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Breast Reduction Male, A.K.A. Gynecomastia
Overview
Another name for enlarged male breasts
is gynecomastia. Ideally, the male breasts are
muscular and well defined. It signifies strength and masculinity. Sometimes, for various reasons, the male breast becomes fatty
and begins to sag. Instead of a healthy masculine look, the
man is left with an unhealthy, out of shape, feminine look.
The causes of this problem range from
hormonal changes, to intake of medications, to genetic predisposition. In fact, it is not uncommon for healthy teenage boys, usually
around 14 years of age, to have this problem for 1 to 2 years. The reason is hormonal and usually goes away after puberty.
Often, the cause of gynecomastia is never
identified. Certain diseases and medications can be the cause
and these need to be looked into by your family doctor. The
medical causes range from deficiency of testosterone to excess
of estrogen. Being overweight can cause too much estrogen
and, therefore, it is highly recommended to lose weight.
Medications that are known to cause gynecomastia
are as follows: Estrogens, digitalis, clomiphene, ketoconazole,
metrondazole, cisplatin, spironolactone, cimetidine, isoniazid,
methyldopa, tricyclic antidepressants, valium, heroin, and
marijuana. Liver problems can also be the cause. These are
the common causes but there are many more possibilities and
only a medical evaluation can determine them with any certainty.
The good news is that with modern plastic
surgery, gynecomastia can be effectively treated so that you
no longer have to be embarrassed to take your shirt off. Normally, gynecomastia is treated with liposuction because
the majority of the breast tissue is fat. If you are relatively
young with good healthy skin, the skin shrinks back after
the fat is removed and a good result is obtained.
Sometimes the gynecomastia is so bad
that liposuction alone will not get rid of the sagging breasts. In these cases, Dr. Cruise must also remove skin in addition
to the fatty tissue in order to obtain the desired results.
Another tool in Dr. Cruise's armamentarium
to treat gynecomastia is ultrasonic liposuction. This is
particularly useful when the excess tissue is very hard and
fibrous. The ultrasonic liposuction does a great job in removing
this type of tissue.
 Dr. Cruise's philosophy regarding Breast Reduction Male
 Male breast enlargement, or gynecomastia, can seriously affect the psyche of a man. The reality is, breasts are for women and should only be on women's bodies. The good news is that it can be effectively treated usually without scars. I have found that between using regular liposuction and ultrasonic liposuction, I am able to treat over 90 per cent of men with gynecomastia without visible scars.
One of the important things for the surgeon, who is treating this problem, is to remember that it is important not to take out too much and leave an indentation. All men have some fat and even some breast tissue under the nipple. This must be respected and maintained.
In the event that the breasts are too big, skin as well as fat may need to be removed and this will leave of scars. I am very careful to minimize the scars and place them in positions that are not easily visible.
Often patients with gynecomastia also have other areas of fat collection that are very amenable to liposuction. It is not uncommon to treat these areas at the same time to give an enhanced look. Often, love handles and the abdomen are treated at the same time. This gives a flatter, healthier, more masculine appearance to the entire body.
Benefits
The benefits of male breast reduction
surgery are both physical and psychological. From the physical
perspective, you are able to get rid of those unattractive,
sagging breasts, and allow the more defined pectoralis major
muscles hidden below to show through like they should. From
a psychological perspective, you no longer have to suffer
with the embarrassment of having breasts. You can take your
shirt off in public and not have to worry about being made
fun of.
Another benefit of getting rid of fatty,
sagging breasts is that it allows for shirts to fit much better. After the surgery, you will be able to buy better fitting
shirts and feel confident.
Possible complications
The most common complication after male breast reduction is asymmetry or incomplete removal of breast tissue. It must be pointed out, however, that all breasts have some asymmetry. In men, this asymmetry is usually not noticed but it is present. A male breast reduction, in fact, can do a lot to correct asymmetry but it is unreasonable to expect both breasts to be identical.
Another potential complication is over reduction. Dr. Cruise is careful to prevent this, but, nonetheless, it can happen.
Loss of nipple sensation is possible. In men, this is not usually a problem. Normally, the sensation returns within a few months. Other complications that must be considered, but are possible with any operation, are the risks of infection, wound healing problems, fluid or blood collection, and contour irregularities.
Are
you a good candidate?
The question as to whether or not you
are a good candidate is easier to answer than finding out
the exact cause of the gynecomastia. A good candidate is
simply any man who feels self-conscious about his breasts
or that his looks could be improved if only his breasts were
made smaller. If this problem is treated by a competent plastic
surgeon, like Dr. Cruise, the fat can be effectively and safely
removed.
Remember, gynecomastia is usually not
caused by any serious medical problems. In fact, the cause
is usually never identified. However, it must be emphasized,
that there are some significant medical problems that do cause
gynecomastia and must be looked into. To determine if you
have treatable medical reasons for your gynecomastia you must
see your family doctor. When seeking consultation, it is
important to list all the medications you are taking as well
as providing a complete medical history.
Prior to surgery
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Medications. Certain medications thin your blood and should not be
taken within 3 weeks of surgery. The most notable is
aspirin and aspirin containing products. Vitamin E and
many herbal products also thin the blood and should not
be used within 3 weeks of surgery. Dr. Cruise will go
over this more thoroughly prior to the procedure.
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Sleep. It is important to get a good night's rest prior to the
procedure. If you think this may be a problem, please,
do not hesitate to ask Dr. Cruise for something to help
to sleep.
-
Smoking. Please do not smoke within 3 weeks before and
after surgery. Smoking has a profound effect on reducing
wound healing capabilities. It significantly increases
the likelihood for infection, wound healing problems,
and scar formation. It also affects your airway, therefore,
making anesthesia much more difficult.
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Eating. Do not eat within 8 hours of surgery and do not drink
within 6 hours of surgery. It is OK to take medications
with a sip of water. Please discuss all medications with
Dr. Cruise and the anesthesiologist.
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Washing. It is a good idea to wash the surgical area thoroughly
the night before and the morning of surgery. This includes
cleaning crevices such as the belly button and any folds
in an effort to prevent infection.
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Arrival. It is best to arrive on time to ensure that things run
smoothly. Please be sure to have someone else drive you.
- State of mind. Remember,
this should be a happy and exciting time. A certain amount
of nervousness is normal but you should not be overly concerned. Cruise and ICRS are well trained and experienced. Excessive
worrying can actually be detrimental and you should discuss
this with Dr. Cruise prior to surgery so that something
can be prescribed to make sure you remain calm.
Anesthesia
ICRS uses only board certified anesthesiologists
to make sure you have the best anesthesia possible. The anesthesiologist
will discuss with you what type of anesthesia is best for
you. He/she will take into consideration your medical history,
the procedure, and your personal wishes.
If only the breasts are being worked
on it is possible to perform the procedure under local anesthesia
if you are willing to tolerate some pain and inconvenience. Usually, it is done under general anesthesia or twilight anesthesia. The choice is up to you. Dr. Cruise will help
you with this decision at the time of consultation.
After
the procedure
The procedure itself will take about
1 to 2 hours.
Immediately. Right
after the operation you will be watched for 1 or 2 hours and
encouraged to walk around. Dr. Cruise is a strong advocate
of good pain relief so you will be given as much pain medication
as necessary both immediately after the operation and for
the next 4 to 5 days. You'll have tape around your breasts
as well as a compressive dressing. Keep this tape and dressing
on until you shower the next day.
That evening. It
is recommended that you take it easy. You can walk around,
eat, but not too much more. It is very important not to move
your arms too much so that bleeding is not started. Aggressive
arm movements should not be done within the first 4 weeks
after the procedure. You should take as much pain medication
as necessary and try to go to sleep early. It is best if
you sleep with your head and chest slightly elevated to promote
proper lymphatic drainage
First
48 hours. You can take a shower the day after. Just
be gentle. Remove the compression dressing and just let the
water run over your chest. Do not move your arms too much. Remember, your chest will be swollen and it will take approximately
3 to 4 months before your skin stretches back. Until the
skin stretches back, it will hang somewhat and be swollen. When you are done with the shower put the compression dressing
back on with a little bit of bacitracin over the incision
and then gauze. The incisions will continue to ooze for about
3 days.
First
week. At about day 3 you can move around normally. Just continue limiting movements of your arms. The majority
of the bruising and swelling will go away in about 2 to 3
weeks.
Beyond. Swelling will not completely resolve for about 6 months but,
as mentioned above, the majority of it will be gone by 3 weeks. You can start moving your arms aggressively at about 2 weeks
at that time you can also start working out with your arms. Skin contraction will not start until about 4 weeks after
the procedure and will continue to contract until about 6
months. The final result will not be evident until 1 year
when all the swelling has resulted and skin contraction is
complete.
Recovery
time
Some people with sedentary jobs go back
to work after 2 days. If your job, however, requires a lot
of aggressive arm movements it may take as long as 2 weeks
to return to work. Most people return to work in about 1
week.
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