After Gynecomastia Surgery

So many patients ask what happens after a male breast reduction procedure, I prepared a handout listing virtually all the questions that are most frequently asked. (FAQs.)

(I also have a handout instructing patients what to do before surgery.)

After any cosmetic plastic surgery procedure, the main concerns are:

• Infections
• Bleeding
• Fluid collections

The chest is usually – temporarily – swollen and slightly bruised at the surgery site. So you won’t be able to see the results of the surgery right away.

You may also be aware of some numbness, tingling, itching or mild burning that goes away after a few weeks.

Usually, I tell patients their chests will feel like they’ve done a very heavy chest workout like 300 push-ups.

A tight fitting compression vest is vital to stop fluid or pools of blood building up under the skin. Rarely, you may have some surgical drains under the vest.

And here’s where you have to be your own plastic surgeon and make yourself do what’s in your own best interest: wear the compression vest 24 hours daily, seven days a week except for showering.

And we’re talking three to four weeks after surgery. Not to worry; a compression vest fits nicely under your street clothes.

Here are some rare, but possible, post surgery symptoms for which you should get back to me or my staff immediately:

• Severe discharge, redness, tenderness or pain at the surgical site
• One side much more swollen
• Muscle aches beyond soreness
• Nausea
• An overall ill feeling with fever

Most guys are able to go back to sitting activities like desk work in two to three days.

More hardy exercise or sports can usually be resumed after about three to four weeks. But you’ll have to wait three to six months to see the full results of surgery on your chest.

Another rare, possible but totally unpredictable side effect is scar development on the chest or directly under the nipple any time after surgery. I’ll treat those at no extra charge for up to a year after your surgery.

Looking at the long term, the bulging, female-like breast tissue that was causing you so much embarrassment will not return. However, if you gain a lot of weight, some fat will appear on your chest.

But look on the bright side: if you protect your surgical investment, consume a sensible low-fat diet and continue with a reasonable exercise plan, you will only enhance the results of gynecomastia surgery!

(model)

Read the comments on bulletin boards at gynecomastia.org and you’ll find that teens, younger and older men are often puzzled what to tell others about an upcoming male breast reduction surgery.

First: the law of the land governs your right to total medical privacy. That law, HIPAA (Health Insurance Portability Accounting Act) requires everybody to respect your medical privacy rights.

Sure, you have to explain an absence but “medical treatments” covers it.

Telling your parents?

Teens can point to the rash of teen suicides sprung in whole or in part by school bullies who cause yet other teens to live in utter misery due to an inherited body part that makes him look different.

So go ahead and tell your folks how having “man boobs” affects your life and how others bully or put you down.

In many cases, when a teen suffers, the parents suffer right along. (Read a heartfelt letter from a concerned mom with a 15-year-old who had gynecomastia.)

As for many Dads: They can be difficult at first because they worry about the family purse strings. Because they can see nothing is wrong with you, they may say no to surgery at first. But if you let your hair down with dad, and explain the meanness in your life, they often relent.

Many wonder how – or if — to break the news to their girlfriends.

Well, if you haven’t learned yet, let me clue you in: women love intimate conversation and knowing your innermost fears because they then feel closer to you. If you are humiliated, spell it all out for her, along with your plans for male breast reduction surgery.

She probably can already see you have some bulging on your chest and likes you nonetheless. And if she’s worth her salt, she’ll be the first to understand, support and see you through recovery.

Besides, it’s very difficult to hide your surgery recovery from an intimate.

And don’t think your case is the only one. If you read the bulletin boards and forums at gynecomastia.org, you’ll find kindred souls who are going through the exact same thing.

Skip ahead on those boards and you’ll find others who had the surgery; read how their lives, along with their self-confidence – have vastly improved.

Many describe gynecomastia surgery as having a huge weight lifted from their shoulders!

(Look at somebefore and after gynecomastia surgery pictures.)

The next step was removing the dense, fibrous male gynecomastia breast tissue with a pair of forceps and then, for removal, making an incision at the bottom of the breast tissue that sits atop the chest muscle.

That works but it also involves a scar, a longer breast surgery and a longer healing time – two to four months for most patients — as well as swelling and bruising.

Drains are usually involved, too, even though they are placed under the compression vest the patient must wear for up to four weeks.

I almost always perform liposuction during the same procedure and soon wondered if it was possible to combine the liposuction with surgical excision of the breast tissue.

The method offers several benefits. Because a liposuction instrument, or cannula, is thin – less than the width of a #2 pencil – a smaller entry hole through the skin, a “stab” wound, is used.

That helps reduce swelling, bruising and healing time which leads to a happier patient who can return sooner to his normal activities. In many cases, it can eliminate the need for any other incision on the chest.

The basic liposuction cannula tip is blunt and rounded. My version has a sharp tip, and is known as a “cobra” tip; it’s pointed and thin but not sharp, something like the prow of a ship that cuts its way through water. It can penetrate some breast tissue.

But thick, dense tough breast tissue cannot be liposuctioned — it must be excised with a scalpel.

About five years ago, I figured that by cutting a sharpened aperture into the tube of the cannula, I can remove a thin slice from the gland, let it be sucked into the cannula and out of the body.

The cannula I now use in most cases works very much like a cheese knife peeling off a thin slice of cheese. I push the cannula through the breast gland and then pull it back — so its sharp aperture removes a slice of breast gland.

Result?  Multiple to and from movements into and through the gland, removing it all – without that longer incision in the areola. It’s like “whittling” it down from the inside.

But, alas, in a few cases, the breast gland is as hard as a golf ball and my cheese-cutting instrument just, well, does not cut it!

So I use a scalpel and surgically excise that breast tissue.