Male Breast Removal ( Gynecomastia )
Excessive breast tissue in a male is called Gynecomastia, and this can develop during puberty or later in life. It may be related to weight gain or normal hormonal changes, but some underlying abnormal hormonal causes must be considered. For these men the presence of breasts is a source of embarrassment, and surgical removal with minimal scarring is the best alternative.
Gynecomastia surgery reduces both fat and breast tissue, and improves definition of the chest. By removing overlying abnormal tissue, the underlying chest (pectoral) muscles can be better seen, and work-out of these muscles will produce noticeable results that would otherwise be hidden behind fat. With the exception of the inconvenience of having to wear a compression binder over the chest for 4 weeks, the recovery is usually very easy, and most patients have very little discomfort. The results are immediate and long lasting.
The procedure is done under general anesthetic or intravenous sedation as day surgery. The operation takes about 1.5 hours, and you need to stay for about 2 hours after surgery for recovery. After you are asleep, but before beginning surgery, Dr. Goldberg injects a long acting local anesthetic in order to prevent sensitization of pain nerves and minimize discomfort after surgery. The procedure has 2 components. The first part involves the use of Liposuction to remove the fat tissue from the breast and chest area. Once the fat is removed, the second part involves cutting out the extra breast tissue, which is too dense and fibrous to be suctioned out with the liposuction. The excision of breast tissue is done through an incision just along the border of the nipple-areola at the edge between the dark and light tissue. This helps to camouflage the scar. For some patients with very excessive Gynecomastia some excision of skin is required a well, and this may require a scar that extends onto the chest. Very few patients need this. At the end of surgery a tight dressing is applied that wraps around the chest and compresses the area of the surgery.
You will be able to go home the same day of surgery. Dr. Goldberg prescribes several medications to ensure your comfort. These usually include Celecoxib and Percocet to control inflammation and pain, and an antibiotic to help prevent infection. You will need to keep the dressing on for 1 week until you return for a follow-up visit. You can return to light activity right away. However, you must wear a tight binder around your chest and avoid strenuous activity for 4 weeks after surgery.
There are general risks with Gynecomastia surgery such as bruising, bleeding, infection, and risks associated with general anesthetic. There are also some specific risks. There can be collection of blood or body fluid in the area of surgery. This may require drainage with a needle, or very rarely even further surgery in the worst case. If a patient gains weight in the future, there will also be weight gain in the chest. However, no new breast tissue will ever grow where it has been removed. Most often sensation of the nipple is unchanged, but there can be some decrease in sensation, though this is usually temporary. Other more minor risks can be discussed with Dr. Goldberg.
For some very rare causes of Gynecomastia hormonal treatment or other surgery may be needed. For the vast majority of cases there is no non-surgical alternative. For some cases liposuction alone may be adequate.
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