A word about breast reduction in men...
Gynecomastia is a medical term that comes from the Greek words
for "women-like breasts." Though this oddly named condition
is rarely talked about, it's actually quite common. Gynecomastia
affects an estimated 40 to 60 percent of men. It may affect
only one breast or both. Though certain drugs and medical problems
have been linked with male breast overdevelopment, there is
no known cause in the vast majority of cases.
For men who feel self-conscious about their appearance, breast-reduction
surgery can help. The procedure removes fat and or glandular
tissue from the breasts, and in extreme cases removes excess
skin, resulting in a chest that is flatter, firmer, and better
contoured.
If you're considering surgery to correct gynecomastia, this
brochure will give you a basic understanding of the procedure--when
it can help, how it's performed, and what results you can expect.
It can't answer all of your questions, since a lot depends on
your individual circumstances. Please be sure to ask your doctor
if there is anything about the procedure you don't understand.
THE BEST CANDIDATES FOR GYNECOMASTIA
CORRECTION
Surgery to correct gynecomastia can be performed on healthy,
emotionally stable men of any age. The best candidates for surgery
have firm, elastic skin that will reshape to the body's new
contours.
Surgery may be discouraged for obese men, or for overweight
men who have not first attempted to correct the problem with
exercise or weight loss. Also, individuals who drink alcohol
beverages in excess or smoke marijuana are usually not considered
good candidates for surgery. These drugs, along with anabolic
steroids, may cause gynecomastia. Therefore, patients are first
directed to stop the use of these drugs to see if the breast
fullness will diminish before surgery is considered an option.
ALL SURGERY CARRIES SOME UNCERTAINTY
AND RISK
When male breast-reduction surgery is performed by a qualified
plastic surgeon, complications are infrequent and usually minor.
Nevertheless, as with any surgery, there are risks. These include
infection, skin injury, excessive bleeding, adverse reaction
to anesthesia, and excessive fluid loss or accumulation. The
procedure may also result in noticeable scars, permanent pigment
changes in the breast area, or slightly mismatched breasts or
nipples. If asymmetry is significant, a second procedure may
be performed to remove additional tissue.
The temporary effects of breast reduction include loss of breast
sensation or numbness, which may last up to a year.
PLANNING YOUR SURGERY
The initial consultation with your surgeon is very important.
Your surgeon will need a complete medical history, so check
your own records ahead of time and be ready to provide this
information. First, your surgeon will examine your breasts and
check for causes of the gynecomastia, such as impaired liver
function, use of estrogen-containing medications, or anabolic
steroids. If a medical problem is the suspected cause, you'll
be referred to an appropriate specialist.
Your plastic surgeon may, in extreme cases, also recommend
a mammogram, or breast x-ray. This will not only rule out the
very small possibility of breast cancer, but will reveal the
breast's composition. Once your surgeon knows how much fat and
glandular tissue is contained within the breasts, he or she
can choose a surgical approach to best suit your needs.
Don't hesitate to ask your surgeon any questions you may have
during the initial consultation- including your concerns about
the recommended treat- ment or the costs involved. Treatment
of gynecomastia may be covered by medical insurance--but policies
vary greatly. Check your policy or call your carrier to be sure.
If you are covered, make certain you get written pre-authorization
for the treatment recommended by your surgeon.
PREPARING FOR YOUR SURGERY
Your surgeon will give you specific instructions on how to
prepare for surgery, including guidelines on eating, drinking,
and taking certain vitamins and medications.
Smokers should plan to stop smoking for a minimum of one or
two weeks before surgery and during recovery. Smoking decreases
circulation and interferes with proper healing. Therefore, it
is essential to follow all your surgeon's instructions.
WHERE YOUR SURGERY WILL BE PERFORMED
Surgery for gynecomastia is most often performed as an outpatient
procedure, but in extreme cases, or those where other medical
conditions present cause for concern, an overnight hospital
stay may be recommended. The surgery itself usually takes about
an hour and a half to complete. However, more extensive procedures
may take longer. |
Many men have gynecomastia -- enlarged,
female-like breasts--causes by excess glandular tissue or fat
(or both).
Glandular tissue must be cut out, usually through a small incision
near the edge of the areola.
Fatty tissue can be removed by liposuction. A small, hollow
tube is inserted through a tiny incision, leaving a nearly imperceptible
scar.
Following surgery for gynecomastia, the
patient has a more masculine chest contour.
|
TYPE OF ANESTHESIA
Correction of enlarged male breasts may be performed under
general, or in some cases, under local anesthesia plus sedation.
You'll be awake, but very relaxed and insensitive to pain. More
extensive correction may be performed under general anesthesia,
which allows the patient to sleep through the entire operation.
Your surgeon will discuss which option is recommended for you,
and why this is the option of choice.
THE SURGERY
If excess glandular tissue is the primary cause of the breast
enlargement, it will be excised, or cut out, with a scalpel.
The excision may be performed alone or in conjunction with liposuction.
In a typical procedure, an incision is made in an inconspicuous
location--either on the edge of the areola or in the under arm
area. Working through the incision, the surgeon cuts away the
excess glandular tissue, fat and skin from around the areola
and from the sides and bottom of the breast. Major reductions
that involve the removal of a significant amount of tissue and
skin may require larger incisions that result in more conspicuous
scars. If liposuction is used to remove excess fat, the cannula
is usually inserted through the existing incisions.
If your gynecomastia consists primarily of excessive fatty
tissue, your surgeon will likely use liposuction to remove the
excess fat. A small incision, less than a half-inch in length,
is made around the edge of the areola--the dark skin that surrounds
the nipple. Or, the incision may be placed in the underarm area.
A slim hollow tube called a cannula which is attached to a vacuum
pump, is then inserted into the incision. Using strong, deliberate
strokes, the surgeon moves the cannula through the layers beneath
the skin, breaking up the fat and suctioning it out. Patients
may feel a vibration or some friction during the procedure,
but generally no pain.
In extreme cases where large amounts of fat or glandular tissue
have been removed, skin may not adjust well to the new smaller
breast contour. In these cases, excess skin may have to be removed
to allow the removing skin to firmly re-adjust to the new breast
contour.
Sometimes, a small drain is inserted through a separate incision
to draw off excess fluids. Once closed, the incisions are usually
covered with a dressing. The chest may be wrapped to keep the
skin firmly in place.
AFTER YOUR SURGERY
Whether you've had excision with a scalpel or liposuction, you will
feel some discomfort for a few days after surgery. However, discomfort
can be controlled with medications prescribed by your surgeon. In
any case, you should arrange to have someone drive you home after
surgery and to help you out for a day or two if needed.
You'll be swollen and bruised for awhile--in fact, you may wonder
if there's been any improvement at all. To help reduce swelling, you'll
probably be instructed to wear an elastic pressure garment continuously
for a week or two, and for a few weeks longer at night. Although the
worst of your swelling will dissipate in the first few weeks, it may
be three months or more before the final results of your surgery are
apparent.
In the meantime, it is important to begin getting back to normal.
You'll be encouraged to begin walking around on the day of surgery,
and can return to work when you feel well enough--which could be as
early as a day or two after surgery. Any stitches will generally be
removed about 1 to 2 weeks following the procedure.
Your surgeon may advise you to avoid sexual activity for a week or
two, and heavy exercise for about three weeks. You'll be told to stay
away from any sport or job that risks a blow to the chest area for
at least four weeks. In general, it will take about a month before
you're back to all of your normal activities.
You should also avoid exposing the resulting scars to the sun for
at least six months. Sunlight can permanently affect the skin's pigmentation,
causing the scar to turn dark. If sun exposure is unavoidable, use
a strong sunblock.
YOUR NEW LOOK
Gynecomastia surgery can enhance your appearance and self-confidence,
but it won't necessarily change your looks to match your ideal. Before
you decide to have surgery, think carefully about your expectations
and discuss them frankly with your plastic surgeon.
The results of the procedure are significant and permanent. If your
expectations are realistic, chances are good that you'll be very satisfied
with your new look. |