Gynecomastia

In some men, the volume of the breasts is affected by an excess of mammary tissue and accumulated fat. This condition can cause embarrassment, social inhibition and self-consciousness for those who suffer from it.

 If you think that you have this condition you should consult your physician to rule out more serious conditions such as liver or endocrine disease. If you are otherwise healthy, breast reduction surgery may significantly help your appearance and self-image.

This procedure is used to remove fat and/or glandular tissue from the breasts. In extreme cases, skin is removed as well. The result is a flatter, firmer, more masculine-looking chest.

Depending on the patient’s specific case, the volume of the breasts can be reduced with Liposuction or with Areola incision. In both instances, a small elliptical incision is made on the lower half of the nipple area. These procedures are done with local anesthesia and sedation.

For those men with tissue that is more glandular in nature, all breast tissue directly under the nipple is removed. This can improve the appearance of the chest in cases where diet and exercise have failed.

On the other hand, if the patient shows more fat excess then Liposuction is indicated.  During this procedure, a 3mm cannula is used to extract the fat. Liposuction is a cosmetic procedure where unwanted fat deposits that are sometimes resistant to diet and exercise are removed from areas of the body. This procedure results in a more masculine chest contour.

BEFORE THE SURGERY:

  • Send pre-evaluation photographs.
  • Schedule an appointment with Dr. Fournier. During this office visit you may ask him any questions you might have about the surgery.
  • Have a complete medical check up, an electrocardiogram and laboratory blood and urine tests; including a complete blood count, partial thromboplastin time, prothrombin time, platelets, and HIV.
  • Take antibiotics such as Augmentin 500mg (one capsule three times a day with each meal), Cipro or Ceclor 500mg (one capsule twice a day with a full breakfast and dinner) two days before, the day of, and seven days after the surgery.
  • Inform Dr. Fournier of your daily vitamin and medication intake.
  • Notify Dr. Fournier if you develop a cold or flu a week before your surgery.
  • Please avoid: Aspirin, more than 500mg of Vitamin E, ginkgo biloba, ginseng and blood thinners for two weeks before your surgery. Also avoid alcohol intake and smoking (primary and secondary) for a month before and a month after the surgery, as nicotine and alcohol delay and might even complicate your healing process.

THE DAY OF THE SURGERY:

  • Please brush your teeth, but do not eat or drink coffee or tea. Only fruit juice with your antibiotic.
  • Please remove your contact lenses or dentures before the surgery. Do not wear make up or apply moisturizer to your eyes or face. 
  • The evening and the morning before your surgery, clean the area to be operated on with soap and water.
  • Please do not bring any jewelry or valuables to the Hospital. 
  • Please wear a robe, housecoat or tracksuit that buttons or zips in the front and flat shoes after the surgery. No tight-fitting clothes.
  • Someone will have to drive you home, to your Hotel or Recovery Home.

* Post-operative instructions regarding activity, medications and office visits will be given to you after your surgery.

AFTER THE SURGERY:

  1. To relieve pain and reduce swelling, place ice cubes or crushed ice in a plastic bag, cover it with a towel (to avoid burning the skin) and place over the breast area.
  2. Take oral antibiotics: Azithromycin (Zithromax) 500mg (once a day), Ceclor 500mg or Cipro 500mg (twice a day), Augmentin 500mg (three times a days). They should be taken with fruit juice at breakfast and dinnertime or with each meal, starting two days before, the day of, and for 8 more days after surgery. (TOTAL: 10 days)
  3. For pain take Tylenol or Winasorb every 4-6 hours. Feldene Flash is prescribed in cases where a stinging or pinching feeling is present.
  4. Following the surgery, some patients develop a slight afternoon fever (1°C) for three to five days.
  5. Patients can shower once a day and should follow a healthy low-fat diet with fruit, vegetables, fish and skinless chicken.
  6. Internal bleeding is a rare complication which produces pressure and localized pain. If the condition is severe it is called hematoma or seroma. Drains are used to extract the accumulated blood, and are removed after one or two days. To prevent internal bleeding avoid physical exertion, smoking, alcohol, aspirin, products containing aspirin, and sun exposure for at least two-four weeks, preferably before and after surgery.
  7. Please consider that each side of our bodies is different from the other, and as a result the size of the breasts after surgery is always different.
  8. Remember that swelling reduces with time. Normal areola and nipple sensation will be recovered six to twelve months after surgery.      
  9. Bruising lasts around 3 to 4 weeks if liposuction was performed.

If after the procedure one breast remains noticeably larger, outpatient liposuction under local anesthesia may be required. It is recommended to have it done one year after surgery.

The results of these procedures are significant and permanent, and most men are very satisfied with the outcome. Patients do not complain of significant post operative pain. Some report feeling a stinging or pinching sensation in cold weather. Use warm garments with slight pressure over the breast area to ease such discomfort and avoid catching a cold.

PLEASE AVOID:

  • Stress and anxiety
  • Bending over or sudden arm movements

For one month after the surgery: Alcohol, smoking, exercise, aspirin, products containing aspirin, Vitamin E, saunas, sun exposure and showering or bathing with hot water

Arnoldo Fournier M.D., F.A.C.S. ©

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