Displeased with the results of your gynecomastia surgery? You are not alone. Gynecomastia surgery, like all surgery, is all about attention to detail. The details, in this case, are identifying and treating each component of what comprises gynecomastia. Gynecomastia, or enlargement of the male breast typically has three major components.
The first is the fatty component. This is typically approached effectively by the surgeon with liposuction. A small incision is made, fluid containing local anesthetic and a vasoconstricting agent is injected into the area, and a cannula is used to remove the fatty component of the gynecomastia and contour the chest to a masculine appearance. The second component, which is often overlooked or undertreated by surgeons, is the glandular component. The glandular material cannot be treated adequately with liposuction alone, whether it be conventional suction assisted liposuction or ultrasonic or laser liposuction.
To adequately address the glandular component, the gland must be removed. This means separating the gland from the skin above it and from the pectoralis major muscle beneath it. The goal of surgery is to remove the fat and the glandular material between the skin and the muscle and then encourage the skin to redrape over the muscle properly. This is typically achieved with a compression vest and foam material to compress the skin on to the muscle. This also helps prevent complications such as hematoma or fluid collection under the skin.
The final component of gynecomastia is the diameter of the areola. In most cases of gynecomastia, the areola is enlarged and puffy. By thinning the sub areolar tissue, the puffiness will be addressed and typically the areola will shrink. If you think you may have gynecomastia or are displeased with the results of previous surgery, call to schedule a complimentary consultation.
Gynecomastia revision surgery is performed as an outpatient procedure under a general anesthetic. and takes 1-1.5 hours in experienced hands. Recovery time is usually 3-4 weeks with restriction of arm movement for the first week.
After male breast reduction surgery, if a lump is felt weeks or even months later, the natural reaction is the breast tissue has grown back. Unless the patient has been taking anabolic steroids, Propecia or other substances that may cause breast tissue growth, it is most likely the formation of scar tissue. Scar formation is normal after any type of surgery and generally takes 4 to 12 weeks to form.
If there is puffiness early in the recovery, it could be residual swelling or possibly not enough tissue was removed, but it would not be scar tissue.
When the initial results appear to be excellent, most likely the right amount of tissue and fat were removed. However, if the patient notices a firm lump most likely under the nipple, and it is determined to be scar tissue, revision surgery probably is not necessary. The surgeon can inject cortisone, like Kenalog, that will gradually dissolve the scar tissue. Sometimes more than 1 injection is needed.
Gynecomastia surgeons are very careful not to remove too much tissue, or the result may be a “crater deformity.” In the unfortunate situation where not enough tissue removed, or too much, gynecomastia revision surgery will be needed. The scarring in these cases can be problematic, and require the expertise of a gynecomastia specialist. The scar tissue from the original surgery makes the dissection more challenging, and the scar tissue will impede the contraction of the skin.
So, you have put in the work and have finally shed that stubborn extra weight, congratulations! While you are now a healthier version of yourself, you may notice that you are left with excess skin and tissue on your body, including on your chest. This can result in the look of enlarged breasts, which some people call “man boobs“. Thankfully, gynecomastia surgery after weight loss is an effective solution to help you enjoy your new body without that excess tissue. Read on to learn more about what gynecomastia is, what to expect during surgery, and how this procedure can be especially beneficial after losing weight.
What is Gynecomastia?
Gynecomastia is a common condition that causes an increase in breast tissue on the male chest. It is usually caused by hormonal changes or an imbalance in hormone levels, but may also be caused by certain medications, certain drugs, and the use of anabolic steroids. Surgical correction is often the best option for those who have not found success with other avenues.
What to Expect During Gynecomastia Surgery After Weight Loss
For some men, the 2 stage procedure is an excellent solution to remaining tissue and skin after weight loss. The first stage reduces the amount of skin and tissue by excision in a doughnut shape around the areola which is then closed with purse string-type sutures. The second stage can be done as an office procedure under local anesthesia.
The 2 stage procedure is not an option for some men with excessive amounts of skin to be removed. In order to achieve a more masculine chest, your surgeon will need to make incisions around the areola, and vertical to the breast crease, known as an inverted T or the anchor incision. This incision will leave visible scars, but most men are comfortable with the trade-off.
Gynecomastia After Weight Loss
After Gynecomastia Surgery
Unless the patient is prone to keloids or developing raised scars, the incision heals nicely. However, for those who end up with more visible scarring, there are several treatments today that can minimize the final result. A skilled gynecomastia surgeon will use deep suturing techniques to reduce tension on the skin.
Silicone sheeting has proved to be a good treatment once the incision has healed by keeping the skin hydrated. Steroid injections, massaging, and laser treatments are all possible treatments. For the most difficult scars, scar revision surgery may be needed.
Schedule a Consultation Appointment
For the best possible results, it is important that you seek out a skilled, board-certified plastic surgeon to perform your male breast reduction surgery. With more than 30 years of success treating gynecomastia patients, you can feel confident that you are in good hands with Dr. Delgado. To learn more about gynecomastia surgery and if it is right for you, please contactDr. Delgado today to schedule a consultation appointment.
Gynecomastia Surgery FAQs
Is gynecomastia surgery a cosmetic surgery?
Yes, if a surgery is electively chosen for cosmetic reasons, it is considered a cosmetic procedure. Gynecomastia surgery falls under this umbrella.
Can obesity cause gynecomastia?
Those who are experiencing enlarged male breasts due to excess fatty tissue have what is known as pseudo-gynecomastia. Weight loss is an effective way for those who are overweight to reduce the size of their chest.
What can I expect during a consultation?
During a consultation, you will have a chance to speak with Dr. Delgado regarding your medical history and the reason for wanting to correct your gynecomastia. He will determine if you are an ideal candidate and then create a personalized treatment plan to help boost your self-confidence and overall sense of well-being.
Puffy- nipples | Gynecomastia (male breasts) before and after
The results of gynecomastia surgery should be natural-looking and help men achieve a flatter chest. Unfortunately “puffy nipples” aftergynecomastia surgery seems to be a common problem; it is mentioned frequently on the forums on this site and the popular website “Real Self.” Read on to learn why some men may have puffy nipples after gynecomastia surgery, how this can be corrected, and more.
To begin, let us give a brief overview of gynecomastia and how to treat it. Gynecomastia is a condition that can affect males of all ages, resulting in enlarged breasts. It is most often caused by imbalanced hormone levels, though it may also be caused by the use of anabolic steroids, some recreational drugs, or certain prescription medications.
To diagnose gynecomastia, it is best to consult with a healthcare professional or gynecomastia surgeon. Some patients may believe that they have true gynecomastia, when in fact, their high level of body fat is the cause of their enlarged breasts. These cases are known as pseudo-gynecomastia, which can often be corrected with weight loss alone.
In individuals with true gynecomastia, the most effective gynecomastia treatment is male breast reduction surgery. This is because the cause of enlarged breasts is glandular tissue and excess breast tissue, which cannot be corrected with diet and exercise alone.
What Can Cause Puffy Nipples
In less experienced hands, some gynecomastia surgeons will try to reduce male breast enlargement with liposuction alone which will not remove the breast gland or glandular tissue. Other surgeons are very conservative in the surgical removal of breast tissue for fear of a “crater deformity.” In both cases, “puffy nipples” and “crater deformity” will require revision surgery for correction.Gynecomastia revision surgery for a “crater deformity” will involve fat grafts or a fat flap. Revision for “puffy nipples” will require additional excision which will be more complicated due to formed scar tissue from the original surgery.
It is vital that surgeons remove all of the glandular tissue to ensure that puffy nipples do not occur following surgery. When this is done, the recurrence of gynecomastia is very rare.
The Best Way to Avoid Complications Like Puffy Nipples
Overall, it is imperative to choose a board-certified plastic surgeon who specializes ingynecomastia surgery to avoid puffy nipples. Sculpting the chest with the right balance of remaining fat and breast tissue is an art and needs to be performed by an expert. If too much breast gland is removed a “crater deformity” will be the result. If too much gland is left behind the areola /nipple complex it will push outward and “puffy nipples” will be the result.
When choosing your gynecomastia revision surgeon, do your homework. Be sure your surgeon has experience in revision surgery. Also, ask to see before and after pictures of patients who have had corrective surgery. This will help to give you a clearer idea of what the surgeon can accomplish.
Gynecomastia Surgery in San Francisco and Novato
If you are experiencing gynecomastia symptoms or are bothered by enlarged male breasts due to gynecomastia, gynecomastia surgery may be right for you. Pleasecontact Dr. Delgado today to schedule a consultation appointment. During this consultation, he will discuss your health conditions, health history, and your desired results to create a personalized treatment plan for you.
Gynecomastia/Puffy Nipples FAQs
What are the symptoms of gynecomastia?
While some individuals only experience enlarged breast tissue and/or excess breast tissue in one or both breasts, others may also experience furthersymptoms such as puffy nipples, sensitivity in the nipple area, nipple discharge, and breast pain or discomfort.
What do puffy nipples look like?
Puffy nipples have a noticeable cone shape, causing the areola to appear puffed out. They may be more pronounced during warmer temperatures, which can be distressful for individuals during the summer when many males go shirtless. Most patients with puffy nipples who visit Dr. Delgado explain that they avoid situations that involve taking their shirt off or tight clothing such as physical activity or spending time at the beach due to their gynecomastia and puffy nipples.
How do I know if gynecomastia surgery is right for me?
Overall, treating gynecomastia effectively depends on the underlying cause. Meeting with a board-certified plastic surgeon is a great chance to discuss your treatment options. Those with true gynecomastia often find that breast surgery is an effective option for them.
Do all males with a hormone imbalance develop gynecomastia?
No, not all men with hormonal imbalances will acquire gynecomastia. Though, those with certain changes in testosterone levels and estrogen levels may develop this condition. Individuals who take certain medications such as those to treat prostate cancer may also experience gynecomastia. The best way to determine if you have gynecomastia is to seek advice from a healthcare professional.
Do all surgeons perform gynecomastia surgery?
No, not all surgeons perform male breast reduction. To ensure that you employ the best possible surgeon for your individual case, you must be sure to do your research. Specifically, seek out board-certified plastic surgeons who have experience performing techniques to correct gynecomastia.
Reasons for Gynecomastia Revision Surgery, Men who have made the decision to have male breast reduction surgery have found it can be a life changing event. They no longer have to try to hide their chest in loose fitting clothing or hunch their shoulders together. Social events are broadened to include all types of beach, pool and sports activities that may require a man to remove his shirt.
This new lease on life can be dashed if the surgical outcome is not what was expected. Some post-operative results are so disappointing that they will require a revision or “redo” surgery. Needing a revision can be complicated as now there is scar tissue the surgeon must contend with, and the elasticity of the skin may be somewhat compromised. Additionally, the patient will be faced with more surgical fees and another recovery period.
The most common cause of gynecomastia revision surgery is the repeated error of surgeons attempting to reduce the male breast with liposuction alone. True gynecomastia is a combination of fat and breast tissue, removing only the fat by liposuction will leave the breast tissue looking, even more, pronounced. There are many fancy names for “new” liposuction machines, but breast tissue is just too dense to be effectively removed through the cannula of the liposuction machine.
My gynecomastia practice is now at 40% revision surgery, most of the cases are where liposuction alone was done. Some fat must be left to be a buffer to allow the skin to move over the muscle, if too much fat and tissue are removed, it will lead to the second cause of gynecomastia revision surgery, the crater deformity.
The crater deformity is where there is a depression (or crater) under the nipple/areola complex from over resection of the fat and gland. To correct the crater deformity, the surgeon needs to do a fat transfer or a fat flap.
Other revisions include asymmetry, scar revisions, etc., to avoid the necessity of male breast reduction revision surgery choose your gynecomastia surgeon very carefully, do your homework! It takes a skilled gynecomastia specialist to shape and contour the male breast for a pleasing result. Make sure your surgeon is Board Certified in Plastic Surgery and specializes in gynecomastia. Ask to see before and after pictures of the surgeon’s patients.
For personalized information about gynecomastia plastic surgery procedures, please complete Dr. Delgado’s inquiry form.