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Gynecomastia

Gynecomastia surgery is a procedure to remove excess fat, glandular tissue, and/or skin from enlarged male breasts.  The severity of gynecomastia can vary between patients.  In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola.  In these cases, the position and size of the areola may need to be improved, and excess skin may need to be reduced.  In more mild cases, you may only need liposuction and/or glandular resection.  Gynecomastia may result from heredity, disease, hormonal changes, or the use of certain drugs.  It can be on one or both sides.  There are a variety of techniques that can be used to treat gynecomastia, and the technique that is best for you will be determined by the severity.  If you are overweight, you will want to lose weight before having this surgery performed.

How much pain will I have?

Moderate to high

What will it cost?

A price quote detailing facility, anesthesia, and surgeon fees will be given to you at your consultation.  This procedure is covered by some insurance companies depending on medical necessity and severity.

What is the hospital/surgery center time?

The procedure usually takes between 2-4 hours.  You will usually go home the same day, but overnight stay in the hospital may be needed depending on your individual needs.

What medications should I take or avoid taking with my surgery?

You should not take any blood thinners or anti-inflammatory medications for a week before your procedure, and you should hold all over the counter supplements a week before surgery.  This will help reduce the risk of bleeding intraoperatively, and help reduce the risk of postoperative hematoma (collection of blood).  If blood thinners are prescribed for you by your cardiologist or primary care physician, you should get clearance from them to hold these medications before they are discontinued.  You should hold all hormones 6 weeks before surgery.  Birth control pills should be held 6 weeks before surgery as well.  Of course you should make sure to use alternative forms of birth control during and after this time.  Hormones and birth control pills put you at a higher risk of blood clots.  These clots can go to your lungs and cause serious illness or even death.  We call this a pulmonary embolus.  Steroids should be weaned off at least a month before your surgery, and this weaning process should be set up and cleared by your prescribing physician.  Dr. Lovelace and the staff will go through your list of medication, and let you know what exactly you need to do with those medications preoperatively.  Make sure that you bring all of your medications with you to your consultation.  You will usually be given your prescriptions for your postoperative medication on your preoperative visit so that they can be filled and at your house when you get home from surgery.

Will I need clearances from any other physicians?

Depending on your age and medical issues, Dr. Lovelace and her staff will set you up with your primary care physician, cardiologist, etc. for clearance prior to your surgery.  At that time any necessary labs, EKGs, or chest x-rays will be done.

What is the recovery?

Sutures are typically dissolvable.  You may have drains depending on the amount of resection.  These are removed once the output is decreased which is typically a week after your procedure.  The majority of patients take about a week off work, but your needs will need to be determined on an individual basis. Most swelling, bruising, and soreness is gone within 6-8 weeks.  The scar will continue to flatten and fade between 3 months to 2 years.  You will be asked to wear a compression garment usually for 6-8 weeks.

What are the risks?

The risks of gynecomastia surgery include bleeding, infection, scarring, hematoma, seroma, possible need for drains, dehiscence, contour irregularities, asymmetry, poor cosmesis, need for further intervention, weight gain/loss can change result, numbness/hypersensation, intra-thoracic injury, nipple/skin necrosis, fat necrosis, scar tissue, nipple inversion, cancer in resection specimen, recurrence of gynecomastia, cardiac/pulmonary/stroke/DVT/PE events, death, etc.