Gynecomastia – correction of the male breast

Gynaecomastia is a benign enlargement of the mammary gland tissue in men. It can occur on one or both sides and gives the breast a rounder, sometimes feminine-looking shape. Many men find this unpleasant or embarrassing. In addition to the appearance, feelings of tension or pain can also occur.
A basic distinction is made between two forms: „True“ gynaecomastia is caused by increased growth of the glandular tissue itself, often triggered by hormonal changes. Pseudogynaecomastia, on the other hand, is an accumulation of fatty tissue in the breast area - often as a result of obesity; mixed forms occur.
A particular variant is pubertal gynaecomastia, which can develop during the hormonal changes in adolescents and usually disappears again on its own.

There are many reasons for male breasts. There is often a hormonal shift in which the proportion of female hormones (oestrogens) outweighs the male hormones (androgens). This can be age-related or triggered by life circumstances, medication or illness.
Genetic factors, obesity, liver or kidney disease and certain active substances such as anabolic steroids or psychotropic drugs can also favour breast growth.
In some patients, enlarged breasts are already apparent at birth; the cause is usually the transfer of female hormones via the placenta. This phenomenon usually disappears spontaneously.
It is important to clarify the exact cause, as this will determine the appropriate therapeutic approach for the individual patient.

Before the procedure, Dr Matiasek takes the time for a comprehensive consultation. You describe your complaints, wishes and expectations; he then explains the procedure and all medically relevant points.
Diagnosis involves a clinical examination, supplemented by ultrasound and hormone or blood count analyses if necessary. This helps to clarify whether the patient has true gynaecomastia, pseudogynaecomastia or a mixed form.
Please note the following in the two weeks before the operation: Only discontinue blood-thinning medication in consultation with your GP. Reduce or avoid alcohol and nicotine to support blood circulation and wound healing. As the operation is usually performed under general anaesthetic, you should not eat six hours before the day of the operation; clear liquids such as water or unsweetened tea are permitted up to two hours before the anaesthetic.

In most cases, surgical treatment is the most effective method of achieving a permanently flatter, masculine contoured breast. In the case of certain hormonal causes, additional drug therapy may be useful; however, surgery usually provides the most reliable long-term result.
Lecturer Dr Matiasek usually combines two techniques: a gentle liposuction (Liposuction) removes excess fatty tissue and, if necessary, enlarged glandular tissue is also surgically removed. In some cases, liposuction alone is sufficient. To tighten the skin, Dr Matiasek often recommends an additional BodyTite- or quantum treatment. Which method is best for you will be determined in a personal consultation.
After general anaesthesia has been induced, a small, inconspicuous incision is made - usually at the lower edge of the areola, alternatively in the armpit or along the underbust crease. The excess tissue is removed through these openings, liposuction is performed and BodyTite/Quantum is used for tightening if necessary. Dr Matiasek then shapes the breast, closes the skin and applies a supportive dressing; a drain is often inserted so that wound fluid can drain away safely.
The procedure usually takes about one to two hours. Depending on the extent of the procedure, you can go home the same day or stay overnight for observation. In the case of pronounced skin sagging, an additional breast lift This will be discussed together in advance.

The operation is a proven routine procedure, but as with any operation, risks cannot be completely ruled out. Common, generally harmless side effects include temporary swelling, bruising or a feeling of tightness; these usually subside within days to weeks.
Occasionally, temporary changes in sensation occur in the nipple area, which usually disappear completely. Noticeable scarring is rare as the incisions are made in inconspicuous areas. Wound healing disorders or hardening are possible, but can often be avoided with careful aftercare.
It is important to be well prepared for the anaesthetic. Please inform Dr Matiasek and the anaesthesia team about any allergies or intolerances so that the anaesthesia can be optimally adapted.

Immediately after the operation, you will be given a special compression girdle that you should wear continuously for around six weeks - during the day and at night. It supports the healing of the new contour and reduces swelling.
From the second week onwards, lymphatic drainage using Endermology (LPG) - ideally twice a week in the surgery - to speed up the decongestion process.
Allow yourself to rest for the first one to two weeks and avoid physical exertion. Showering is possible after about two days; however, the wounds should not come into direct contact with water. Full baths, swimming pools, solariums and saunas should be avoided for several weeks. Direct sunlight on the treated area should also be avoided in order to promote optimal scar healing.
Sports activities can be resumed after four to six weeks at the earliest, depending on the course of the operation. A balanced diet that is as low in fat as possible and regular exercise support the healing process and help to maintain the result in the long term.
The following applies to returning to work: office work is usually possible after a few days. For physically strenuous activities, you should plan a break of at least two to three weeks - approval is given individually in consultation with lecturer Dr Matiasek.

An initial change is often recognisable immediately after the procedure. In the first few days, however, the area is still swollen and held in place by the supporting bandage - a little patience is required here.
The final result can usually be reliably assessed after around three to four months; in individual cases, complete stabilisation can take up to twelve months.
The results are generally permanent. However, strong weight fluctuations or renewed hormonal influences can change the breast shape.
Cost coverage: Whether there is a medical indication must be assessed on an individual basis. In suitable cases, an application can be submitted to the health insurance company; Dr Matiasek will be happy to assist you with the assessment and the process.
Whether regression is possible without surgery depends on the cause: pubertal gynaecomastia often regresses spontaneously; however, if the enlargement persists for longer or if there is a permanent increase in fatty and glandular tissue, spontaneous regression is unlikely - in this case, surgery offers the most reliable correction.