Prominent fatty tissue may occur in the normal man in the breast area. This can be developmental and occurs in the early teens, it is relatively common and usually settles in a few months. It is the result of temporary hormonal imbalance during adolescence. However sometimes it may fail to resolve. Alternatively the condition may occur later in life as the result of weight gain and this can include the accumulation of fat in the breast area. This problem is termed gynaecomastia and is relatively common and can represent an embarrassing condition for many men. The result of the fat and breast tissue increasing in volume may lead to the appearance of what is sometimes termed ‘man boobs’ Whilst there are several but uncommon causes of gynaecomastia such as the use of anabolic steroids in body-building, marijuana, and some prescribed medications for the majority there is no known cause for the condition. There are two common situations where gynaecomastia can appear. The first is at puberty when the male breast swells slightly and instead of reverting to normal in some boys it persists and here there is usually a ‘breast-bud’ which can be felt beneath the nipple. In the second case later in life fat is deposited beneath the nipple to give a breast-like shape
The operation usually involves removal of the ‘breast-bud’ through a small incision made around the lower half of the nipple. Liposuction may be undertaken at the same time to even out the chest area. Occasionally if the gynaecomastia is entirely fatty then a surgical incision around the nipple may not be needed, however it cannot always be known before the operation if this will be the case. After the operation, a small drain may be used and a special pressure garment is worn for six weeks.