Gynaecomastia Treatment, Vasectomy Reversal, Cosmetic Surgery and Body Lifting for Men – Melbourne, Victoria
A common misconception is that cosmetic surgery is only for women. This is not so, as many men are interested in body contouring procedures to improve their physiques as well as eyelid surgery, facelift and necklift surgery, and other procedures that can help them look younger and more vigorous. In addition to these procedures, surgery for correction of gynaecomastia and vasectomy reversal are available at Mr. Maxwell's practice in Melbourne, Victoria.
Surgery for Gynaecomastia
Gynaecomastia refers to a condition in which men have enlarged breasts due to an increase in the amount of breast tissue. The excess breast tissue may be on one side (unilateral) or on both sides (bilateral). Men with this condition often feel embarrassed and may be hesitant to be seen in T-shirts or to take their shirts off in public, such as at the beach.
Gynaecomastia is usually a physiological condition occurring at puberty and in older age, due to increased sensitivity of the breast tissue to circulating hormones. It may also be due to certain therapeutic drugs, or to the use of anabolic steroids or growth hormone in body builders. Occasionally gynaecomastia is due to a testicular or pituitary tumour or is part of a genetic condition. All patients with gynaecomastia therefore must have a full medical assessment before surgery can be considered. Unfortunately the increase in breast tissue does not generally resolve despite adequate treatment of any underlying cause. Some patients present with 'pseudo-gynaecomastia' where the breast enlargement is due to an accumulation of fat rather than true breast tissue. This group responds well to liposuction alone. 'True' gynaecomastia requires removal of the actual breast tissue by surgical excison with or without liposuction.
The surgery is performed under general anaesthesia usually as a day case. The surgical approach is via an incision which follows the margin of the bottom half of the nipple/areola complex. Following removal of the breast tissue/fat and cauterisation of any bleeding points, suction drains are inserted and the incisions closed. A firm compression garment is then applied.
Occasionally, despite the use of cautery, suction drains and a compression garment, there may be fresh bleeding into the surgical space under the skin left after removal of the breast tissue, causing painful, tense swelling which if unrelieved may threaten the viability of the nipple-areolar complex and the adjacent skin. This is called a haematoma. In this situation the patient has to be taken urgently back to the operating theatre for evacuation of the blood.
The compression garment is worn for two to four weeks depending on how much liposuction has been performed. The drains are removed 48hrs - 72hrs after the procedure.
The patient is reviewed in the rooms 10 days after the surgery. Not infrequently some tissue fluid may have collected in the subcutaneous space. This is called a 'seroma'. This fluid may need to be drained off in the rooms on several occasions before it resolves.
In significant gynaecomastia there is the additional potential problem of skin excess which causes wrinkles and irregularities when the skin is laid back down onto the chest wall ('re-draped'), and due to the loss of the filmy layer which normally exists between the skin and the underlying pectoral muscle and which allows the skin to move freely over the muscle, the skin tends to sticks down to the underlying pectoral muscle making the skin irregularities hard to get rid of. Both these problems improve with the passage of time and with regular massage. Occasionally, especially in the massive weight loss situation, the skin excess is so great that it needs to be excised and the nipple moved to a new position. This puts scars on the chest.
To learn more about gynaecomastia and its treatment, please schedule an individual consultation with Mr. Maxwell today.
Vasectomy Reversal (Vasovasostomy)
For men who have had a vasectomy and now wish to have children again, modern advances in microsurgery have made vasectomy reversal possible. The procedure involves re-connection of the vas deferens on each side using the operating microscope. Following the procedure the patient must abstain from sexual activity for six weeks. At this stage a semen analysis is performed.
The 'patency rate', i.e. free flow of semen across the joins, is around 80%, but the success rate measured in terms of actual conception is around 60% if the reversal is performed within 2 years of the vasectomy and falls off thereafter, in proportion to how long ago the vasectomies were performed. Also, if the original vasectomies were performed very low down near the epididymis of the testis, the reversal procedure is technically very much more difficult, with a greatly reduced chance of success. It must be remembered that successful conception is a function of the fertility of both partners. If conception fails to occur in the context of a technically successful vasectomy reversal based on the semen analysis at 6 weeks post-operation, then the couple is referred on for fertility assessment as for any infertile couple.
To learn more about vasectomy reversal, please schedule a consultation with Mr. Maxwell at one of our three locations in the Melbourne area.
Please Note: At the time of writing, there is a Medicare rebate for this surgery.
Bodylifting for Men
Although substantial weight loss offers many health and cosmetic advantages to the obese patient, it is often very much just the beginning, as individuals are often displeased with the amount of excess skin that remains. As for women, a full body lift can help men complete their transformation after massive weight loss - see Bodylifting After Massive Weight Loss.
Schedule a Consultation with Our Cosmetic Surgeon
To learn more about procedures for men including gynaecomastia treatment, vasectomy reversal, and bodylifting, contact our Melbourne, Victoria practice.