Though some drugs and medical conditions have been linked with male breast enlargement, there is no known cause for this condition whose name derives from the Greek word for “women-like breasts.” Up to 60% of the male population may be affected by Gynecomastia and it may affect one or both breasts.
There are two types of Gynecomastia: primary and secondary. Primary Gynecomastia usually develops during puberty. There is no underlying cause for primary Gynecomastia. Secondary Gynecomastia develops because of some underlying cause. Causes of secondary Gynecomastia are obesity and the use of certain drugs such as steroids, alcohol or marijuana.
If a patient is obese, drinks alcohol in excess, smokes marijuana or takes steroids, they will be discouraged from having surgery and asked to stop using these drugs to see if breast fullness is reduced.
In the treatment of primary Gynecomastia, once your surgeon knows how much fat and glandular tissue is within the breasts, he or she can choose a surgical approach to best suit your needs.
The best candidates for this surgery have firm, elastic skin that will reshape itself to a new contour after surgery.
Preparing for Surgery
2 Weeks before surgery
- Avoid all aspirin containing products, all anti-inflammitory medications (ie: Ibuprophen such as Advil or Motrin), all products containing 400 IU's of vitamin E and all herbal products. These products can increase bleeding both during and after surgery and may lead to increased post-operative bruising, swelling and recovery time.
- Stop or at least cut down on smoking. Smoking constricts small blood vessels causing delayed healing, increased scarring and increased recovery time.
- Begin taking a multivitamin tablet daily, which can speed healing and shorten recovery time. It is recommended to continue your multivitamin for one month following surgery.
- Arrange for transportation to and from surgery. You must have someone responsible pick you up and remain with you for a minimum of 24 hours. You cannot take a taxi home on your own.
- It is recommended to restrict activity for approximately 2 weeks following surgery. It is advisable to make arrangements for assistance.
- Avoid dental appointments 2 weeks prior to your surgery as well as 2 weeks post operatively.
- Arnica capsules or pellets can be taken orally starting 2 days before surgery and can continue for 5 days post op. This homeopathic medication can assist in decreasing bruising and swelling due to surgery.
24 hours before surgery
- Avoid alcohol or smoking.
- Nothing to eat or drink after midnight the night before your surgery (no water, no gum). If surgery is booked after 12 noon, clear fluids may be allowed up to 6 hours before surgery (ie: black coffee/tea, clear juice, water). Our nurse will advise you on this when you are given your time for surgery.
Day of surgery
- Wear loose, comfortable button-up/zipper clothing (ie: jog suit, slip on shoes).
- Leave valuables at home (remove contact lenses, jewellery or piercing of any kind).
- Take any regular prescribed medications (ie: blood pressure medications) with a small amount of water.
Surgery for Gynecomastia is most often performed as an outpatient procedure. The surgery itself takes about an hour and a half.
Correction of enlarged male breasts may be performed under general, or local anesthesia plus sedation. Dr. Waslen will discuss with you which option is best for you.
The surgery to correct male breast enlargement removes fat and/or glandular tissue from the breasts. Rarely, if necessary, excess skin may also be removed.
The surgery is usually performed using a small incision near the nipple that permits the excess tissue to be removed. Liposuction is often performed around the edges of the breast to ensure a smooth, natural-looking final result.
In extreme cases where large amounts of fat or tissue are removed, the skin may not adjust well to the breast contour. In this case, excess skin may be removed to allow the breast to adjust to its new shape.
To help reduce swelling, you will probably be advised to wear an elastic pressure garment for a week or two after surgery.
- Some pain and nausea can be expected. This can be relieved with anti-pain and anti-nausea medications. Take them as directed. If you are coming from out of town, please have these medications with you.
- Begin taking antibiotic medication once home from surgery and continue until the prescription is finished.
- Any bandages worn post-operatively should be comfortable and not too tight. Adjust as necessary.
- Use cold compresses 20 min on and off during waking hours. Use a facecloth soaked in ice water and drape over face. Never place ice directly on skin.
- Maintain a regular fluid intake during the day. Gatorade is a good option. Restrict fluids after supper; increased fluid intake will increase swelling.
- Rest is important to minimize pain, nausea and swelling.
- Try to maintain an upright sitting position at all times (ie: 25-45 degree angle) for the first 2-7 days post-op. This will assist in the reduction of post-operative swelling and speed healing time.
- Begin a light nutritional regime and increase food intake as tolerated.
- Take anti-pain medications with food to avoid an upset stomach. Begin taking antibiotic medication once home from surgery and continue until prescription is finished. Eat yogurt while taking antibiotics. If diarrhea occurs, stop antibiotics and call our office for further direction.
Call (403) 228-1313 if you have any questions or concerns.
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Post-operative Day 1
- You may remove your binder and shower if you wish. Remove all gauze, but leave the white skin tapes intact for approximately 2 weeks post-op (you may notice a blister near the tape area, polysporin can be applied over the tapes as needed).
- Be aware of any unusual swelling or a sudden increase in pain. If either of these are noted, phone the office as soon as possible.
- Continue to maintain a regular fluid intake during the day, decrease after supper.
- Continue to maintain an upright position.
- Use cold compresses for 72 hours to decrease swelling (ie: ice cubes or ice chips in a bowl of cold water with facecloths).
- Be aware of decreased skin sensation. Do not apply excessive heat or cold to the operative areas.
- Do not smoke.
- Rest as much as possible.
- A nurse will call you by noon to assess how you are doing. At this time, you will be given further post-operative instructions as well as an appointment for your first post-operative visit.
Post-operative Days 2-7
- Gradually increase your activity level after 7 days post-operatively. As individuals, everyone's post-operative healing phases will differ. Generally speaking, gentle exercise may resume at 10 days with moderate exercise resuming after 3 weeks. It is advisable to abstain from a full exercise regime until 6 weeks post-operatively.
- Scar tissue (firmness or hardening of operative tissues) may increase up to 6 weeks with the resultant softening of the tissues.
- Approximately 75% of swelling will diminish within 3 - 4 weeks. Any remaining swelling can take from 6 months to 1 year to absorb.
- Best results are usually not seen until 3 months following surgery.
- The final stages of healing are usually not complete until 1 year post-operatively.
Risks & Safety Information
Complications related to surgery are infrequent and usually minor. The risks associated with this surgery are: infection, excessive bleeding, and excessive fluid loss or accumulation. Noticeable scars can also result from this surgery as can permanent pigment changes in the breast area, or asymmetrical breasts or nipples. If asymmetry is significant, a second procedure may be performed.
The temporary effects of gynecomastia surgery include numbness which may last up to a year.
Every surgical procedure involves a certain amount of risk. It is important that you understand the risks involved with this procedure. An individual's choice to undergo a surgical procedure is based on the comparison of risk to potential benefit. Although the majority of patients do not experience these complications, you should understand the potential complications.