Mr Richards, Leading Plastic Surgeon at Aurora Clinics describes the treatment options available if you have Male Breasts medically known as gynaecomastia. These include advice on exercise and fitness as well as the possible surgery options available. These include liposuction and techniques such as Webster’s procedure. He explains why a different scars are used in each case according to the amount of tissue and skin that needs to be removed. For more information or to schedule a FREE Consultation with our specialist plastic surgeons, call us on 01844 214362.

Male Breast Reduction – How Can Male Breasts Be Treated

Hello. My name is Adrian Richards. I’m a consultant plastic and cosmetic surgeon, and I’m the Surgical Director of Aurora Clinics. Today I’m going to be talking, following our last video on causes of gynecomastia, I’m going to be talking about what you can do about it. So just to rerun, gynecomastia is a condition which affects males with abnormal prominence of the breast tissue, and it can either be just of the area under the nipple or it can be the whole breast tissue. So if it’s just the nipple area, sometimes the nipple, the areola which is the brown bit around the nipple, can be slightly domed, and that’s normally because there is an area of breast tissue actually behind there which needs to be removed.

So the question is, what’s causing the gynecomastia? There are two elements to the breast. One is the fibrous tissue, which is the actual breast tissue which is typically underneath the nipple. And that’s firm fibrous tissue. The other main element is the fatty tissue which, as I mentioned in a previous podcast, is where you tend to hold your fat. So that will be in the chest area, and in between the breast tissue there will be fatty tissue

So really we need to assess your chest. The first thing is, is it mostly fatty? Does it feel mostly fatty? Is there an actual nubbin of breast tissue underneath the nipple? And the final thing is how much skin excess is there? Because if you’ve really been very big and there’s a lot of excess skin with the nipple being slightly low, really you need to look then at, do we need to remove some skin?

So simple fatty gynecomastia, fairly moderate, no excess skin, the best technique really for that is liposuction. So that’s done by normally, I normally do it by three sites because we like to crisscross where we do the liposuction like a lattice to get everything as neat as possible. If you just do it from one area, you’re more likely to get sort of ridges. So I tend to do two incisions. One here, one here, so below the nipple here the below the breast and one actually underneath the bottom of the areola, and that way I can access the breast tissue by three areas and perform liposuction. That’s very effective. Normally some bruising, some discomfort, and we like you to wear a support garment for about two to three weeks afterwards. But it’s very effective at reducing the fatty element, and the advantage is only very minimum scarring because the liposuction entry sites are about two to three millimetres in length, and often if there are pre-existing moles, I’ll put it through so it will be concealed in a mole.

So that’s fatty, pure fatty gynecomastia. If you’ve got some breast tissue, that won’t be removed in a liposuction procedure. So the traditional procedure we tend to do is called a Webster’s procedure, and that’s where we do a semicircular incision below the areola. So the areola, remember, is the brown bit of your nipple and then you go on to the normal skin. We do a semicircle cut underneath the areola, and then we can take away the breast tissue. This is often combined with some liposuction as well. So advantages of this technique, you can remove actual tissue which you can’t get with liposuction. Disadvantages are scar underneath the areola.

Next procedure, if there is more breast tissue and you want to tighten the skin up, you think there’s some skin excess, we can make an incision around the nipple, like a donut around the nipple and then we can remove a circular area a bit like a Polo mint the skin around the nipple, and this gives good access to remove the tissue, so we can actually remove the tissue and perform liposuction. We can also tighten up the skin slightly because we’ve made a slightly bigger circle around the nipple, and I removed a donut shape of the skin and I’m bringing the skin in. So I’m tightening the skin up a little bit. The advantages of that are some skin removal. Disadvantages, really, are that you have a scar right around the nipple. In a Webster’s procedure, semicircle underneath. This procedure right the way around.

The final technique, which I rarely use, is for people with very severe gynecomastia, really, liposuction and just removing the tissue won’t do it because it’s a skin problem. There’s too much skin. So with these people, who are rare, you need to think about removing some skin, and we can’t remove enough skin via the incision around the nipple. So I have to actually go onto the breast tissue to remove skin, and normally that’s done by incision around the nipple and it normally extends downwards and along the fold underneath the breast. So it is possible. Advantages, you’ll be much flatter. Disadvantages, there’ll be scarring and it wont be all that well concealed because, although we can conceal scarring around the nipple, it’s much more difficult to do so on the native breast tissue.

So I hope that’s been helpful. It is a complicated subject, and really there’s no one solution for everyone. It really depends on the severity of the gynecomastia, what’s best for you. So if you’d like to come in and have a chat about it or just make an inquiry or send us a photo, please either email us or contact us via the Aurora Clinic website, which is Aurora-Clinics.co.uk, or just phone us and arrange a consultation or chat to one of our surgeons. So thanks for listening. I hope you found it interesting, and we hope to see you soon.