(Gynecomastia)
Men with gynecomastia (overdeveloped breasts) may benefit from male breast reduction surgery. The procedure removes excess fat and/or glandular tissue and sometimes excess skin from the breasts so that the chest has a more masculine contour. The best candidates for surgery are men with firm elastic skin. Heavy users of alcohol, marijuana or anabolic steroids are generally not considered good candidates for surgery. These drugs may cause gynecomastia, so discontinuing their use may resolve the problem without the need for surgery. Likewise, overweight men may find that normalizing weight will reduce breast fullness.
Breast reduction is usually accomplished by liposuction to remove excess fat or via open excision of excess glandular tissue. The procedure takes 1-2 hours and is generally done on an outpatient basis. It is usually done under general anesthesia..
Bruising, swelling, numbness, soreness and a burning sensation are common transient side effects after surgery. Discomfort usually subsides within a few days, but swelling and bruising may persist for three to six months. Some patients may need repeat procedures to remove additional tissue.
The patient can return to work within three to seven days and resume more strenuous activities in 3-4 weeks. You should avoid exposing the operated area to the sun for at least six months to eliminate the risk of permanently altered skin pigmentation. Improvement is permanent, barring massive weight gain or use of certain drugs.
Improvement is permanent, barring massive weight gain or use of certain drugs.
Procedural Steps
First, Anesthesia is induced
Medications are administered for your comfort during the surgical procedure. This procedure is usually done under general anesthesia
Liposuction technique
In cases where gynecomastia is primarily the result of excess fatty tissue, liposuction techniques alone may be used. This requires insertion of a cannula, a thin hollow tube, through several small incisions.
The cannula is moved back and forth in a controlled motion to loosen the excess fat, which is then removed from the body by vacuum suction.
There are various liposuction techniques that may be used; the technique most appropriate in your case will be defined prior to your procedure.
Excision technique
Excision techniques are recommended where glandular breast tissue or excess skin must be removed to correct gynecomastia. Excision also is necessary if the areola will be reduced or the nipple will be repositioned to a more natural male contour. Incision patterns vary depending on the specific conditions and surgical preference.
Combination of liposuction & excision techniques
Sometimes gynecomastia is treated with both liposuction and excision.
Gynecomastia surgery recovery
During your gynecomastia surgery recovery period, dressings or bandages will be applied to your incisions and an elastic bandage or support garment may be used to minimize swelling and support your new chest contour as it heals after surgery.
You will be given specific instructions that may include how to care for the surgical site and drains, medications to apply or take orally to aid healing and reduce the potential for infection, specific concerns to look for at the surgical site or in your general health, and when to follow up in the office.
The final results of gynecomastia surgery are permanent in many cases. However, if gynecomastia resulted from the use of certain prescription medications, drugs (including steroids), or weight gain you must be fully free from these substances and remain at a stable weight in order to maintain your results.
Gynecomastia surgery risks and safety
The decision to have plastic surgery is extremely personal, and you will have to decide if the benefits will achieve your goals and if the risks and potential complications of gynecomastia surgery are acceptable.
You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.
Gynecomastia surgery risks include:
- Reactions to tape, suture materials, glues, topical preparations or injected agents
- Anesthesia risks
- Bleeding (hematoma)
- Blood clots
- Breast asymmetry
- Breast contour and shape irregularities
- Changes in nipple or breast sensation may be temporary or permanent
- Damage to deeper structures – such as nerves, blood vessels, muscles, and lungs – can occur and may be temporary or permanent
- Deep vein thrombosis, cardiac and pulmonary complications
- Fatty tissue found in the breast might die (fat necrosis)
- Fluid accumulation (seroma)
- Infection
- Persistent pain
- Poor wound healing
- Possibility of revisional surgery
- Unfavorable scarring