Male Chest Contouring Sydney

Chest Contouring

Chest contouring is surgery to reshape the chest by reducing glandular breast tissue, excess fat or loose skin, or a combination of these. For men, the most common reason is gynaecomastia, the enlargement of male breast tissue, which can make the chest look fuller or more prominent than a person wants and can cause tenderness or discomfort.

Gynaecomastia has several causes. Hormonal shifts at puberty are common, and many adolescent cases settle without surgery. It can also relate to weight change, certain medications, anabolic steroid use, alcohol, some medical conditions affecting the liver, thyroid or testes, and occasionally an underlying problem that needs investigating. Where the fullness is mainly fat rather than gland, the term used is pseudogynaecomastia, and the surgical approach differs.

Because the cause guides the treatment, assessment comes before any decision about surgery. That may include examination, blood tests, imaging such as ultrasound, and referral back to your GP or to an endocrinologist. Gender affirming chest surgery is a separate procedure with its own considerations and is covered on its own page. Dr Maryam Seyedabadi, Specialist Plastic Surgeon, consults in Paddington, Sydney.

Who chest contouring may suit

• Persistent gynaecomastia that has been present for more than a year and has not settled on its own
• Chest fullness that remains after weight loss and consistent training
• Tenderness, chafing or a firm disc of tissue behind the nipple
• Puffiness or projection of the nipple and areola out of proportion with the chest
• Loose chest skin after significant weight loss
• Adults at a stable weight, in good general health, who have stopped any contributing medication or substance where possible and after medical advice

What the chest contouring procedure involves

Chest contouring is usually performed under general anaesthetic as day surgery or with one night in hospital, and generally takes one to two and a half hours.

1. The chest is assessed and marked with you upright, noting how much of the fullness is fat, how much is gland, and how much is excess skin.
2. Where fat predominates, liposuction is used through small incisions to reduce volume and blend the chest into the surrounding contour.
3. Firm glandular tissue is removed directly, usually through a short incision at the lower border of the areola, with a layer left behind under the nipple to avoid a hollowed appearance.
4. Where there is significant skin excess, skin is removed and the nipple and areola are repositioned or reduced in size, which involves longer scars.
5. Drains are used in some cases, the wounds are closed and a compression vest is fitted.

Recovery

Recovery is usually straightforward but varies between individuals, and the timeframes below are a general guide.

• Bruising, swelling and tenderness are expected for roughly the first two weeks.
• A compression vest is generally worn day and night for around four to six weeks to help the skin settle onto the new contour.
• Many people return to office work within about one week, and to driving once off stronger pain medication.
• Chest and upper body training is typically deferred for around six weeks, guided by your reviews.
• Firmness and oedema can take three to six months to resolve, and scars continue to fade for a year or more.

Risks and considerations

Risks include bleeding and haematoma, which is a recognised complication of gynaecomastia surgery and may require a return to theatre, along with infection, seroma, delayed wound healing, contour irregularity, asymmetry between sides, over-resection leaving a dished or hollow area under the nipple, under-correction, changes in nipple or skin sensation that may be permanent, partial loss of nipple tissue in rare cases, loose skin once volume is reduced and visible scarring. Anaesthetic complications and blood clots are uncommon but possible.

Gynaecomastia can recur if the underlying cause continues, including ongoing anabolic steroid use, some medications or weight gain. Firm breast tissue in men is occasionally due to something other than gynaecomastia, so any suspicious lump is investigated and tissue removed at surgery can be sent for histopathology. Outcomes depend on your skin quality and anatomy, and no particular result can be promised.

Your consultation with Dr Maryam

Where chest contouring is performed for cosmetic reasons, Australian requirements apply: a referral, preferably from your usual GP, is needed before the consultation, and a cooling-off period of at least seven days applies between giving informed consent and surgery, or at least three months for patients under 18.

Dr Maryam will examine your chest, consider whether investigation of a cause is warranted, and explain which technique applies, where scars will sit, and the risks and alternatives, including treating an underlying cause, weight and training changes, liposuction alone, or no surgery. Fees are quoted after the consultation. Surgery performed for a medical indication may attract a Medicare item number if the relevant criteria are met, while purely cosmetic surgery does not. Rooms are at 2c Heeley Street, Paddington, phone 1300 067 668.