Before & After

15 y/o male who mild gynecomastia with minimal fatty tissue that was reduced with excision of the glandular tissue with a periareolar incision. The patient is shown here 6 months after surgery.

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Gynecomastia

Many men have enlarged breasts which is commonly called gynecomastia. It can be the result of some medications, hormones or genetics. Excessive alcohol use, tobacco use, marijuana use and anabolic steroid use can also lead to gynecomastia. Gynecomastia can cause physical as well as emotional problems. Surgical reduction of the breasts may result in a more masculine contour of the upper body and a better self image. Surgery may just remove excess fat or glandular tissue and may involve removing excess skin in some patients.

What should I expect from the consultation?

The first step in having this surgery of course is the initial consultation. During this meeting I will discuss your condition as well as any other medical conditions and medicines that might affect the surgery. The different options for male breast reduction surgery will be discussed as well as possible complications.

How is breast reduction surgery performed?

There are several techniques available for male breast reduction. The method used depends upon the amount of glandular tissue and excess skin. The surgery is performed with you under a general anesthesia typically at an outpatient surgery center. Frequently the reduction can be done using only liposuction. This technique works best if the breasts are not very glandular (firm) and you have minimal excess skin. If the tissue is glandular in nature a small incision along the lower border of the areola (dark skin around the nipple) can be used to excise the glandular tissue. If a lot of excess skin is present larger incisions will be necessary to excise the loose skin.

The majority of patients have no complications. The most common is fluid collection in the wound and delayed healing of an incision. It is very important to not smoke at least 2 weeks before and after the surgery.

What can I do to prepare for surgery?

• Do not smoke for two weeks before and after your surgery.
• Avoid medications that can cause bleeding (aspirin, ibuprofen, Advil, Nuprin, etc) for about 10 days before the surgery.
• Arrange for help or special care following surgery.

Post-Operative Information

Day of Surgery

After your surgery you will spend 1-2 hours in the recovery room and then you may be discharged home. A few patients wish to spend the night in the hospital and this can sometimes be arranged with your insurance company. You will be given prescriptions to get filled. You will need someone to drive you home. Sleep with several pillows behind you to keep your head and chest elevated. There will be a mildly compressive garment over the breast area to help reduce swelling. Ice packs may be used during the first 24 hours if you wish. You will need someone to pamper you this first day, as you will be sore.

Day 1 After Surgery

You may take the garment and all dressings off your chest and shower. No dressings need to be put back on unless there is a little drainage. You may then wish to wear a sports bra or replace the garment; whichever is most comfortable. Do as little as possible around your house. Lift nothing over 5-10 pounds. Do not bend over to pick things up.

Days 2-7 After Surgery

You will slowly feel better with discomfort gradually improving. The breasts will be swollen and may have some areas of bruising. You may gradually increase your activity, but still no bending over and lifting over 10 pounds. You will be asked to come to the office about 7 days after your surgery for suture removal. Do not drive as long as you are taking pain pills. Most patients are already feeling much relief of their symptoms of neck and back pain at this time.

After 1st Week

Pain and swelling continue to improve. Some people feel up to working, doing light activities only, after the 1st week Gentle sexual activity may be resumed. You will be asked to come back to the office about 2 weeks after suture removal for a follow-up visit.

After 1st Month

You may resume most activities but still no heavy lifting. Mild exercise programs may be resumed. You will be asked to come back to the office for another follow-up visit about 7-8 weeks from the date of your surgery. The time needed off work varies from patient to patient and by what work you do. Many patients can return after 2 weeks to light duty and most all patients can return by 1 month.

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