Gynecomastia

What is gynecomastia?

Gynecomastia is a condition of over-developed or enlarged breasts in men that can occur at any age. The condition can be the result of hormonal changes, heredity, obesity, or the use of certain drugs.

Gynecomastia can cause emotional discomfort and impair your self confidence. Some men may even avoid certain physical activities and intimacy simply to hide their condition.

Gynecomastia is characterized by:

  • Excess localized fat
  • Excess glandular tissue development
  • Sometimes excess breast skin
  • Presence unilaterally (one breast) or bilaterally (both breasts)

What is gynecomastia surgery?

Gynecomastia surgery reduces breast size, flattening and enhancing the chest contours.

In severe cases of gynecomastia, the weight of excess breast tissue may cause the breasts to sag and stretch the areola (the dark skin surrounding the nipple). In these cases the position and size of the areola can be surgically improved and excess skin may be reduced.

Plastic surgery to correct gynecomastia is technically called reduction mammaplasty.

Gynecomastia surgery candidates

Gynecomastia surgery candidates include:

  • Men whose condition cannot be corrected through alternative medical treatments
  • Healthy individuals who do not have a life-threatening illness or medical conditions that can impair healing
  • Non-smokers and non-drug users
  • Men with a positive outlook and specific goals in mind for improving the physical symptoms of gynecomastia
  • Men who are physically healthy and of relatively normal weight
  • Men who have realistic expectations
  • Men whose breast development has stabilized
  • Men who are bothered by the feeling that their breasts are too large

Adolescents may benefit from surgery, although secondary procedures may be needed in the future should breast development continue.

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.

A small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

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 with Dr. Freeman.

Be sure to ask Dr. Freeman specific questions about what you can expect during your individual recovery period.

  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery? When will they be removed?
  • Are stitches removed? When?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?

It’s very important to follow Dr. Freeman’s instructions and attend follow-up visits as scheduled.

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.

Please discuss this with Dr. Freeman before making changes to your prescription medications.

Recovering from gynecomastia surgery at home

If you experience shortness of breath, chest pains, or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment.

Following Dr. Freeman’s instructions is essential to the success of your surgery.

It’s important that the surgical incisions are not subjected to excessive force, swelling, abrasion, or motion during the time of healing. Dr. Freeman will give you specific instructions on how to care for yourself.

Gynecomastia surgery procedure steps

gynecomastia procedure includes the following steps: .

Anesthesia

Medications are administered for your comfort during the surgical procedures. The options include intravenous sedation and general anesthesia. Dr. Freeman will recommend the best option for you.

Liposuction technique

male breast reduction

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

male breast reduction

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

male breast reduction

Sometimes gynecomastia is treated with both liposuction and excision.

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

These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with Dr. Freeman.

Your gynecomastia surgery consultation

During your gynecomastia surgery consultation be prepared to discuss:

  • Your surgical goals
  • Medical conditions, drug allergies and medical treatments
  • Current medications, vitamins, herbal supplements, alcohol, tobacco and recreational drug use (including steroids)
  • Previous surgeries

Dr. Freeman may also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Perform diagnostic testing to determine the underlying cause of gynecomastia; this may include testing of your endocrine function
  • Examine your breasts and may take detailed measurements of their size and shape, skin quality, and placement of your nipples and areolas
  • Take photographs for your medical records
  • Discuss your options
  • Recommend a course of treatment
  • Discuss likely outcomes of gynecomastia correction and any risks or potential complications
  • Discuss the use of anesthesia during your procedure

Be sure to ask questions.

It’s very important to understand all aspects of your surgical prcoedure. It’s natural to feel some anxiety, whether it’s excitement for your anticipated new look or a bit of preoperative stress. Don’t be shy about discussing these feelings with Dr. Freeman.

Preparing for gynecomastia surgery

In preparing for gynecomastia surgery, you may be asked to:

  • Get lab testing or a medical evaluation
  • Take certain medications or adjust your current medications
  • Stop smoking
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

The success and safety of your gynecomastia procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires, and lifestyle.

Male breast reduction surgery may be performed in an accredited, office-based surgical facility, licensed ambulatory surgical center, or a hospital. Be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.