Gynaecomastia surgery in Düsseldorf

Gynaecomastia is an abnormal increase in the size of the male mammary gland. The condition is usually caused by hormonal issues but can also be due to age-related changes in a man’s metabolism, chronic diseases or medication.

Gynaecomastia often occurs during puberty and, in most cases, goes on to subside of its own accord. In some young men, however, this regression does not take place.

In addition to “real” gynaecomastia, some people suffer from what is known as pseudogynaecomastia. This is not caused by excess glandular tissue but rather by fat accumulations in the chest region. This can also cause a man’s breast to appear visibly more feminine.

In principle, gynaecomastia surgery is suitable any men suffering from enlarged breasts which appear feminine. Before the procedure, however, it is crucial to rule out pathological or hormonal causes. It is crucial to determine in advance whether the gynaecomastia may be due to hormonal issues as the issues could otherwise reoccur after the procedure.

Gynaecomastia can also be caused by medications or anabolic steroids. This is another possibility to consider when planning treatments before electing for a surgical procedure.

In the case of pseudogynaecomastia, it may sometimes be necessary for patients to lose some weight. If the patient still has significantly enlarged breast even after weight loss, a surgical procedure to correct this could be highly beneficial once any medical contraindications have been excluded.

Gynaecomastia surgery is a challenging procedure; however, it promises a very good chance of success and the rewards are considerable. As a fundamental rule, it is also important not to postpone the procedure for too long because, if the skin in the breast area becomes overstretched, this could impact on the final aesthetic results due to the reduced elasticity of the skin.

Before gynaecomastia surgery, the physician treating you will carry out a detailed consultation. He will inform you about your treatment options, alternative methods and the surgery’s prospects of success. In addition, some examinations need to be carried out to identify the cause of the gynaecomastia or the enlarged male breast.

If conservative, non-surgical measures fail to provide the desired success, we would then consult you and take the decision on whether to perform surgery together.

The steps in gynaecomastia surgery can vary depending on the specific case. In the case of “real” gynaecomastia, the excess glandular tissue is removed via small incisions in the skin. Depending on the scope of the treatment and the patient’s wishes, the procedure can be performed under local anaesthetic or twilight sedation. For more extensive procedures, we recommend engaging an anaesthetist to allow the surgery to be performed under general anaesthetic.

In the case of pseudogynaecomastia or a mixed form of the conditions (in which the patient presents with excess glandular tissue and excess fat tissue), the surgeon first removes the excess fat tissue. This requires a surgeon with specific experience and a clear understanding of the male breast so that it does not subsequently appear drooping, indented, irregular or pointed. The procedure uses special cannulas inserted via tiny incisions in the armpit area and/or near the intramammary line. No major incisions are involved.

In extreme cases, such as following massive weight loss and irreversibly sagging skin, the plastic surgeon may also lift the surrounding skin.

Depending on the scope of the operation, it may be worthwhile for you to spend one night as an inpatient in our licensed, specialist clinic. If you choose to do so, you will receive round-the-clock care from our certified nursing team until you are discharged.

You must stop taking blood-thinning and anticoagulant medications at least 14 days before the operation. This also includes some over-the-counter flu medication and painkillers such as acetylsalicylic acid or aspirin. The specialist treating you will be glad to advise you of the alternatives open to you prior to treatment.

After the operation, we will apply a compression bandage that you will wear for several days. You will also be required to wear a special compression garment (elastic compression vest) for at least 2 weeks – but ideally for a period of 4 weeks up to a maximum of 6 weeks.

You should refrain from physical exertion and avoid strenuous activities for the first few weeks. You can start to exercise again after about 4 to 6 weeks and may be able to perform light physical activities even sooner.

You should avoid exposing the treated areas to direct sunlight for at least 3 to 6 months to prevent the scars from become discoloured (due to pigment disorders).

Like any operation, gynaecomastia surgery involves general surgical risks. In rare, isolated cases, patients can develop infections, wound healing disorders, post-operative bleeding and sensory disturbances. It is important to remember that, if an operation is performed improperly or without due care and attention, patients can develop an irregular skin texture (indentations) or broad scars. Contouring the male chest also requires a plastic surgeon with a clear vision and an advanced understanding of the specific 3D structure of the male thorax. If these conditions are not met, the results may be aesthetically unsatisfactory even if the medical aspect – removing the enlarged breast tissue – has been successful.

Essentially, it would be fair to describe gynaecomastia surgery as a rather low-risk procedure with advanced aesthetic requirements.

Here at the KOEBE KLINIK, Dr Koebe personally performs all surgeries of this type. This means you can rest assured you will be in the very best, most experienced hands with us.

If there is a demonstrable psychological or physical impairment, some health insurance providers will accept the costs of gynaecomastia surgery. The requirements that must be met may vary depending on the health insurance provider. However, the costs of liposuction are not usually covered. That also means that such a gynaecomastia operation (covered by health insurance) cannot include liposuction; the procedure is therefore limited to removal of glandular tissue – the extent of which may vary – and while not include the delicate aesthetic shaping that liposuction can achieve. This limited procedure is not usually sufficient to achieve the best possible result; in some cases, the psychological damage could be even greater after the procedure. The number of unnecessary corrective surgeries we perform (scar correction, filling in indentations) confirm our belief that, while there may be a fundamental medical justification for this procedure, it is essential that it is performed with the requisite aesthetic vision and expertise.