Breast development in men

Breast development in men (gynaecomastia) often causes embarrassment and reduced self-confidence. Breast development may be due to an accumulation of fat, the development of mammary gland tissue or a combination of both.

The cause is usually unknown. In some cases, a hormonal disorder, the use of certain medications or hormones, a thyroid condition, liver disease or a tumour of the adrenal glands or testicles may cause breast development in men.

Medical examination by an endocrinologist is recommended before proceeding to surgical treatment for gynaecomastia.

In cases of unilateral breast enlargement in men, the rare possibility of breast cancer must first be ruled out through imaging studies.

If no clear cause is found, often the only possible treatment for gynaecomastia is surgery, that is male breast reduction.

The procedure is performed under general anaesthesia and takes about 90-120 minutes.

The excess glandular tissue is removed through a small incision at the lower edge of the areola. Often, the procedure needs to be combined with liposuction of the excess fat of the breast skin to achieve a balanced result. Only absorbable sutures are used. Thin drainage tubes (small tubes) are placed to drain excess fluid. These are usually removed before the patient’s hospital discharge.

You may leave the hospital the same day (day hospital admission).

• An elastic compression garmentis placed at the end of surgery, and this should be worn for six weeks (day and night for three weeks, then just during the day for another three weeks.)
• You may shower after the procedure. The sutures dissolve on their own.
• The chest muscles may feel sore and stiff for the first week. The skin of the chest may be swollen, show bruising, and feel numb.
• Light work is possible after one week.
• Intense exercise using the pectoral muscles is not recommended for six weeks.
• Follow-up consultations are scheduled for 1 week, 6 weeks, and 3-6 months.

As with any surgery, there is a small risk of post-operative bleeding. The excess blood is usually removed through drainage tubes. Rarely, a second surgery may be necessary to remove a hematoma (post-operative bleeding). Wearing the elastic compression garment and following the post-operative instructions significantly reduces the risk of bleeding.

Infection of the surgical wound is rare, except in smokers and diabetics. Stopping smoking a few weeks before and after surgery is definitely recommended. Good glycaemic controls in diabetics are also indispensable. High fever and chest redness after the procedure may indicate an infection and should be reported to your attending surgeon immediately. Infections are treated with antibiotics.

A portion of the costs are only reimbursed by the mandatory health insurers in the treatment and surgery of true gynecomastia (overdeveloped breast gland tissue in men, without fat accumulation).

Latest publication date: 02/08/2024
Supervising author: Dr Vertriest Rudolf