Surgical Procedures - Plastic Surgery For Men

MALE BREAST REDUCTION (GYNECOMASTIA REPAIR)

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Reducing and reshaping male 'breasts' surgically to give a more pleasing appearance.

The medical term 'gynecomastia' comes from the Greek for 'women-like breasts'. This rarely talked about condition is actually quite common affecting an estimated 40 to 60 percent of men to varying degrees. One breast or both may be affected. There is usually no known cause though certain drugs and medical problems are suspected. For men who feel self-conscious about their appearance surgery can help. Fat and/or glandular tissue is removed and, in some cases, excess skin to give a flatter, firmer, better-contoured chest. What can and should be done in your case will depend on a Consultation with your surgeon. However the following introductory paragraphs will, we hope, be helpful.

RIGHT FOR YOU?

Surgery can be performed at any age. The best subjects are healthy, emotionally stable men with firm, elastic skin that will readily take on the new contours. Surgeons may well discourage obese men who have not first attempted exercise and dieting to reduce the fat. Also, individuals who drink alcohol in excess or smoke marijuana are usually not considered suitable for surgery. These drugs, along with anabolic steroids, may cause gynecomastia so the first thing to try is to stop using them.

Some Risk

When this 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 anaesthesia, and excessive fluid loss or accumulation. Surgery may also leave noticeable scars, permanent colour changes in the breast area, or slightly mismatched breasts or nipples. Significant asymmetry may be corrected by a second procedure. A further, usually temporary, effect is numbness in the breast area which may last up to a year.

PLANNING

Your surgeon will need your complete medical history, so please bring this information with you. First, your breasts will be examined and your surgeon will check for causes of the gynecomastia, such as any impaired liver function or use of medications containing oestrogen or anabolic steroids. If a medical problem is suspected you will be referred to an appropriate specialist. In extreme cases a breast X-ray may be needed to rule out the very small possibility of cancer, and to reveal the breast's composition. Knowing how much fat and glandular tissue lies within the breasts, will allow your surgeon to select the techniques that best suit your needs. Discuss treatment and costs fully at this stage. Treatment of gynecomastia may be covered by medical insurance but policies vary greatly. Check your policy or call your insurer to be sure. If you are covered, be sure to get written confirmation from your insurer before any surgery.

PREPARATION

Important and specific instructions will be given on how to prepare for surgery, including guidelines on eating, drinking, and taking certain vitamins and medications. Smokers should plan to stop completely for a minimum of one or two weeks before surgery and during recovery. Smoking decreases circulation and interferes with proper healing.

WHERE?

Our surgeons perform male breast reductions in the operating theatre at the Hurlingham Clinic or in one of the London private hospitals where they serve as a Consultant. The surgery usually takes one to three hours, but may take longer. Many patients are able to go home on the day of the surgery; some remain in the hospital for one or two days.

ANAESTHESIA

Breast reductions for gynecomastia may be performed under local anaesthetic with a sedative to make you drowsy so that you are awake but relaxed. Alternatively, under a general anaesthestic, you sleep through the whole operation. Agree the most suitable technique with your surgeon.

WHAT HAPPENS?

The cause of the breast enlargement will be tissue that is primarily glandular or primarily fatty.

Hurlingham Clinic Male Breast Reduction Fatty tissue can be removed by liposuction alone, usually ultrasound-assisted liposuction, and most patients, in fact, qualify to have their problem treated in this way. A small incision, less than a half-inch long, is made around the edge of the dark skin that surrounds the nipple (the areola) or under the arm . The slim suctioning tube (cannula), attached to a vacuum pump, is inserted into the incision. Then the surgeon moves the cannula carefully through the layers beneath the skin, breaking up the fat and suctioning it out. Patients may feel a vibration or some friction but generally no pain.

Glandular tissue may have to be removed with a scalpel. The incision is made in an inconspicuous location-either on the edge of the dark skin are around the nipple (the areola). Working through the incision, the surgeon removes excess tissue and fat from the breast. These scars are usually very inconspicuous. Major reductions may require larger incisions that result in longer scars. If liposuction is also used to remove fat, the cannula is usually inserted through the existing incisions.

Hurlingham Clinic Male Breast Reduction Where large amounts of tissue have been removed, the skin may not adjust well to the new smaller chest contour and some skin may have to be removed. Sometimes, a tiny drain is inserted to draw off excess fluids. The closed incisions are usually covered with a dressing and the chest may then be wrapped to keep the skin firmly in place while it heals.

Recovery

Post-surgery discomfort will be controlled by prescription medications. However, you should arrange to have someone drive you home after surgery and to help you out for a day or two if needed.

To help reduce the natural swelling and bruising, you will probably be instructed to wear an elastic pressure garment continuously for a week or two, and at night for a few weeks after that. The worst of your swelling will go down in the first few weeks but it may be three months or more before the final results of your surgery become apparent.

As a start to getting back to normal you will be encouraged to begin walking about on the day of your surgery, and you can return to work as soon as you feel well enough. This could be as early as a day or two after surgery. Any stitches will be of the dissolving type and so do not need to be removed.

Hurlingham Clinic Male Breast Reduction Your surgeon may advise you to avoid sex for a week or two, and heavy exercise for about three weeks. You will also be warned to avoid 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 will be able to resume all your normal activities.

You should avoid exposing your scars to the sun for at least six months. Sunlight can affect the skin's pigmentation, causing the scar to turn dark permanently. If exposure is unavoidable, use a strong sunblock.

HAPPY?

Gynecomastia surgery can enhance your appearance and so increase your self-confidence, but it will not necessarily achieve your ideal. So, before you decide on surgery, discuss everything frankly with your surgeon. Provided you are being realistic the chances are you will very pleased with the results.