|
| |
Gynecomastia - Correction of
Enlarged Male Breasts
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.
Many men have gynecomastia --
enlarged, female-like breasts--causes
by excess glandular tissue or fat
(or both).
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.
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.
Glandular tissue must be cut out,
usually through a small incision
near the edge of the areola.
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.
Fatty tissue can be removed by
liposuction. A small, hollow tube
is inserted through a tiny incision,
leaving a nearly imperceptible scar.
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.
Following surgery for gynecomastia,
the patient has a more masculine
chest contour.
|