Gynaecomastia may cause considerable psychological distress, especially in adolescents who are struggling with issues related to sexual identity and self-image.

Prolonged presence of breast enlargement in the male patient leads to the development of periductal fibrosis and stromal hyalinisation, preventing regression of breast tissue and causing pain and discomfort due to the distension and tightness from the hypertrophied breast. Since the surgery is straightforward, it offers a quick remedy to the discomfort, physical and social, that the patient suffers.

This is done through a small, semi-circular incision in the lower circumference of the nipple, at its junction with the normal colored skin. A surprisingly large gynaecomastia can be corrected through this innocuous incision. The surgery takes about an hour and a half to do. Drains are inserted under the skin at the end of the procedure.

I prefer General Anaesthesia as it allows for better control over the patients vital parameters.

Patient stays in hospital until the drains are removed, generally 48 to 72 hrs.

Asymmetry in size and shape is a possibility, though every effort is made to avoid this. Lumpiness, more palpable than visible, cannot always be avoided, though this is generally temporary. If the patient is relatively hairless, the scar may be visible. In large gynaecomastia, the skin excess may take months to resolve, remaining sometimes as a loose skin fold that may need additional correction at a later date.

After drain removal, the patient is allowed to shower daily. Follow up is once in 3 to 4 days. Stitches are removed after 10-12 days. In very large gynaecomastia, the patient may be asked to wear a chest corset to help the skin excess settle faster and better.

It is very important for the patient to understand that every normal male also has a breast mound. It is dangerous to surgically flatten the chest completely, since this would endanger the blood supply to the skin, not to mention that the final appearance may be abnormal.

Although the operation only reduces glandular and/or fat accumulation on the chest and cannot replace dieting or exercise for weight loss, having the surgery can remove any inhibitions that the patient may have in going to the gym or the swimming pool.