The term “gynaecomastia” literally means “female breast” and the aims of gynaecomastia surgery therefore include reduction of breast volume and size in addition to optimising the appearance of the nipple areolar complexes in order to achieve an aesthetic male chest.
Features of the breast which can be addressed surgically include:
The decision to undergo gynaecomastia surgery is significant and adjustment to change in appearance needs be considered in addition to the process of post-operative recovery.
The aim of the consultation is to ascertain expectations and identify potential limitations to achieving those expectations such as skin quality, breast anatomy and scarring from previous surgery. Patients seeking gynaecomastia surgery have typically lost a significant amount of weight and have experienced limitations in clothing due to disproportionate breast size. These patients are also typically self-conscious of the appearance of their breasts and seek to improve their self esteem and confidence.
Two or more consultations are often required prior to surgery to ensure a good understanding of procedure, the likely results and the period of recovery and downtime required.
It is important that the Surgeon is made aware of previous surgery and history of scarring, along with significant medical history including a tendency for easy bruising and excessive bleeding, deep venous clots involving the legs, all prescription and non prescription medication, allergies to anaesthetic agents, antibiotics and dressings, history of smoking and psychological or psychiatric issues. These issues are important as they have the potential to affect the surgery, anaesthesia, potential complications and recovery. A history of Raynaud’s disease or conditions affecting the peripheral circulation is also significant.
If necessary, further medical consultation may be necessary to minimize complications including consultation regarding blood thinning agents which may need to be either ceased or modified in preparation for surgery. Diagnostic tests including blood tests may also be necessary for the Surgeon to obtain a complete assessment of bleeding tendencies and to optimise fitness for general anaesthesia.
If advised by the Surgeon, it may also be necessary to cease some medications. It is important to avoid Aspirin, Disprin and non-steroidal anti-inflammatory medication such as Nurofen in addition to herbal medications such as Garlic, Ginseng, Ginko, Arnica and Fish and Krill oils two weeks prior to and after surgery. It is essential that smoking cease six weeks prior to and after surgery to minimise the risk of surgical wound complications and anaesthesia. Nicotine containing products can also affect wound healing and should be ceased two weeks prior to and after surgery.
A further significant aim of consultation is to facilitate understanding of the potential risks of gynaecomastia surgery.
Risks which are infrequent but common to all operations include problem scarring around the areolar and if necessary vertically under the nipple areolar complex, wound complications including infection, wound breakdown, or haematoma (collection of blood) or seroma (collection of tissue fluid) in addition to the risk of further surgery to address such complications.
Risks specific to gynaecomastia surgery which can improve over eighteen months to two years include swelling, redness, numbness of the breast skin and loss of sensation of the nipple areolar complexes. Whilst less common, a very significant complication is necrosis of the nipple areolar complex. Specific risks which may require revisional surgery include asymmetry, contour irregularities and dog ear formation, which are contour irregularities at either end of the scar. Revisional surgery is necessary in approximately 3- 5 per cent of patients who undergo gynaecomastia surgery.
It is only at the culmination of the consultation process, after having the opportunity to have questions addressed by the Surgeon, should consent to gynaecomastia surgery be given. The consent process will also include discussion regarding the costs of surgery and potential revisional surgery.
In Australia, surgeons are strongly discouraged from advertising a set price for a medical procedure. This is in line with the Guidelines for advertising of regulated health services by the Australian Medical Board. For this reason we do not include a cost per procedure on our website.
Once Mr Patrick Tansley or Dr Sugitha Seneviratne have met with you in an initial consultation, part of this consultation will be to discuss the cost of this procedure. We can provide approximate costs for out of pocket costs before your initial consultation including any applicable Medicare rebate. We are happy to provide these by phone 03 9088 5000 or via enquiry through our website.
There is a cost for an initial consultation at our Brisbane clinic, with the potential to receive a portion of this back via Medicare where eligible for rebate, provided you have a referral from your GP. You can call our Brisbane office on 07 3180 3400 to enquire about any out-of-pocket costs before your initial consultation as well. During your consultation you will be given a personalised cost or quote for your surgery. You will need to allow one hour for your consultation.
These procedures are performed through access incisions around the nipple areolar complexes which remove breast tissue by excision and minimal access liposuction ports used to contour the breast at its periphery. Occasionally, short horizontal scars either side of the nipple areolar complex may be required to address loose skin and is usually undertaken as a secondary procedure if residual skin is a concern after several months. The most appropriate of these surgical access incisions will be discussed during your consultation.
The operation is performed using a variety of specialised techniques under general anaesthetic in an accredited hospital. Typically patients are treated in hospital for the day and receive antibiotic therapy and pain management.
The internal wounds are repaired with dissolving stitches and water proof dressings applied which are suitable for patients to shower. A compressive garment will be provided and is worn for approximately 3 weeks.
The post-operative recovery period is approximately one to two weeks, during which the breasts can be swollen or bruised. Swelling typically improves over six to eight weeks after surgery. Whilst most patients are able to return to work within one to two weeks of surgery, overall improvement can be expected for a number of months. Advice will be provided with regard to scar maturation strategies and resumption of driving, typically around one week after surgery. Physical exercise can resume three to four weeks after surgery.
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