Gynecomastia

Gynecomastia is a medical term that comes from the Greek words for "woman-like breasts." Though this oddly named condition is rarely talked about, it's actually quite common. Gynecomastia affects an estimated 40 to 60 percent of men. It may affect only one breast or both. Though certain drugs and medical problems have been linked with male breast over development, there is no known cause in the vast majority of cases.

For men who feel self-conscious about their appearance, breast-reduction surgery can help. The procedure removes fat and or glandular tissue from the breasts, and in extreme cases removes excess skin, resulting in a chest that is flatter, firmer, and better contoured.

Typical Patient Profile

Surgery to correct gynecomastia can be performed on healthy, emotionally stable men of any age. The best candidates for surgery have firm, elastic skin that will reshape to the body's new contours.

Surgery may be discouraged for obese men, or for overweight men who have not first attempted to correct the problem with exercise or weight loss. Also, individuals who drink alcoholic beverages in excess or smoke marijuana are usually not considered good candidates for surgery. These drugs, along with anabolic steroids, may cause gynecomastia. Therefore, patients are first directed to stop the use of these drugs to see if the breast fullness will diminish before surgery is considered an option.

What to Expect in Surgery

If excess glandular tissue is the primary cause of the breast enlargement, it will be excised, or cut out, with a scalpel. The excision may be performed alone or in conjunction with liposuction. In a typical procedure, an incision is made in an inconspicuous location -- either on the edge of the areola or in the underarm area. Working through the incision, Dr. Ratliff cuts away the excess glandular tissue, fat, and skin from around the areola and from the sides and bottom of the breast. Major reductions that involve the removal of a significant amount of tissue and skin may require larger incisions that result in more conspicuous scars. If liposuction is used to remove excess fat, the cannula is usually inserted through the existing incisions.

If your gynecomastia consists primarily of excessive fatty tissue, Dr. Ratliff will likely use liposuction to remove the excess fat. A small incision, less than a half-inch in length, is made around the edge of the areola, the dark skin that surrounds the nipple. Or, the incision may be placed in the underarm area. A slim hollow tube called a cannula, which is attached to a vacuum pump, is then inserted into the incision. Using strong, deliberate stokes, Dr. Ratliff moves the cannula through the layers beneath the skin, breaking up the fat and suctioning it out. Patients may feel a vibration or some friction during the procedure, but generally no pain.

In extreme cases, where large amounts of fat or glandular tissue have been removed, skin may not adjust well to the new smaller breast contour. In these cases, excess skin may have to be removed to allow the remaining skin to firmly re-adjust to the new breast contour.

Sometimes, a small drain is inserted through a separate incision to draw off excess fluids. Once closed, the incisions are usually covered with a dressing. The chest may be wrapped to keep the skin firmly in place.

Potential Risks and Side Effects

With any surgery, there are risks. Risks with gynecomastia include infection, skin injury, excessive bleeding, adverse reaction to anesthesia, and excessive fluid loss or accumulation. The procedure may also result in noticeable scars, permanent pigment changes in the breast area, or slightly mismatched breasts or nipples. If asymmetry is significant, a second procedure may be performed to remove additional tissue.

The temporary effects of breast reduction include loss of breast sensation or numbness, which may last up to a year.

Recovery

Whether you've had excision with a scalpel or liposuction, you will feel some discomfort for a few days after surgery. However, discomfort can easily be controlled with medications prescribed by Dr. Ratliff. In any case, you should arrange to have someone drive you home after your surgery and to help you out for a day or two if needed.

You'll be swollen and bruised for a while -- in fact, you may wonder if there's been any improvement at all. To help reduce swelling, you'll probably be instructed to wear an elastic pressure garment continuously for a week or two, and for a few weeks longer at night. Although the worst of your swelling will dissipate in the first few weeks, it may be three months or more before the final results of your surgery are apparent.

In the meantime, it is important to begin getting back to normal. You'll be encouraged to begin walking around on the day of surgery, and can return to work when you feel well enough, which could be as early as a day or two after surgery. Any stitches will generally be removed about one to two weeks following the procedure.

Dr. Ratliff may advise you to avoid sexual activity for a week or two, and heavy exercise for about three weeks. You'll be told to stay away from any sport or job that risks a blow to the chest area for a least four weeks. In general, it will take about a month before you're back to all of your normal activities.

You should also avoid exposing the resulting scars to the sun for at least six months. Sunlight can permanently affect the skin's pigmentation, causing the scar to turn dark. If sun exposure is unavoidable, use a strong sunblock.

Typical Results

Gynecomastia surgery can enhance your appearance and self-confidence, but it won't necessarily change your looks to match you ideal. Before you decide to have surgery, think carefully about your expectations and discuss them frankly with Dr. Ratliff.

The results of the procedure are significant and permanent. If your expectations are realistic, chances are good that you'll be very satisfied with your new look.

To schedule a consultation with Dr. Ratliff please click here or call us at (918) 894-5754.