improve until the final results become visible after a year.

The recovery period is not that long. Most patients can go back to work after two days, and resume their normal activities within a few days. They are typically scheduled for a follow-up visit one week after the procedure, then once a month for the next six months.

Undergoing a mastectomy for gynaecomastia can reduce the chances of a recurrence, but this is not 100% guaranteed.

Possible Risks and Complications

Patients who undergo a mastectomy for gynaecomastia are at risk of:

• Hematoma
• Surgical wound infection
• Breast asymmetry
• Changes in breast sensation
• Necrosis of the areola and/or the nipple
• Seroma
• Scarring
• Deformed breasts
  
  

References:

• Song YN, Wang YB, Huang R, He XG, Zhang JF, Zhang GQ, Ren YL, Pang JH, Pang D. “Surgical treatment of gynecomastia: mastectomy compared to liposuction technique.” Ann Plast Surg. 2014 Sep;73(3): 275-8. http://www.ncbi.nlm.nih.gov/pubmed/23644441

• Mario Mucio Maia de Medeiros. “Surgical approach to the treatment of gynecomastia according to its classification.” Rev Bras Cir Plast. vol. 27 no. 2 Sao Paulo Apr/June 2012. http://www.scielo.br/scielo.php?pid=S1983-51752012000200018&script=sci_arttext&tlng=en

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Title: Understanding Mastectomy for Gynaecomastia: An Overview ⁢of Benefits and Expected Outcomes



Keywords: Mastectomy⁢ for Gynaecomastia, Breast Reduction Surgery, Enlarged Male ​Breasts,⁤ Treatment Options, Cosmetic Surgery



Question: What ‍is Mastectomy for Gynaecomastia?



Answer: ⁤Mastectomy ⁣for Gynaecomastia is⁢ a surgical procedure ⁣designed ‍to correct ⁢the condition of enlarged male ⁢breasts. It involves the removal‍ of excess breast tissue, resulting in a more masculine chest contour.‍ Mastectomy for Gynaecomastia can be performed using various techniques, including traditional open surgery, endoscopic surgery,⁢ or liposuction.



Question: What are the Benefits of Mastectomy for Gynaecomastia?



Answer: Mastectomy for Gynaecomastia offers several key benefits:



-⁣ Improved Appearance: Reduces breast size, creating a ​more masculine‍ chest contour.



– Enhanced Self-Esteem: Corrects the underlying cause of embarrassment or self-consciousness related ⁤to enlarged breasts.



– Relief from Physical Discomfort: Mastectomy can alleviate pain, chest sensitivity, and skin irritation⁢ associated with enlarged breasts.



– Increased Confidence and Participation in⁢ Physical Activities: Helps individuals feel more confident and comfortable ​engaging‍ in sports and other physical activities.



– ⁤Enhanced ⁣Sexual Function: Can improve sexual self-esteem and‌ satisfaction by⁢ correcting the appearance of enlarged breasts.



Question: What are the Expected‍ Results of Mastectomy for Gynaecomastia?



Answer: Following Mastectomy for Gynaecomastia, patients can anticipate the following outcomes:



– Reduced Breast⁣ Size: Achieve a flatter and more masculine chest contour.



– Improved Body ‌Shape: Restored balance and proportion to the chest and torso.



-‍ Reduced Skin Sensitivity:⁢ Relieve⁤ hypersensitivity ‌and irritation caused by enlarged ‍breast tissue.



-⁤ Increased Mobility: Eliminate physical discomfort and ⁣limitation in movement.



– Improved Psychological Well-being: Restore confidence and self-esteem, leading to an​ overall enhanced quality of life.



Question: How is Mastectomy for Gynaecomastia Performed?



Answer: Mastectomy for ⁤Gynaecomastia​ can be performed using⁤ three ​main techniques:



1.Traditional Open Surgery: An incision ⁢is made around⁢ the areola and breast ⁢tissue, allowing direct excision of excess tissue.



2.Endoscopic Surgery: A​ less invasive approach involving small incisions and the use of a specialized camera and instruments.



3.Liposuction: Employs a small cannula to suction out excess fat tissue. This technique is ​suitable for cases‍ involving predominantly fatty breast tissue.



The choice‌ of‍ technique depends on‍ the severity of Gynaecomastia, the patient’s ​preferences, and the surgeon’s expertise.



Conclusion:

Mastectomy for Gynaecomastia is a safe and effective surgical procedure that addresses enlarged male breasts, offering numerous benefits such as improved physical appearance, enhanced self-esteem, ⁢and restored confidence.⁤ Patients can expect reduced ⁤breast size, improved body contour, ⁤relief from physical discomfort, and an overall ⁤improved ⁢quality of life.‌ With ⁣careful selection of⁣ a qualified surgeon and⁤ appropriate post-operative care, most patients achieve successful and satisfactory outcomes from Mastectomy for Gynaecomastia.