Gynecomastia
Also, known as male breast reduction, gynecomastia treatment is to reduce breast size in men who are embarrassed by overly large breasts. Reduction methods include liposuction, cutting out excess glandular tissue or using a combination of liposuction and excision.
Gynecomastia often leads to reduced self-confidence in men as they are unable to remove their clothing in public or participate in sports or other activities. In some men, the breasts are significantly disproportionate to rest of the body which gives discomfort.
Male Breast enlargement can also occur due to Smoking, Alcoholism, excess steroids and drugs. This surgery can be done under local or general anesthesia. If the enlarged breast has more of fatty tissue or less of glandular tissue, this can be removed with only liposuction through .5 mm incision in chest.
Gynecomastia is usually not caused by any serious medical problems; in fact, its cause is rarely identified. However, because there are some medical problems that do cause gynecomastia, your first step is to see your family doctor to rule this out.
The following are some common reasons why you may want to consider gynecomastia treatment:
- You are unhappy with the size or appearance of your breasts.
- You experience physical discomfort because of your breasts.
- You have good skin elasticity. Successful gynecomastia surgery involves adequate skin contraction after your excess skin is surgically removed. Your skin may lack the necessary elasticity for good contraction if you are age fifty or older, have significant sun damage, have breasts with a lot of stretch marks or have undergone gastric bypass surgery. You have first tried diet and exercise to reduce your breast size.
- You do not use banned drugs, steroids or drink alcoholic beverages excessively (it is theorized that these substances may cause gynecomastia).
If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.
The goal of gynecomastia surgery is to restore a normal male breast contour and to correct deformities of the breast, nipple or areola. Surgical options include liposuction, excision (surgical removal of tissue) or a combination of both approaches.
- The choice of surgical technique depends on the likelihood of skin redundancy after surgery. Skin shrinkage is greater in younger than older patients.
- The length of your incision will be based on your anatomy.
- In severe gynecomastia, skin resection (surgical removal of part of an organ or structure) and moving the nipple (nipple transposition) may be necessary.
- Minimally invasive gynecomastia surgical procedures have gained popularity. In the "pull-through technique," a very small incision (approximately 5 mm) is made at the areolar edge. Following liposuction, the glandular tissue from the overlying areola is pulled through the incision. The major advantage of this procedure is the smaller incision.
- In liposuction-assisted breast reduction, there is less compromise of blood supply, nipple distortion and areola slough. Liposuction-assisted breast reduction is not effective for correcting glandular gynecomastia.
Choose your surgeon based on quality, training and experience—not cost. It's important that you choose a right surgeon based on:
- Education, training and certification
- Experience with hair transplantation
- Your comfort level with him or her
After finding a board-certified plastic surgeon in your area who is experienced in performing gynecomastia surgery, you will need to make an office appointment to set up your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.
Dr. Nageshwari will provide thorough preoperative instructions, answer any questions you may have, take a detailed medical history and perform a physical exam to determine your fitness for surgery.
If you are older than 45 years, or have heart disease, you should have a preoperative ECG. Get medical clearance from your internist or specialist, especially if you have heart disease, low blood count, or any other medical condition.
You cannot have liposuction if you are anemic. If your surgeon recommends weight benchmarks or lifestyle changes, do your best to achieve them to ensure the best results. Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery and critical outcomes.
In advance of your surgery, your surgeon will probably ask you to:
- Quit smoking and nicotine use at least four weeks before surgery since nicotine can impair and delay healing. This includes any nicotine patch or nicotine-containing product.
- Two weeks before surgery, stop all aspirin-containing products, medications that contain blood thinners (Ibuprofen, Advil etc.), vitamin E and herbal supplements. You may take one multivitamin a day.
- Let the doctor know if you develop an illness, cold or any skin infection in the chest area within a week of surgery.
- Make sure all requested lab results and doctors' clearances are submitted.
- Schedule time off work, approximately one week; two weeks if your job is labor intensive.
- Gynecomastia is usually performed on an outpatient basis. Make sure a responsible adult is available to drive you to and from surgery and that someone is available to stay with you around-the-clock for 24 hours after surgery.
- Your doctor will advise you to purchase surgical chest compression garments ahead of time, which you should bring to your surgery. You will wear these over a tee shirt, following surgery, for a time specified by your doctor.
- Have some comfortable shirts available to wear during the first four weeks after surgery. These need not be larger in size, just comfortable.
- If you routinely have your chest hair removed, avoid doing this for two weeks before and six weeks after surgery.
- Place plenty of fluids and all medications, including over-the-counter antacids, at your bedside.
You will be bandaged, wearing a compression garment, and you may have a surgical drain. The first three postoperative days are critical in your recovery. You must be at full rest at home, but not necessarily in bed; sitting and watching TV or having meals in the kitchen or living room is permissible.
Movements of the waist and elbow are acceptable, but you should curtail vigorous shoulder movement for the first few days. Lateral arm movements are generally permitted, but do not lift your arms up vertically.
Your recovery time after surgery for gynecomastia depends on how severe your condition is and what was performed for you. The average patient, treated with a combination of liposuction and breast gland tissue excision, will likely be back to work after a week. Gynecomastia surgery usually has a relatively gentle recovery period.
All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:
- Adverse reaction to anesthesia
- Hematoma or seroma (an accumulation of blood or fluid under the skin that may require removal)
- Infection and bleeding
- Changes in skin sensation
- Scarring
- Allergic reactions
- Damage to underlying structures
- Unsatisfactory results that may necessitate additional procedures
You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your gynecomastia surgery.
