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What is Gynecomastia Surgery?
Gynecomastia surgery, also known as male breast reduction, is a procedure designed 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.
Good Candidates for Gynecomastia Surgery
Good candidates for gynecomastia surgery are men struggling to deal with glandular tissue, fat, or excess skin that give the appearance of enlarged breasts. Ideally, men should be in good physical health, be within their ideal weight range, and have realistic expectations. 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.
Choosing to undergo gynecomastia surgery should not come from the influence of others. The procedure is highly individualized to help you achieve your appearance goals. The best candidates for gynecomastia surgery are people with realistic expectations.
Your Gynecomastia Consultation
Dr. Lovelace will ask about your male breast reduction goals. The two of you will have an in-depth conversation about the possible surgical techniques and expected results.
Discuss your complete medical history to make sure an effective and safe procedure can be properly prepared for you. Inform Dr. Lovelace of all allergies and current medications. Be ready to take a few lab tests to confirm your eligibility.
Once you are eligible for the surgery, we will provide special instructions to help you prepare for surgery. It is important to prepare your physical health before considering a gynecomastia procedure. Quit smoking for at least four to six weeks and avoid drinking alcohol for at least 48 hours before the procedure.
What to Expect During the Procedure
The gynecomastia procedure begins with administering general anesthesia or a combination of local anesthesia and sedation. Once the anesthesia takes effect, the patient will be unconscious.
The areas where incisions will be made will be temporarily marked. The surgeon will then begin the procedure. Excess fat, glandular tissue, and/or skin will be removed. Sutures will be used to close the incisions. The whole procedure takes two to four hours.
How much pain will I have?
After the procedure is over, you can expect to experience some degree of discomfort. It varies from person to person, but it can be managed with the help of medication prescribed from a highly skilled plastic surgeon such as Dr. Candis Lovelace.
What will it cost?
The cost of cosmetic surgery varies from person to person depending on the unique needs of each individual. 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. It’s important that you arrange for someone to take you home after the procedure is over to ensure your safety and comfort.
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 embolism. 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 medications, 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?
The sutures used during the procedure 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.
Pain or discomfort may be felt during recovery. Pain-control medication will be prescribed and must be taken as directed. Antibiotics will also be prescribed to prevent infections.
Please have a companion with you during the first 24 hours after surgery. The majority of patients take about a week off work, but your needs will need to be determined on an individual basis. During this initial recovery period, it is highly recommended to restrict movement and get enough rest.
After one week, you can resume desk work. Walking or light exercises can be resumed when cleared. Strenuous activities like running or weightlifting can be resumed after around six weeks.
Expect swelling or bruising. Gently apply a cold compress to reduce swelling. Avoid adding pressure to the newly reconstructed area for a smooth and quick recovery.
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 the 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.
Schedule Your Consultation
If you’re interested in learning more about the steps involved to address gynecomastia, we can walk you through the process during a consultation. Contact our office to schedule your appointment and begin your journey to a flatter, more masculine chest.