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Breast reduction surgery is not only an option for women. Some men who have large breasts may need to have a breast reduction, which is a procedure called a gynaecomastia. Unlike the female breast reduction – which is carried out to both reduce and reshape the breasts – male breast reductions are usually required to flatten the breast area.
Large breasts in men are often believed to be a result of obesity, but this is not the only cause. Men, like women, can have an abnormal growth of glandular breast tissue, usually due to a hormonal imbalance. Some studies have shown that male breast growth could be as a result of high levels of the female hormone oestrogen being present in their bodies. Other causes of male breast enlargement include:
- Excessive alcohol intake.
- Use of certain drugs, particularly anabolic steroids (often used by bodybuilders).
- Dramatic weight loss, causing skin to sag.
The surgical procedure for male breast reduction is exactly the same as the procedure carried out for women (see how it is performed section). However, the male operation usually only takes an hour. The recovery time is also the same (see recovery section), with men needing to wear an elastic garment (sometimes referred to as a pressure garment) for up to four weeks after the operation. The elastic garment helps to encourage smooth results.
BEFORE THE OPERATION
Once you have chosen a surgeon and scheduled your procedure, your surgeon will give you a list of pre-operative instructions. This will include some lab testing such as routine blood work and a cardiac work-up if you have any history of heart disease. Your surgeon will likely ask you to stop taking certain medications, including aspirin, non-steroidal anti-inflammatory drugs (NSAIDs) and blood thinners, all of which can increase bleeding risk.
Certain herbal remedies may also increase bleeding risk. For example, vitamin E, omega-3 fatty acids, green tea and gingko biloba all may increase bleeding risk during and after surgery. Make sure you tell your surgeon about everything that you are taking, even if it seems harmless.
The pre-op instructions will also include a list of dos and don'ts about eating and drinking before your procedure.
Most surgeons recommend that prospective patients kick the smoking habit for the month before and the month after surgery. Smoking can cause a delay in wound healing and skin necrosis (death). The good news is that many tools are available today to help smokers become ex-smokers. Nicotine replacement products such as nicotine patches, nicotine gum and nicotine lozenges are available over-the-counter. A nicotine nasal spray and inhaler are available by prescription. These products can help relieve nicotine withdrawal symptoms.
Nicotine patches and other nicotine replacement systems can't be used as smoking cessation aids immediately before or during surgery. They cause some of the same problems with wound healing as cigarette smoking. Tell your surgeon if you are using any nicotine replacement products.
Drugs such as buproprion SR (Zyban) and varenicline tartrate (Chantix) are non-nicotine pills that may help you quit smoking before surgery. Talk to your doctor about a prescription. Hypnotherapy or acupuncture may help some people quit smoking, too. Acupuncture involves placing extremely thin needles into the skin along specific acupuncture points to help curb the desire to smoke.
HOSPITAL STAY AND TYPE OF ANESTHESIA
The surgery will take up to 1-3 hours depending on the individual patient. Most patients can go home on the day of the surgery, however some will stay in the hospital for a couple of days.
THE PROCEDURE
If your enlarged breasts consist primarily of excessive fatty tissue, your surgeon may use liposuction. If excess glandular tissue is the primary cause, the tissue may be cut out with a scalpel. This excision may be performed alone or in conjunction with liposuction.
During an excision procedure, the incision is made either on the edge of the nipple (areola) or in the underarm area. The surgeon cuts away the excess glandular tissue, fat and skin from around the pigmented area surrounding the areola and from the sides and bottom of the breast by working through the incision. Major reductions that involve the removal of a significant amount of tissue and skin may require larger incisions and more visible scars.
If liposuction is also used to remove excess fat, a slim, hollow tube (cannula), is inserted directly through the existing incisions. The cannula is attached to a vacuum pump to suction out the fat.
For liposuction-only breast reduction, your surgeon will likely make a small incision of less than a half-inch in length around the edge of the areola. Or he or she may make the incision in the underarm area. You may feel a vibration or some friction during the procedure, but generally no pain.
Sometimes a small drain is inserted through a separate incision to remove excess fluids. Once closed, the incisions are covered with a dressing. The chest may be wrapped to keep the skin firmly in place.
Breast reduction surgery for gynecomastia is most often performed on an outpatient basis, in an office-based or ambulatory surgical facility or in the hospital. Sometimes an overnight hospital stay is recommended. Time in surgery is typically an hour and a half, but a more extensive male breast reduction may take longer.
The procedure may be performed under general anesthesia or local anesthesia with sedation. Your surgeon will discuss your anesthesia options with you once you have decided on surgery.
AFTER THE OPERATION
Have someone drive you after surgery and help you at home for a day or two if needed. Whether you've had liposuction, excision with a scalpel or both for your gynecomastia, you will feel discomfort for a few days. The pain can be managed with a prescription from your doctor.
To help reduce swelling, you'll probably need to wear an elastic pressure garment continuously for a week or two, and for a few weeks longer at night. Although the worst of the swelling will subside in the first few weeks, it may be three months or more before the final results of your surgery are apparent.
You'll be encouraged to begin walking around on the day of surgery, and to return to work when you feel well enough, which could be in a couple of days. Stitches are removed one to two weeks after the procedure.
Your surgeon may advise you to avoid sexual activity for a week or two and heavy exercise for about three weeks. You will be told to stay away from any sport or job that risks a blow to the chest area for at least four weeks. Your activities should be back to normal after about a month.
It's important to avoid exposing surgical scars to the sun for at least six months. Sunlight can affect the skin's pigmentation permanently, causing the scar to turn dark. If sun exposure is unavoidable, use a strong sunblock.
If you experience shortness of breath, chest pains, or unusual heart beats after the procedure, contact your surgeon immediately. These complications may require hospitalization and additional treatment.
We apologize for not showing any photos here for ethical reasons. You may refer to the following website for before and after photos: www.plasticsurgery.org
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