James A. Rieger MD -Board Certified Plastic Surgeon -Wichita,Hutchinson,Salina,Newton,Garden City,Dodge City Kansas
316-652-9333


Gynecomastia - Male Breast Reduction                                          Free Consultation Visit at our Plastic Surgery Office

If you are considering a  male breast reduction .....

Gynecomastia (male breast enlargement) is a very common condition in men. Men with gynecomastia (women like breasts) may experience a variety of problems. The are extremely self-conscious and embarrassed. They may avoid bare chest activities like swimming and try to hide the chest area.

 Male breast reduction is a procedure that removes fat and glandular tissue, and rarely skin from the breasts. Making them smaller. The goal is to give a better-shaped male breasts.

If you're considering gynecomastia surgery, this will give you a basic understanding of the procedure- when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on your individual circumstances. Please be sure to ask Dr. Rieger if there is anything about the procedure you don't understand.


The best candidates for male breast reduction

All surgery carries some uncertainty and risk

Most cases of gynecomastia resolve over time without treatment. However, if gynecomastia is caused by a medical condition then that problem needs to be treated. Gynecomastia is common in boys and resolves. However if it continues then surgery may be needed to help with the embrassement or other symptoms.


Male breast reduction is not a simple operation, but it's normally safe when performed by a qualified plastic surgeon. Nevertheless, as with any surgery, there is always a possibility of complications, including bleeding, infection, or reaction to the anesthesia. Some patients develop contour irregularities. You can reduce your risks by closely following Dr. Rieger's advice both before and after surgery.

The procedure does leave noticeable, but small permanent scars. (Poor healing and wider scars are more common in smokers.) The procedure can also leave you with slightly mismatched breasts or unevenly positioned nipples.

Some patients may experience a permanent loss of feeling in their nipples. Rarely, the nipple and areola may lose their blood supply and the tissue will die. (The nipple and areola can usually be rebuilt, however, using skin grafts from elsewhere on the body.)

Planning your surgery
In your initial consultation, it's important to discuss your expectations frankly with your surgeon, and to listen to his or her opinion. Every patient-and every physician, as well-has a different view of
what is a desirable size and shape for breasts.

 

The male breast may have firm breast tissue.

 

The surgeon will examine and measure your chest, and will probably photograph them for reference during surgery and afterwards.


Your surgeon should describe the procedure in detail, explaining its risks and limitations and making sure you understand the scarring that will result. The surgeon should also explain the anesthesia he or she will use, the facility where the surgery will be performed, and the costs.


Preparing for your surgery

 You'll also get specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding certain vitamins and medications. Some surgeons suggest that their patients diet before the operation.
 

If you smoke, plan to quit at least two weeks before your surgery and not to resume for at least two weeks after your surgery.


Breast reduction doesn't usually require a blood transfusion. However, if a large amount of breast tissue will be removed, your physician may advise you to have a unit of blood drawn ahead of time. That way, if a transfusion should be needed, your own blood can be used.

While you're making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days if needed.

Where your surgery will be performed

Dr. Rieger prefers to perform the operation in a state-of-the art accredited surgery center.
The surgery itself usually takes two hours, but may take longer in some cases.

Type of anesthesia
Gynecomastia is usually performed under general anesthesia. You'll be asleep through the entire operation.

The surgery
Techniques for male breast reduction vary, but the procedure involves placing one or two incisions in the crease and along the lateral chest- breast. The surgeon removes excess fat using liposuction (see liposuction information pages).

Then a new procedure is performed if a larger firm breast mass is still present after liposuction which is usually the case. An arthroscopic shaver blade which is used in knee orthopedic procedures for shaving and smoothing cartilage is used to remove the firm fibrous breast tissue that can not be removed with liposuction.

The shaver blade as shown below oscillates(rotates)  back and forth in a protected metal tube with an opening on one side. This opening faces away from the skin to protect the skin and faces towards the breast mass which is excised(cut away) and suctioned away through the tube. This technique allows for removal of the breast mass without having to make a large incision around the areola nipple area.

 

Tip of shaver blade showing oscillating blade inside metal suction tube.  

Close up of tip used for gynecomastia tissue excision

Pictures of hand pieces that controls the shaver blade and suction for gynecomastia surgery

Diagram of a shaver blade and suction system

In rare cases skin also needs to be removed and the nipple and areola moved into a new position. Liposuction may be used to remove excess fat from the armpit area.


In most cases, the nipples remain attached to their blood vessels. However sensation may be lost.  If the breasts are very large or pendulous, the nipples and areolas may have to be completely removed and grafted into a higher position. (This will result in a loss of sensation in the nipple and areolar tissue.)

 
The small incisions to perform the liposuction and shaver blade excision of the gynecomastia are closed with two or three sutures only.  Scars are usually small and concealed

   


After your surgery


After surgery, you'll be  in a compression garment for a month or two.  Failure to wear the garment can cause fluid or blood to collect under your breast and require further surgery to replace the drains or control bleeding.


You may feel some pain for the first couple of days-especially when you move around or cough-and some discomfort for a week or more. Your surgeon will prescribe medication to lessen the pain.

The very few skin sutures will be removed in two weeks.

If your skin is very dry following surgery, you can apply a moisturizer several times a day, but be sure to keep the suture area dry.

You may also experience random, shooting pains for a few months. You can expect some loss of feeling in your nipples and breast skin, caused by the swelling after surgery. This usually fades over the next six weeks or so. In some patients, however, it may last a year or more, and occasionally it may be permanent.

Getting back to normal
Although you may be up and about in a day or two, your chest may still ache occasionally for a couple of weeks. You should avoid lifting or pushing anything heavy for 6 weeks.

Your surgeon will give you detailed instructions for resuming your normal activities. Most men can return to work (if it's not too strenuous) and social activities in about two weeks. But you'll have much less stamina for several weeks, and should limit your exercises to stretching, bending until your energy level returns.

You may be instructed to avoid sex for a 3 weeks, since sexual arousal can cause bleeding.

A small amount of fluid draining from your incisions, is normal. If you have any unusual symptoms, such as bleeding or severe pain, don't hesitate to call your doctor.

Your new look
Although much of the swelling and bruising will disappear in the first few weeks, it may be six months to a year before your breasts and chest settle into their new shape. Even then, their shape may fluctuate.

   

With, better proportioned
chest, you'll feel more comfortable

call 316-652-9333 for a consult about Male breast reduction gynecomastia surgery with orthopedic arthroscopic shaver blade system in Wichita, Kansas.

 

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