Gynecomastia surgery in Lebanon: recovery and what to expect

What gynecomastia is

Gynecomastia is enlargement of the male breast. Two things can be present, and they are not the same. A firm disc of glandular tissue sits directly behind the nipple; it does not shrink with diet or training. Softer fat can sit around it, and that fat does respond to training — which is why the fat can shrink while the firm disc under the nipple stays, and becomes more noticeable rather than less.

When surgery is considered, and when it is not

The NHS lists causes of breast enlargement in men including hormone changes at puberty or after 50, an overactive thyroid, kidney disease, anabolic steroids, and certain medicines (NHS). Where a medicine or an untreated condition is the cause, treating it can reduce the size without an operation. Enlargement that begins at puberty can also settle on its own. That assessment is gone through at the consultation, before any decision to operate.

Liposuction, gland excision, or both

Liposuction removes fat through incisions of three to four millimetres. It changes the fat around the gland; it does not remove the firm disc behind the nipple. Gland excision removes that disc, through a small incision at the lower border of the areola, where the change in skin colour hides it. Where both are present, combining the two in one operation — excision for the gland, liposuction to blend the edges into the chest wall — is how a flat contour is reached, rather than a lump under the nipple or a hollow at the centre.

Recovery: stage by stage

These are published ranges for the operation, not this practice's own figures. The timeline for a specific operation is gone through before surgery.

• Day 1: home the same day, wearing a compression vest fitted at the end of the operation. Tightness, tenderness and swelling across the chest are expected.
• Week 1: the vest stays on day and night for 1 to 2 weeks after the operation (NHS).
• Weeks 2 to 6: stretching, strenuous exercise and heavy lifting stay off until 3 weeks; full return to normal activity comes at 6 weeks (NHS).
• 3 to 6 months: firmness under the areola settles and the scar fades into the areolar border. Final results are reached at 3 to 6 months (American Society of Plastic Surgeons).

Risks, in plain words

• Bruising and swelling that take weeks, not days, to settle.
• A residual firmness under the areola for months, which is healing rather than remaining gland.
• A depression at the centre if too much gland is taken, or a lump if too little is.
• Asymmetry between the two sides.
• Recurrence, uncommon after adequate excision but more likely if anabolic steroid use continues.

At this practice

Dr. Vincent ElKhoury, a board-certified plastic and reconstructive surgeon, operates on every gynecomastia case himself, at Hayek Hospital or Bellevue Medical Center. The consultation beforehand takes place at his clinic in Mansourieh, Metn. What the operation changes, how it is done, and the printed patient information sheet are on the gynecomastia page. Liposuction is also used for body contouring outside gynecomastia; the choice between liposuction and an abdominal operation is covered in liposuction or tummy tuck: which to choose.

Questions

FAQ

Sources

• NHS — Gynaecomastia
• NHS — Breast reduction (male)
• American Society of Plastic Surgeons — Gynecomastia Surgery Recovery

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