Gynecomastia
Taken from Greek roots, this medical term literally means “woman-like breasts.” This condition, though not widely talked about, affects an estimated 40 to 60 percent of men, and may affect just one breast or both. This condition is not age-dependent, and symptoms can appear suddenly. This condition can also be caused by hormonal changes, heredity, disease, and by the use of certain drugs. This condition usually causes emotional distress and lower levels of self-confidence. Healthy activities and intimacy are avoided simply to veil the existence of the condition.
CHARACTERISTICS OF GYNECOMASTIA INCLUDE:
• A surplus localized fat
• Excess glandular tissue development
• A blending of the two
The condition can occur with just one breast (unilaterally) or with both breasts (bilaterally).
Surgical treatment for gynecomastia is extremely individualized. In order for this procedure to be a good option for you, you must be:
• In good physical health
• At a somewhat normal body weight
• Realistic in your expectations
• Stable in your breast development
Juvenile patients may undergo this procedure; however, and secondary, or a follow-up procedure, may be needed in the future if breast development continues.
ADDITIONALLY, IN ORDER TO BE CONSIDERED A GOOD CANDIDATE FOR THIS PROCEDURE:
• Surgery must only be considered after screening for alternative medical treatments
• You must be healthy and free from life-threatening illness
• You must not have a medical condition that will interfere with healing
• You must not be actively smoking or abusing drugs of any kind
• You must have a positive outlook on life and a realistic method for improving the physical symptoms of gynecomastia
BEFORE AND DURING THE SURGERY
Your surgeon will want to meet with you prior to scheduling a procedure to determine whether or not you are a good candidate for surgical correction of gynecomastia. The following points cover some of the information your surgeon will want to know:
• Why do you want to the procedure?
• What is your desired outcome?
• Do you have any current medical conditions or drug allergies, and are you being treated for any other medical conditions?
• Have you undergone any previous surgeries?
• What medications, vitamins, herbal and other supplements, and drugs (including steroids) are you currently using?
• Do you use alcohol and tobacco?
This is not all. Your surgeon will want to complete a physical evaluation to determine your current level of physical health. The information he or she will gather could include:
• Any risk factors you are experiencing, along with any pre-existing conditions
• Diagnostic testing to determine the biological cause of your gynecomastia, possibly including a blood test to evaluate your endocrine function
• A breast examination to determine their size, shape, skin quality, and the placement of your nipples and areolas
• Photographs that will be included in your medical record, and to aid in determining the extent of improvement
• Treatment options and recommendations
• Discussing possible outcomes of the procedure
• The use of anesthesia during the procedure
BEFORE THE DAY OF THE SURGERY, YOU WILL BE ADVISED OR REQUIRED TO:
• Complete routine blood tests to determine overall physical health
• Avoid taking aspirin, anti-inflammatory drugs, or herbal supplements that increase bleeding
Your doctor will also inform you of what to do on the day of the surgery, and the post-operative care and follow-up that will be required for the procedure.
The surgical procedure is technically called a reduction mammaplasty. There are a few techniques used to surgically treat gynecomastia. Liposuction is used in cases where gynecomastia is caused by an excess of fatty tissue in the breast area. There are two other options that involve more invasive means of correction.
After anesthesia is administered, the incisions begin. The first possible incision type is made around the areola and is doughnut-shaped. This incision reduces the size of the areola and allows the remaining skin and breast tissue to be tightened around the now smaller areola.
The second incision type is made around the areola and then vertically on the breast between the areola and the breast crease. The size of the areola is reduced and the amount of skin the breasts are made up of is reduced. This allows the breast to be lifted.
IN ALL CASES, AFTER THE SURGEON MAKES THE INCISION:
• The principal breast tissue is reshaped to increase your masculine contour
• The areola may be repositioned to a more sensible position
• Excess breast skin is removed to compensate for the lack of elasticity
When the reshaping is finalized, the incisions are closed with sutures. Deep sutures are used to help support the new shape. Sutures are also used in visible areas, along with skin adhesives and surgical tape. Incision lines remain permanent but fade over time. In many cases, incision lines can be hidden along natural breast contours. Your results are visible immediately.
AFTER THE PROCEDURE IS COMPLETE
After the surgery is complete, the patient is usually allowed to go home. Surgical dressings are placed over the incisions, and a soft, supportive bra is required for the first three weeks or so. The breasts will be swollen and bruised for a few days and any pain can be treated with over-the-counter medication. The breasts and nipples will be numb until the swelling subsides, typically over the next six weeks. Breasts heal progressively. Light activity levels can be resumed within a few days; routine activities and vigorous exercise should be avoided for a while. Your surgeon will detail when normal activities can begin again. You must follow the directions your surgeon gives you in order to have successful results. Surgical incisions should not be exposed excessive force, abrasion, or motion while they are healing.
If you experience shortness of breath, chest pains, or unusual or irregular heartbeats, seek immediate medical attention. You may be hospitalized if any of these serious medical conditions occur.
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Dr. Fred Sahafi
Dr. Joseph Bivens
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