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Gynecomastia

Many men suffer from too much chest tissue, or “man boobs.” This can be from a variety of factors including hormonal imbalance, weight fluctuations, tumors, genetics, or even medications. Enlargement of the male breast tissue is relatively common in babies just after birth, during puberty, and again in the retirement age. The extra breast tissue makes many men self conscious about their appearance, even to the point of avoiding certain social situations or clothing choices. If you want to stop suffering from gynecomastia and get back to feeling and looking good, our surgeons can help.

Gynecomastia can have several components including too much skin, breast tissue, or fatty tissue. During your consultation, your surgeon will discuss when the enlargement started, how long it has been present, and how it has varied over time. They will inquire about medication use, weight changes, liver, kidney, and thyroid disease. You may need to have your neck, abdomen, and testicles examined along with the chest area. The breast tissue will be assessed for the amount of fatty to firm tissue, excess skin, asymmetries, and adjacent areas of concern including the outer chest wall and arms. Your surgeon may need to order some additional testing prior to proceeding with surgical correction.

Our surgeons incorporate a variety of techniques as a customized approach to each patient. This includes liposuction, fat grafting, and excisional surgery. Patients with good skin quality and mild fullness may benefit from liposuction only. Other patients with more advanced gynecomastia may need the extra skin excised and the nipples repositioned. Fat grafting to the upper and inner breast can be performed to enhance the pectoralis muscle outline if desired. Compression vests are an important part of the postoperative recovery and will be discussed at your consultation.

QUICK FACTS:

    • Length: 1.5-3 hours
    • Anesthesia: General
    • Overnight stay or Outpatient, same day surgery
    • Recovery: 1-2 weeks
    • Side Effects: Bruising, swelling, numbness, asymmetries.

GYNECOMASTIA SURGERY CAN:

  • Decrease the size and projection of the breasts
  • Remove excess skin of the breast and chest wall
  • Reposition the nipples to an appropriate level
  • Remove firm, fibrous tissue
  • Improve chest wall appearance and patient confidence

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PREPARING FOR GYNECOMASTIA SURGERY:

Smoking and all nicotine cessation is recommended for at least 2-4 weeks prior to this procedure as significant wound healing complications can occur otherwise. This includes e-cigarrettes, patches, and gum.

Any medications and supplements which cause an increased risk of bleeding should also be stopped 2 weeks prior to any major surgery. Please see our list of medications and supplements to avoid. As always, make sure to check with your doctor before stopping any medications.

GYNECOMASTIA TECHNIQUE

In the preoperative area, your surgeon will place detailed surgical markings on your breasts and chest wall for planned liposuction, incisions, and/or fat grafting as appropriate. Procedures are usually performed under general anesthesia. Liposuction will be performed through tiny stab incisions only ¼” to ½” long in the armpit, areola, or breast fold as needed. Any residual firm tissue will be excised through an incision usually hidden along the areola border (pigmented flat part of the nipple complex). A small extension may be needed depending on the size of the areolas. If significant excess skin removal is needed, the nipples may be detached from the chest wall and a mastectomy will be performed. The incisions will be meticulously closed along the breast fold with special absorbable sutures. A medical skin glue will be placed on top of this to seal out bacteria. Thin surgical drain tubes may or may not be placed to help remove any fluid during your healing process. You will be placed in a postoperative compressive vest that needs to be worn at all times other than bathing for the first 2 weeks, and nightly for an additional 2 weeks.

RECOVERY FROM GYNECOMASTIA SURGERY

Gynecomastia surgery is usually performed on an outpatient basis or with an overnight stay if combined with other procedures. Patients will have some discomfort, but typically this procedure is not overly painful. Drainage tubes (if used) are removed within 1-2 weeks when the daily fluid output has decreased to acceptable levels. Plan to take 1-2 weeks off of work. Light exercise can typically be resumed in 2-3 weeks, with return to full activities in 4-6 weeks. It takes a little time for the chest tissues to settle in and the swelling to go down. There will be an immediate improvement noticed, with ongoing maturation over 2-4 months. Our surgeons use special plastic surgery techniques to keep your scars as faint and thin as possible. Most remain quite hidden and fade well within 1 year with ongoing good scar care.

FAQS:

A: Typically not unless performed as a symmetry procedure after a male breast cancer removed from the other breast. Most gynecomastia surgeries are considered cosmetic in nature and performed to improve appearance. Thus they incur out of pocket expenses.
A: Absolutely. Many men choose to have additional liposuction performed elsewhere concurrently. Other common procedures include excision of excess outer chest wall and back skin, as well as an arm lift (brachioplasty).

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