GYNECOMASTIA
Gynecomastia or excessive enlargement of the male breast can be treated effectively with surgery. This procedure is usually performed under a general anesthetic and often requires a combination of direct surgical excision of the breast tissue associated with some adjuvant liposuction to smooth the surrounding area. The incision is usually around the perimeter of the nipple allowing for exposure and removal of the fibrous tissue beneath. A compression garment is worn post operatively for six weeks. Sports and heavy lifting are not recommended for four to six weeks, however, the usual recovery time is approximately two weeks.
Gynecomastia is a condition that affects many males. Most commonly it develops during puberty and in many cases will resolve spontaneously before the age of 20. In other cases the gynecomastia or excessive enlargement of the male breast will persist and the patient will seek surgical correction for removal of the redundant and excess fibrous breast tissue.
The condition is usually of unknown cause, however, it can be associated with the ingestion of certain medications to include anti-depressants, blood pressure medications, ulcer medications, AIDS medications and steroids. Sometimes it is related to the imbalance of the sex hormones, estrogen and testosterone. The other contributing factor is the smoking of marijuana.
The condition can be unilateral or bilateral. The extra breast tissue can be painful. The condition does not resolve spontaneously if the medications are discontinued, it is usually persistent and it is at that time that patient will request surgical removal of this excess glandular tissue. Some boys or men will have fat on their chests that make it look as though they have breasts. In this case, diet or exercise would be the treatment. In contrast, true gynecomastia will not likely improve with either diet or exercise and surgical intervention is recommended.
Preparation for Surgery
It is very important that Dr. Van Laeken is aware of the state of your general health prior to surgery. Please let her know of any allergies you have, medications, herbal supplements, or vitamins you are taking as well as the reasons for taking them. It is also important that you inform Dr. Van Laeken if you have a tendency for keloid scarring (thick, wide, or raised scars).
If you are a smoker we encourage you to quit prior to proceeding with surgery. Smoking can interfere with the blood flow to the skin, and will inhibit the healing of the incisions.
Depending on your age as well as your general health pre-operative tests may be ordered, such as blood tests, or an ECG.
It is important that you avoid taking vitamin E, anti-inflammatories or aspirin products for 2 weeks prior to surgery. These products are anti coagulants, and could lead to hematoma formation and bleeding during the surgery.
Most patients who have sedentary jobs plan to take 2 weeks off work. If your job involves a great deal of physical activity Dr. Van Laeken can advise you as to how much time you should take off.
Procedure
Dr. Van Laeken operates at several different facilities but generally performs this procedure at either the Cambie Surgery Centre or the False Creek Surgery Centre. These are both state of the art, fully accredited private surgical facilities.
The surgery is usually performed under a general anaesthetic and it often requires a combination of direct surgical removal of the breast tissue associated with some adjuvant liposuction to smooth the surrounding area. The incision is usually around the nipple allowing for exposure of the fibrous tissue beneath the nipple areolar complex and surgical removal. Through the same incision the liposuction can be performed.
In some cases the condition can be so severe that it requires additional removal of skin, which is associated with additional scarring.
The procedure is done under a general anaesthetic in an operating room and usually takes between one half to two hours to complete the procedure. Patients will usually have a drain exiting from a small stab incision on the lateral aspect of the chest wall, to allow for removal of fluid that may collect in the area where the breast tissue has been removed. The drains are removed between the 3rd and the 5th day. A pressure dressing is applied in the operating room. The dressings will be removed at the same time the drains are removed. Once the dressings are removed, the patient will be placed in a compression garment (vest) for an additional 4 to 6 weeks. The compression garment is worn over the area to apply compression. The wearing of the compression garment facilitates retraction of the skin and contouring of the chest wall.
Recovery
When you arrive home from the clinic, you should rest in bed. Ice packs to the site are helpful for reducing swelling and bruising. Drink plenty of fluids to prevent dehydration. The usual recovery time is approximately 2 weeks. After the drains are removed, a gradual increase in activity can be entertained until the end of the second week at which time full exercise activities are allowed. Sports that involve full contact or heavy weight training for pectoral muscle strengthening should be avoided for 4-6 weeks.
Potential Complications
There are risks associated with any type of surgery. Although the incidence of complications is rare, Dr. Van Laeken feels that all patients should be informed of the potential complications prior to proceeding with surgery.
The procedure is subject to the same complications as all other surgical procedures such as infection, bleeding and failure to heal which could require appropriate treatment including possible further surgery.
- Haematoma
- Infection
- Seroma
- Necrosis
- Swelling
- Hypersensitivity / Numbness
Read definitions for potential complications.
View before and after photos
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