Gynecomastia

Gynecomastia is a medical term that comes from Greek and it is used to describe “female-like breasts”. Although we do not normally hear about this problem, it is quite common nowadays. It is estimated that about 40-60% of men suffer from gynecomastia. It can affect one or both breasts. The use of certain drugs or medicines can be associated to overdeveloped male breasts; however, in most cases the cause is unknown. For men who worry about their looks, a breast reduction can be very useful. The procedure removes excess fat and glandular tissue, and in some extreme cases, as well excess skin, which results in a flat, firm and well – contourned thorax.

If you are thinking of undergoing a gynecomastia, you will find in this text some basic information about the procedure, such as how it can help you, how it is performed and what results to expect. You will not find the answers to all your questions, as many of them depend on your personal circumstances. You must ask any doubts about the procedure.

The surgery for the correction of gynescomastia can be performed on healthy, mentally stable male patients any age. The best results are obtained when the skin is firm and elastic and it adapts to the new body contour.

The surgery is not advisable on obese or overweight men who have not tried to correct the problem with exercise or diet first. Individuals who drink too much alcohol or who smoke hashish derivatives are not considered good candidates. These drugs, as well as anabolic steroids, can cause gynescomastia. Hence, these patients must try to change their lifestyle to see this can result in the reduction of their breast volume before considering surgery.

When the surgery is performed by a qualified plastic surgeon, complications are rare and generally minor. However, as in any other kind of surgery, there are some risks. These include infections, skin lesions, excess bleeding or the appearance of seromas. The procedure can result in visible scars, alterations in the pigmentation in the area of the breast, or slightly asymmetric breasts and nipples. If the asymmetry is very noticeable, further surgery might be necessary in order to remove additional tissue.

The temporary side effects of breast reduction include the loss of skin sensitivity in the breasts, a condition that can last for a year.

The first visit is very important. You will get a full medical check-up and your breasts will be examined trying to find the reasons for the gynescomastia, which could be impaired hepatic functions, the use of drugs containing estrogens or the use of anabolic steroids. If a health problem is suspected, we will address you to the suitable specialist.

In extreme cases, a mammograph might be advisable. This will not only rule out the small possibility of breast cancer, but also reveal the composition of your breast. Once we know how much fat and glandular tissue there is, we can choose the appropriate surgical technique.

Do not hesitate to ask any question you may have in the first visit, -including those related to any aspect of the diagnose, the treatment or even the cost of the procedure-.

You will be given specific instructions about how to prepare, including instructions about fastening, the adjustment of current medication or the administration of some drugs.

Smokers must refrain from smoking at least one or two weeks before the surgery and during the recovery. Smoking reduces blood circulation and it affects scarring. It is essential to follow the directions if we want the treatment to be successful.

Gynecomastia surgery is normally perfomed on an outpatient basis, but in extreme cases, or when there are special health or social conditionings, the patient must stay in hospital overnight. The surgery normally lasts about one and a half hours. However, it can last longer in some special cases.

The correction of enlarged male breasts can be performed under general anaesthetics, or in some cases under local anaesthesia with sedation. You will be awake, relaxed and feel no pain. Extensive corrections may require general anaesthesia, which allows the patient to be asleep through the procedure. We will discuss with you which option is most appropriate in your case.

If the primary cause for enlarged breasts is excess glandular tissue, it will be removed with the scalpel. This procedure can be performed alone or along with liposuction. In a normal treatment, the incision is made in an inconspicuous area, like the edge of the areola. Through this incision, excess glandular tissue, fat or skin are removed. In more severe cases, the removal of excess tissue may require larger incisions and scars, but it is something very rare. If liposuction is used to remove excess fat, a cannula is usually placed through the existent incisions.

If the gynecomastia is primarily the result of excess fat tissue, liposuction is used to remove it. A small incision –less than 1 cm long- is made in an inconspicuous area. A hollow cannula is inserted and the fat is then broken up and removed by vacuum suction. You may feel vibration or friction, but you will not feel pain.

In extreme cases, when a large amount of fat is being removed, the skin might not adjust well to the new body contour. Then, the excess skin may have to be removed for it to re-adjust properly to the new chest contour.

Sometimes a tube is applied to drain any excess fluid that may collect from the wound. Your thorax will be wrapped in a bandage that will help your skin adapt properly.

Both in liposuction and when the incision is made with a scalpel, you will feel some discomfort for a few days after the surgery, which can be relieved with medication. In any case, be sure to arrange for a responsible adult to help you out for a couple of days.

Your chest will be swollen for some time; at first, you may actually wonder if the treatment has been successful. An elastic bandage will be used to minimize swelling. Although most swelling will dispappear in a few weeks, it might take up to three months or longer until the final result of the procedure becomes noticeble.

Meanwhile, you must go back to routine. You must recover gradually and go back to your usual activity when you feel up to it, usually a couple of days after the surgery. If there are stitches, they will be removed in 1 or 2 weeks.

It is advisable to cut down on physical activity at first, avoiding strenuous exercise for three weeks. Generally, it takes about a month to resume usual physical activity.

You must avoid exposing the scars to the sun for at least 6 weeks. Sunlight might cause permanent alterations of your skin pigmentation, darkening the scars. If sun exposure is unavoidable, make sure to use a sunblock.

The results of the procedure are significant and permament. If you have a realistic outlook, the changes will be satisfactory and you will be happy with your new look.

– Information obtained from www.secpre.org.