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A word about breast reduction in men...
Gynecomastia is a medical term that comes from the Greek words
for "women-like breasts." Though this oddly named
condition is rarely talked about, it's actually quite common.
Gynecomastia affects an estimated 40 to 60 percent of men.
It may affect only one breast or both. Though certain drugs
and medical problems have been linked with male breast overdevelopment,
there is no known cause in the vast majority of cases.
For men who feel self-conscious about their
appearance, breast-reduction surgery can help. The procedure
removes fat and or glandular tissue from the breasts, and
in extreme cases removes excess skin, resulting in a chest
that is flatter, firmer, and better contoured.
If you're considering surgery to correct gynecomastia,
this brochure will give you a basic understanding of the procedure--when
it can help, how it's performed, and what results you can
expect. It can't answer all of your questions, since a lot
depends on your individual circumstances. Please be sure to
ask your doctor if there is anything about the procedure you
don't understand.
THE BEST CANDIDATES FOR GYNECOMASTIA
CORRECTION
Surgery to correct gynecomastia can be performed on healthy,
emotionally stable men of any age. The best candidates for
surgery have firm, elastic skin that will reshape to the body's
new contours.
Surgery may be discouraged for obese men, or
for overweight men who have not first attempted to correct
the problem with exercise or weight loss. Also, individuals
who drink alcohol beverages in excess or smoke marijuana are
usually not considered good candidates for surgery. These
drugs, along with anabolic steroids, may cause gynecomastia.
Therefore, patients are first directed to stop the use of
these drugs to see if the breast fullness will diminish before
surgery is considered an option.
ALL SURGERY CARRIES SOME UNCERTAINTY
AND RISK
When male breast-reduction surgery is performed by a qualified
plastic surgeon, complications are infrequent and usually
minor. Nevertheless, as with any surgery, there are risks.
These include infection, skin injury, excessive bleeding,
adverse reaction to anesthesia, and excessive fluid loss or
accumulation. The procedure may also result in noticeable
scars, permanent pigment changes in the breast area, or slightly
mismatched breasts or nipples. If asymmetry is significant,
a second procedure may be performed to remove additional tissue.
The temporary effects of breast reduction include
loss of breast sensation or numbness, which may last up to
a year.
PLANNING YOUR SURGERY
The initial consultation with your surgeon is very important.
Your surgeon will need a complete medical history, so check
your own records ahead of time and be ready to provide this
information. First, your surgeon will examine your breasts
and check for causes of the gynecomastia, such as impaired
liver function, use of estrogen-containing medications, or
anabolic steroids. If a medical problem is the suspected cause,
you'll be referred to an appropriate specialist.
Your plastic surgeon may, in extreme cases,
also recommend a mammogram, or breast x-ray. This will not
only rule out the very small possibility of breast cancer,
but will reveal the breast's composition. Once your surgeon
knows how much fat and glandular tissue is contained within
the breasts, he or she can choose a surgical approach to best
suit your needs.
Don't hesitate to ask your surgeon any questions
you may have during the initial consultation- including your
concerns about the recommended treat- ment or the costs involved.
Treatment of gynecomastia may be covered by medical insurance--but
policies vary greatly. Check your policy or call your carrier
to be sure. If you are covered, make certain you get written
pre-authorization for the treatment recommended by your surgeon.
PREPARING FOR YOUR SURGERY
Your surgeon will give you specific instructions on how to
prepare for surgery, including guidelines on eating, drinking,
and taking certain vitamins and medications.
Smokers should plan to stop smoking for a minimum of one or
two weeks before surgery and during recovery. Smoking decreases
circulation and interferes with proper healing. Therefore,
it is essential to follow all your surgeon's instructions.
WHERE YOUR SURGERY WILL BE PERFORMED
Surgery for gynecomastia is most often performed as an outpatient
procedure, but in extreme cases, or those where other medical
conditions present cause for concern, an overnight hospital
stay may be recommended. The surgery itself usually takes
about an hour and a half to complete. However, more extensive
procedures may take longer.
TYPE OF ANESTHESIA
Correction of enlarged male breasts may be performed under
general, or in some cases, under local anesthesia plus sedation.
You'll be awake, but very relaxed and insensitive to pain.
More extensive correction may be performed under general anesthesia,
which allows the patient to sleep through the entire operation.
Your surgeon will discuss which option is recommended for
you, and why this is the option of choice.
THE SURGERY
If excess glandular tissue is the primary cause of the breast
enlargement, it will be excised, or cut out, with a scalpel.
The excision may be performed alone or in conjunction with
liposuction. In a typical procedure, an incision is made in
an inconspicuous location--either on the edge of the areola
or in the under arm area. Working through the incision, the
surgeon cuts away the excess glandular tissue, fat and skin
from around the areola and from the sides and bottom of the
breast. Major reductions that involve the removal of a significant
amount of tissue and skin may require larger incisions that
result in more conspicuous scars. If liposuction is used to
remove excess fat, the cannula is usually inserted through
the existing incisions.
If your gynecomastia consists primarily of
excessive fatty tissue, your surgeon will likely use liposuction
to remove the excess fat. A small incision, less than a half-inch
in length, is made around the edge of the areola--the dark
skin that surrounds the nipple. Or, the incision may be placed
in the underarm area. A slim hollow tube called a cannula
which is attached to a vacuum pump, is then inserted into
the incision. Using strong, deliberate strokes, the surgeon
moves the cannula through the layers beneath the skin, breaking
up the fat and suctioning it out. Patients may feel a vibration
or some friction during the procedure, but generally no pain.
In extreme cases where large amounts of fat
or glandular tissue have been removed, skin may not adjust
well to the new smaller breast contour. In these cases, excess
skin may have to be removed to allow the removing skin to
firmly re-adjust to the new breast contour.
Sometimes, a small drain is inserted through
a separate incision to draw off excess fluids. Once closed,
the incisions are usually covered with a dressing. The chest
may be wrapped to keep the skin firmly in place.
AFTER YOUR SURGERY
Whether you've had excision with a scalpel or liposuction,
you will feel some discomfort for a few days after surgery.
However, discomfort can be controlled with medications prescribed
by your surgeon. In any case, you should arrange to have someone
drive you home after surgery and to help you out for a day
or two if needed.
You'll be swollen and bruised for awhile--in
fact, you may wonder if there's been any improvement at all.
To help reduce swelling, you'll probably be instructed to
wear an elastic pressure garment continuously for a week or
two, and for a few weeks longer at night. Although the worst
of your swelling will dissipate in the first few weeks, it
may be three months or more before the final results of your
surgery are apparent.
In the meantime, it is important to begin getting
back to normal. You'll be encouraged to begin walking around
on the day of surgery, and can return to work when you feel
well enough--which could be as early as a day or two after
surgery. Any stitches will generally be removed about 1 to
2 weeks following the procedure.
Your surgeon may advise you to avoid sexual
activity for a week or two, and heavy exercise for about three
weeks. You'll be told to stay away from any sport or job that
risks a blow to the chest area for at least four weeks. In
general, it will take about a month before you're back to
all of your normal activities.
You should also avoid exposing the resulting
scars to the sun for at least six months. Sunlight can permanently
affect the skin's pigmentation, causing the scar to turn dark.
If sun exposure is unavoidable, use a strong sunblock.
YOUR NEW LOOK
Gynecomastia surgery can enhance your appearance and self-confidence,
but it won't necessarily change your looks to match your ideal.
Before you decide to have surgery, think carefully about your
expectations and discuss them frankly with your plastic surgeon.
The results of the procedure are significant
and permanent. If your expectations are realistic, chances
are good that you'll be very satisfied with your new look.
Back to Procedures
Information provided by American
Society of Plastic Surgeons. |
