Gynecomastia or “man boobs” is a very common problem for men, but rarely spoken about. It can affect just one breast or both breasts. The problem usually develops in the early teenage years, but in most cases, it regresses. Unfortunately, some cases do not resolve themselves and can lead to a source of embarrassment and social isolation into adulthood. There are certain medical problems and medications that may cause Gynecomastia, but most patients have no known cause.
We most commonly perform this correction on later teenage boys, but Dr. Harrison has also done a gynecomastia correction on a patient that was 75 years old. He told Dr. Harrison he had been embarrassed about his breast shape for years but was more concerned with raising his family. Interestingly, what motivated him to seek correction at 75 years of age was that he did not want to miss out on the opportunity to swim with his grandchildren. Dr. Harrison individualizes the procedure depending on the patient’s deformity. Sometimes volume can be removed from the breast with liposuction, minimizing the scarring and recovery. More often, Dr. Harrison uses a combination of liposuction and direct excision of breast tissue in order to shape more natural appearing breasts.
What You See- Man boobs are more common than most guys realize. Gynecomastia is the excess proliferation of tissue on the male chest that affects up to 20 percent of all males. The appearance can range from puffy nipples to full-blown female-like breast development. The negative impact on the male psyche is the primary reason for gynecomastia surgery. Treatment of gynecomastia is surgical. There are no non-surgical alternatives that work. The goal is a masculine appearance of the chest and the removal of the offending tissue.
Best Candidate- The best candidate is a male patient who is over 18 years of age, at their best weight, good skin tone and is self conscious about the appearance of his chest. Candidates for this operation need to be emotionally and physically healthy and prepared to take surgical steps to correct the deformity.
Risks & Complications- All surgery carries some uncertainty and risk but when performed by a qualified plastic surgeon, complications are infrequent and usually minor. The common effects of any surgical procedure can be expected and will include: swelling, pain, scarring, bruising, the need to wear a compression garment on the chest and fatigue from anesthesia.
Complications can include: asymmetry, infection, fluid collection/seroma, goals only partially met (may require revisions) and hematoma.
Before Surgery- Prior to your first appointment you will be asked by the staff to register on My Touch MD, watch relevant videos and read information about the procedure you desire. The surgical consultation with Dr. Harrison will take about an hour and he will explain the causes of gynecomastia and what treatment steps will be necessary to achieve your desired look while maintaining a natural appearance post-operatively. A surgical plan and a discussion of your goals will be agreed upon at this time. Photos will be taken, a detailed medical history and physical will be discussed and we always leave time for you to ask questions. After your surgery is scheduled you will have a pre-operative appointment to sign consent forms, review the surgical plan, receive prescriptions, discuss pre/post operative written instructions, have blood work done and make any final payments. You will also be fitted for a surgical compression garment to wear post operatively.
The Surgery- Most male breast reduction is done at the hospital day surgery center and lasts about 2 hours. The vast majority of cases require the use of liposuction and tissue removal with a small incision around the areola. Dr. Harrison may choose to do the surgery in the office under local anesthesia if the deformity is minimal. The sutures are all placed under the skin and will not need to be removed. The compression garment will be placed on immediately post operatively.
After Surgery- You will need to have made prior arrangements for transportation home from the hospital and someone to help with your care. Dr. Harrison will instruct you to limit your arm motion, refrain from heavy lifting and exercise for 4-5 weeks after surgery. Dr. Harrison will see you in the office for a post operative appointment after 2 weeks. The surgical garment is to be worn 24 hours a day except when showering, for 4 weeks. Discomfort can be controlled with medication.
Getting Back to Normal- Swelling and bruising will take a few weeks to dissipate. You will be able to return to work and activity 2-3 days postoperatively depending on the extent of your surgery. You can get back to the gym once you come out of the garment at 4 weeks post-op. The best rule of thumb with activity after surgery is; if it hurts stop doing it.
The Results- After surgery most men enjoy a renewed self confidence, are comfortable taking shirt off, and appreciate feeling more “normal”. The scars are well concealed because they are at the junction between the darker areola and normal skin. Scars usually fade to a thin white line within 6-12 months after surgery. One should avoid anabolic steroid and marijuana use as this contributes to recurrence of gynecomastia. You can expect the results to last a lifetime if you maintain a reasonable weight.
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