Gynecomastia

WHO IS A GOOD CANDIDATE?

Sometimes excess breast tissue or prominent breast tissue can cause men to be uncomfortable going shirtless when wearing form fitting or light-colored clothing. Gynecomastia excision is the procedure used to describe either direct excision of the excess breast tissue through an incision, liposuction alone, or a combination of both to reshape the chest and make the excess tissue less prominent. Direct excision vs. liposuction is sometimes due to surgeon preference, however if the tissue is very fibrous, direct excision is recommended as this type of tissue is difficult to liposuction.

THE PROCEDURE

Gynecomastia surgery is usually done under general anesthesia. If direct excision is indicated, a small incision around the areola (colored portion around the nipple) is made, and tissue is removed through this incision. The incision hides well and is usually faintly visible after about 1 year. In more extreme cases where there is a lot of excess fat and skin, a larger incision under the breast fold is sometimes used for a mastectomy type of procedure. If liposuction is being done alone or in conjunction with direct tissue excision, a 3-4mm incision is made in a hidden area on the chest, and excess fat and tissue are removed through this small hole. Sometimes a combination of direct excision and liposuction is used for an optimal result. The procedure usually takes around 1-1½ hours and is done in an ambulatory surgery center. Surgical drains are not usually needed unless there is a large amount of tissue removed.

RECOVERY

Regardless of whether direct excision, liposuction, or both are done, patients will need to wear a compression vest or ACE wrap around their chest for 4-6 weeks to help decrease swelling and decrease the chances of fluid collection (seroma). During this time, overhead lifting should be avoided for 1 week and lifting anything more than 5lbs or high-end exercise is not recommended for 4-6 weeks. Patients are usually back to driving a car within a week, or when they are off all pain medications. Normal exercise can be resumed about 6 weeks out from surgery.