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Gynecomastia

Though rarely discussed, gynecomastia is actually quite common-affecting 40 to 60% of men. The cause of this condition in those within normal weight range has been linked to drug side effects, heredity or certain medical conditions. In most cases the cause is unknown. In men experiencing considerable weight loss, the cause is obvious-excess skin in the chest and other areas of the body resulting from the decrease of overall mass.

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Who is a candidate?

For those who feel self conscious about their appearance, breast reduction surgery can help. Since the procedure removes fat and /or glandular tissue from the breasts, the result is a chest that is flatter, firmer and better contoured. In extreme cases excess skin is removed to achieve this outcome.

The surgery to correct gynecomastia should be performed on healthy, emotionally stable men. Age is not necessarily a consideration; however the best candidates have firm, elastic skin that will reshape to the body’s new contours.

Surgery is not recommended for overweight men—the problem may correct itself through diet and exercise. Individuals who drink alcoholic beverages in excess, or regularly smoke marijuana are not good candidates, nor are those who take anabolic steroids. These drugs can contribute to gynecomastia. Smokers are never good candidates for any surgery since smoking decreases circulation which interferes with proper healing.

How is it done?

Surgery for gynecomastia is most often performed as an outpatient procedure. It is usually done under general anesthesia, although local anesthesia plus sedation is sometimes an option. It takes about an hour and a half to two and a half hours to complete providing there are no extenuating circumstances or multiple procedures involved.

The surgical technique will depend upon whether your condition is primarily comprised of excess glandular tissue, or fatty tissue. In the former case, the glandular tissue will first be removed with a scalpel. This may be done alone, or in conjunction with Liposuction. The incision is usually made along the edge of the areola. Usually the scars are inconspicuous, but their size is dependent upon the amount of tissue and skin that must be removed. The same incision is used for both tissue removal and Liposuction. In the case of extreme amounts of fat or glandular tissue, skin may have to be removed in order for the remaining skin to properly drape over the new breast contour.

If excessive fatty tissue is the primary cause, you will likely have Liposuction to remove the fat. In Liposuction, a slim hollow tube called a cannula is attached to a vacuum pump.

This device breaks up layers of fat and suctions them out using careful, deliberate strokes. As in the case of glandular tissue, the incision will be under the arm or around the perimeter of the areola, but is nearly imperceptible.

Recuperation

At the surgery’s conclusion, a drain may be inserted through a separate incision to draw off fluids. Your main incision will be covered with dressing and your chest may be wrapped to keep the skin firmly in place.

Most patients have some discomfort, but this is easily controlled with pain medication. Swelling and bruising are common. The swelling can be reduced by wearing an elastic pressure garment for one to two weeks or longer. It may be a full six months to one year before you see the final results. Stitches are removed one to two weeks post op. Most patients can return to work 2 days post op providing there is no physical activity involved in their job. Heavy exercise is discouraged for at least 3 weeks. Any sport or job that could potentially cause a blow to the chest must be avoided for 4 weeks.

A word about financing…

Breast reduction can be made very affordable through our partners at CareCredit. Visit them at www.carecredit.com. We would be happy to answer any of your questions or assist you with the necessary paperwork.

  • Prosper Healthcare Lending
  • CareCredit
  • United Medical Credit

Insurance Notes:

Male breast reduction is usually considered a cosmetic procedure and is rarely covered by medical insurance. We are happy to work with your insurance company with any pre-authorization requirements.

Ask Dr. Beck

Q:What is involved in the initial exam?

A:Your initial consultation is very important. You will be asked to bring your medical history. Because underlying conditions such as liver disease, use of estrogen medications or steroids have been linked to gynecomastia, both your history and your breasts will be examined to rule out these obvious causes. Should a medical problem be detected, you will be referred to an appropriate specialist. Depending upon the degree of fat and glandular tissue involved, we will discuss the best surgical approach for you and answer any of your questions.

Q:What kind of scars can I expect?

A:You can expect a two to three millimeter scar at the bottom of the areola when the procedure involves Liposuction of the fatty tissue only. There is a chance that an extended scar along the areola could be necessary if additional breast tissue must be removed.

Q:When can I go out in the sun?

A:This is a very important question. You must avoid exposing your chest to the sun for at least 6 months. Sun can permanently affect the skin’s pigmentation, causing the scars to turn dark. In any case, it is advisable to use a strong sunblock (SPF 45 or greater) and be cautious.

Q:Will my chest ever return to its preoperative condition again?

A:Male breast reduction is permanent. However, significant weight gain, or exposure to drugs and steroids can affect the size of your "breasts".

Q:How do I know if I need a lift along with a reduction?

A:Depending upon the amount of breast tissue and redundant skin, a breast lift may be indicated. In some cases, not only fat and breast tissue is removed, but also excess skin. An exam by the plastic surgeon will be needed to definitively know if a reduction and/or lift will be necessary for the desired result.

Q:What complications should I be aware of?

A:Risks and uncertainty are part of every surgical procedure. Complications associated with gynecomastia are infrequent and usually minor. Having said this, risks include infection, skin injury, excessive bleeding, an adverse reaction to anesthesia and excessive fluid loss or accumulation. It can also result in noticeable scars, permanent pigment changes or slightly mismatched breasts or nipples. Some patients experience temporary loss of breast sensation (rarely permanent) or numbness.

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