Male Gynaecomastia Repair

Surgery to restore gynecomastia aims to reduce the increased size of the male breast and improve its aesthetic appearance.

Medically, gynecomastia should be separated from the simple presence of excess fat or skin on the male breast, although the surgical approach is the same.

Gynecomastia is a medical condition that causes the breasts to swell and increase in size.

The growth varies from a small amount of extra tissue around the nipples to several protruding breasts that look like a woman's breast.

It can affect one or both breasts.

The most common causes of gynecomastia are

• Hormone imbalance is usually between testosterone and the small amounts of estrogen that men normally have. If for some reason the amount of estrogen increases or the amount of testosterone decreases, the excess estrogen causes the breast tissue to grow
• Obesity, which is sometimes also the cause of elevated estrogen levels
• Medication side effects - such as anti-ulcer drugs or medicines for heart disease
• Illegal drugs - such as cannabis or anabolic steroids
• Excessive alcohol
• Kidney failure or liver disease
• Klinefelter Syndrome (rare genetic disorder)
• Diseases or infection of the testicles

Normal gynecomastia

Gynecomastia can affect newborn boys because estrogen is passed from the placenta from mother to baby. This is temporary and will disappear a few weeks after the baby is born.

During adolescence, boys' hormone levels vary. If testosterone levels fall, estrogen can cause breast tissue to grow. Gynecomastia in adolescence usually does not need treatment as as boys grow older and their hormone levels stabilize in normal proportions.

Also as men get older, they produce less testosterone. Older men also tend to have more body fat and this can cause them to produce more estrogen. These changes in hormone levels can lead to overgrowth of breast tissue.

Gynecomastia should have been diagnosed by ultrasound, a hormonal test should have been performed and the cause should be determined.

The reason is that sometimes medication is enough to correct the problem, while other times if not treated properly the gynecomastia will recur even after surgery.

• Adults whose breast development is complete
• Relatively normal body weight without fluctuations
• You are healthy without significant health problems
• If you are not a smoker or intend to follow smoking cessation instructions preoperatively and postoperatively
• You have realistic expectations and you understand what this surgery can offer you

During a breast augmentation test you should be prepared to discuss:

• Why do you want to have gynecomastia surgery, your expectations and the end result that you would consider desirable.
• Medical problems you may have, drug allergies and previous surgeries and medical treatments
• List of medications, vitamins, and supplements you use. Also tell your doctor if you use alcohol, tobacco, or drugs.
• Results of ultrasound, mammograms or previous biopsies on your breast.

Medical examination

Includes palpation of the breasts and axillary lymph nodes and examination of previous imaging examinations (ultrasounds, mammograms, etc.)

Assess your general health and identify any risk factors for surgery.

Aesthetic assessment - Measurements

The doctor will take various measurements of the breasts, their symmetry, the position of the nipples and in combination with your own wishes will suggest the appropriate technique in order to return the size to normal.

At preoperative visits it is important to understand all aspects of gynecomastia surgery

You are expected to be somewhat anxious or excited about your expected new look.

Do not be ashamed to discuss these feelings with your plastic surgeon.

From our experience the best results result if there is good communication and trust develops between doctor-patient

Your safety in the operating room is a top priority for us.

• You will need to have general blood tests, ultrasound and / or mammograms.
• If you are over 40 or have a health problem you may need a chest x-ray, electrocardiogram or some more specialized tests.
• If you have a chronic illness you may need to see your doctor or adjust the doses of the medicines you are taking.
• Smoking cessation at least 2 weeks before surgery.
• Avoid taking aspirin and certain anti-inflammatory drugs and other medications as they may increase bleeding during surgery.
• You will be given a list of medications, supplements and foods we recommend to avoid preoperatively.
• Stop taking drugs because they may interact dangerously with the drugs that will be used in the operating room.

Anesthesia

Options include local anesthesia, intravenous sedation and general anesthesia. Your doctor depending on the size of the problem will recommend the best option for you.

Liposuction

It is applied in cases where gynecomastia is mainly the result of excessive concentration of adipose tissue rather than fibrous and cystic elements.

This is done through small incisions with the help of special cannulas and vacuum suction.

The few fibrous elements that will be present through these small incisions may need to be removed.

Breast reduction surgery

It is an indication in cases where there is enough fibrous and cystic elements (as in most cases)

The amount of fat / mammary gland and excess skin will determine which technique is most appropriate.

A combination of liposuction & breast reduction surgery techniques is also mainly used to normalize the breast contour and more normal results.

All the necessary measures will be taken for the best possible appearance of the postoperative scar (good surgical technique, fine sutures, special creams, preventive instructions, and if necessary laser treatment)

For best results it is necessary to use a special patch as a vest for 1 month after surgery.

The decision for any plastic surgery is personal and should be made by weighing the benefits of achieving your main cosmetic goals and the risks and possible complications of surgery.

Gynecomastia surgery is usually a very safe operation, however, as with any surgery, there are some unavoidable risks.

You will be asked to sign consent forms to ensure that you fully understand the process and the potential risks and possible complications.

The form we have prepared for you is very detailed, analyzes and explains in depth all the possible risks associated with the operation.

In addition to the analysis in the office, this form will be given to you so that you can study it with more time at your disposal at home and to be able to solve any additional questions that may arise during a second visit to our office.

Some of the risks include:

• Hypertrophic / non-aesthetic scars
• Contamination
• Changes in the aesthetics of the nipples or breast, which may be temporary or permanent
• Risks associated with anesthesia
• Bleeding (hematoma)
• Poor wound healing
• Breast contour and shape abnormalities
• Skin discoloration, permanent pigmentation changes, swelling and bruising
• Breast asymmetry
• Accumulation of fluids
• Possible loss of skin / breast tissue where the incisions meet
• Potential, partial or total loss of the nipple and areola
• Thrombosis, deep vein thrombosis, heart and lung complications, for which you may need hospitalization and additional treatment.
• Pain
• Allergic reactions to strips, sutures and adhesives and drugs
• Small intracranial fat necrosis resulting in palpable hardness in the breast.
• You may need surgery to correct some of the complications

When the operation is completed, a special support patch will be applied to minimize swelling and support the breasts as they heal.

The key to the success of your surgery is to follow exactly the postoperative instructions that will be given to you.

It is important that surgical incisions are not subjected to excessive force, friction or movement during healing.

You usually need to be hospitalized for a few hours after the operation in order to recover from the medications given during the operation.

Mobilization takes place immediately in the first postoperative hours and if your doctor examines you if you feel well you can go home the same day.

In any other case the discharge takes place the next morning.

If you experience shortness of breath, chest pain or an unusual heartbeat, contact your doctor.

You will need to take antibiotics for a week and painkillers for 2-3 days.

The surgical wound should be treated with antiseptic spray until the sutures are removed.

For the best possible aesthetic result, we suggest you wear a special patch for 30-40 days and avoid exercising for the corresponding period of time.

Review is recommended on the 7th, 14th postoperative day and the 1st, 3rd and 6th month

The end results of gynecomastia surgery are permanent in most cases.

However, if gynecomastia is due to the use of certain prescription drugs, medications (including anabolic steroids) or weight gain, you need to be completely free of these substances and stay at a steady weight to maintain your results.

Costs may vary depending on the complexity and estimated duration of the operation.

Expenses include:

• Anesthesia fees - fee of anesthesiologist
• Cost of hospitalization and use of surgical facilities
• Medical examinations, medicines, consumables
• Remuneration of surgeon / assistants

Many health insurance plans cover male gynecomastia surgery.

It is a good idea to ask the insurance company for pre-approval before scheduling surgery.

• Am I a good candidate for gynecomastia surgery?
• How should the operation be done to have the best possible results?
• What are the risks and complications associated with surgery? How often do these problems occur?
• How are complications treated?
• How much recovery period and what help will I need during it?
• What should I do to help get the best results?
• Will the picture change over time?
• What if I continue to take anabolic steroids?
• What if I have fluctuations in my weight?
• What are my options if I am unhappy with the aesthetic result of the surgery in the future?