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Gynecomastia

Male breast reduction

GinekomastiaGynecomastia is a medical term that comes from Greek words for „women-like breast”. It′s actually quite common and it may affect only one breast or both. Gynecomastia occurs in the adolescence at young boys as well as in male′s menopauses at men at older ages. In both cases we have to deal with overgrowth of gland tissue. The growth of adipose tissue accompanied by obesity can be one of the reasons of gynecomastia at various ages. There is also gynecomastia that occurs together with some genetic diseases as the Klinefelter′s syndrome as well as other diseases related to gender hypoplasia (hypogonadism), endocrinological diseases as well as post alcoholic liver cirrhosis.

Hyperplasia i.e. smooth growth of gland tissue consists in moderate proliferation of the canals, the so called out-taking canals of the breast and the growth of the fibrous tissue. It is commonly believed that the factor responsible for stimulating this process are estrogen circulating in blood or similar to estrogen substances.

For men who feel self-conscious about their appearance, breast-reduction surgery can help. The procedure removes fat 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 information will give you basic understanding of the procedure – how it is performed, and what results you can expect. It can′t answer all of your questions, since a lot depends on your individual circumstances.

Indications

Surgery to correct gynecomastia can be performed on healthy, emotionally stable men of any ages. 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 or smoke, use drugs along with anabolic steroids are usually not considered good candidates for surgery because these 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.

Complications and risks

When male breast-reduction surgery is performed by a qualified surgeon, complications are infrequent and usually minor. These include infection, skin injury, bleeding, reaction to anesthesia, and 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.

Medical consultation

The initial consultation with our surgeon is very important. Our surgeon will need a complete your medical history. First, our surgeon will examine your breast 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 may be referred to an appropriate specialist.

Our surgeon may, in extreme cases, also recommend a ultrasonograph examination, 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 our 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.

Our 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.

The procedure

Surgery for gynecomastia is usually performed as a inpatient procedure, and overnight hospital stay is recommended. The surgery itself takes about an hour and a half to complete. However, more extensive procedures may take longer.

The breast gland in gynecomastia consist of gland and adipose elements and the surgical procedure depends on the excessive amount of one or the other. In the case when adipose tissue is bigger, it is enough to remove the excessive of the tissue by liposuction. However, when gland tissue is bigger, the surgical procedure should consist in removal of the whole gland. In this case liposuction is ineffective.

Nowadays thanks to the advancements in plastic surgery, the surgical treatment of gynecomastia consists in the first stage on suction of adipose tissue and finishes with it if the growth does not refer to gland tissue.

If liposuction is used to remove fat, the cannula is usually inserted through the incisions in submammal fold. 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 – on the edge of the areola or in the under arm area or a small incision in submammal fold. Working through the incision, the surgeon cuts away the excess glandular tissue and form the sides and bottom of the breast.

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 every surgery the removed tissue is examined histopathologically to exclude neoplastic changes.

Recovery time

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 our surgeon.

You will be swollen and bruised for awhile. To help reduce swelling, you′ll be instructed to wear an elastic pressure garment continuously for four weeks. 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.

It 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 one week following the procedure.

Our surgeon may advise you to avoid sexual activity for a week or two, and heavy exercise and spot for about four weeks. In general, it will take about a month before you are 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.

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 our surgeon.

The results of the procedure are significant and permanent. If your expectations are realities, chances are good that you′ll be very satisfied with your new looks.