Gynecomastia specialists’ see too often the cases of male breast reduction done by less experienced surgeons. Many gynecomastia revision cases are necessary because the primary surgeon removed too much fat and tissue leaving a “crater deformity,” or in some cases, not removing enough tissue. A large percentage of revision cases are due to liposuction alone being performed, and there is breast tissue left behind.
How many cases does the surgeon do in a year? It should be in the hundreds.
There should be available an extensive photo gallery of before and after surgery.
Custom Plan For Your Body Type
Gynecomastia surgery is very complex; each patient needs to have a surgery plan based on their unique case. For example, bodybuilders do not need removal of excess fat or skin. However, they can be at a higher risk for bleeding due to an increase in blood flow in the chest muscles that are highly developed.
What to Avoid
Beware of advertised discounts and specials on surgery fees. Specialists have devoted many years to perfecting their skills. Specialists are in high demand; they do not need to “reduce” their fees to attract new patients. Unless they should get an unavoidable cancellation, you may find that you have to wait a few months to get on their surgery schedule. But it will be worth the wait, avoid the possibility of gynecomastia revision surgery which will compromise your results and add additional fees. Remember you get what you pay for.
Breast asymmetry is unevenness of the breasts, meaning one breast is larger than the other breast. In men, gynecomastia may present in one breast known as unilateral, or gynecomastia may be present in both breast, known as bilateral. The most common gynecomastia diagnosis is when it occurs in both breast at different degrees, this is known as bilateral asymmetry. Glandular tissue can affect the appearance of the size and shape of the breast. The glandular tissue in combination with the breast tissue can change the appearance of the breast, including larger areola in diameter as well as protrusion.
In many cases, men that are suffering with gynecomastia develop insecurities. The insecurities can often lead to low Self Esteem, Depression and social anxiety. This can often interfere with their personal relationships, or in some cases, their day to day relationships.
No two breast are the same. In both men and women, breast will differ in size and shape. In most cases difference is slight and not noticeable to the eye. The degree of the asymmetry can vary in each individual. A Board Certified Plastic Surgeon will do an exam on the patient to determine if they are a candidate as well as determine the asymmetry of the gynecomastia. A procedure plan must be discussed between the individual and the surgeon prior to having surgery.
The asymmetry conditions can often be corrected to some degree in surgery. It is important to be informed of the realistic expectations from the surgery. Individuals should feel that they have been fully informed and educated by their Plastic Surgeon.
Gynecomastia Correction surgery includes removing both the glandular tissue as well as the fatty breast tissue. When removing the breast tissue, this gives the surgeon the opportunity to equal out the symmetry of the breast. This may include removing more tissue from the larger breast to create the same measurements as the smaller breast. This will give an overall appearance of even and symmetric breast.
Do your research on your surgeon, inquire on how many procedures they have performed and look at before and after photos. Realistic expectations are important. However, the most important thing is patient safety and satisfaction. It is highly recommended that you have a “Board Certified Plastic Surgeon”.
As potential patients research all the pros and cons of male breast reduction surgery, there is one issue in particular that comes up from time to time. It is discussed extensively on the forums of this site, and that is the concern of the loss of nipple sensation.
Permanent loss of nipple sensation after gynecomastia surgery is possible although rare, but needs to be considered as a surgical risk. For some men, it may be a deal breaker, and for others the tradeoff is worth it, to be rid of their “man boobs.”
The degree of injury will depend on the extent of surgery and the technique used. Nerves regenerate slowly, depending on the amount of breast tissue that is removed. It is normal for the nipples to be hypersensitive or to lose sensation. This is usually temporary with sensation returning in a few weeks to a few months.
The temporary loss of sensation or numbness is known as neurapraxia and is caused by stretching or compression of the nerves during surgery. It is considered a mild injury with full recovery likely. As sensation starts to return and the nerves begin to regenerate the patient may feel pins and needles which are referred to as dysesthesia/paresthesia. This is a normal condition during the healing process.
After about three weeks into your recovery, gentle massage may help to reduce hypersensitivity, but this should be done only under the direction of your surgeon.
Avoiding complications after gynecomastia surgery is a goal of all surgeons. With careful planning, most complications can be minimized or avoided altogether. Most gynecomastia surgeons believe in the use of drains and the wearing of a compression vest after surgery.
Drains are an effective measure against the accumulation of fluid in the “dead space” left from the excision of breast tissue. The accumulation of clear serous fluid is referred to as a seroma. If left untreated, a seroma can interfere with healing and possibly lead to an infection with swelling and can be painful. Drains collapse the “dead space,” evacuate the fluids and create a negative pressure to the cavity encouraging it to close down.
The drains have tubes that carry the fluids from the surgical site through a tiny incision in the armpit and empty into a small plastic bulb by negative pressure. Then dressings are applied and the placement of a compression vest. Usually within 2 to 3 days will be the first post-operative visit and at that time the drains most likely will be removed. The compression vest is only to be removed when the patient takes a shower and is to be kept in place for 6 weeks. The use of drains reduces the chances of a seroma greatly by removing fluids as they collect.
If drains are not used, needle aspiration will need to be done every few days until the cavity is collapsed, but the healing will be prolonged and is very inconvenient for the patient. Dr. Miguel Delgado has been using drains for his gynecomastia patients for over 25 years with minimal incidence of complications. Dr. Delgado has designed a compression vest that has built-in pockets for the bulbs to rest in, instead of being attached with safety pins.
Deciding to proceed with male breast reduction surgery is an exciting time(Season For Gynecomastia Surgery). It also presents with many arrangements that you will need to make; such as, having someone care for you for at least the first 24 hours, transportation home after surgery, getting lab tests done, filling prescriptions, getting time off work…and when will you have the surgery?
After surgery, you will most likely be wearing a compression garment for 6 weeks. Wintertime is more comfortable for the additional layer of clothing as you can wear thicker shirts and jackets.
By having your surgery in the wintertime allows your recovery to be complete before summer when most people want to enjoy the outdoors. However, be aware that you still need to protect your young scars from the sun to prevent hyperpigmentation (turning dark brown). As long as your incisions remain pink in color, you need to be very careful of the sun, use a sunblock of at least 30 SPF, complete healing can take several months.
It is important to note that you will need to refrain from any type of formal exercise for about 4 to 6 weeks. Outdoor activities such as jogging, bike riding, volleyball, basketball, etc. may be easier to give up when there is inclement weather, than a beautiful sunny day.
With all this being said, if your schedule doesn’t allow you to plan your surgery during the winter months, anytime you can schedule is the right time. Remember it is only a short time to be inconvenienced compared to a lifetime of freedom from your man boobs.
Asymmetry and Gynecomastia, When a man has too much estrogen stored in his body, female type breasts may develop. In most cases when breasts develop, they are mostly the same size and shape. However, it is possible for breasts to be different sizes or possibly only one breast will develop. Asymmetric breast development can cause even more distress for men than symmetric gynecomastia.
It is normal to have some asymmetry, but when it is obvious, it may cause shame and embarrassment. A gynecomastia specialist can correct asymmetry with liposuction and removal of some breast tissue.
Asymmetry can happen during male breast reduction surgery if complications should arise, or lack of experience by the surgeon. Unfortunately, this will require revision surgery, but in the right hands, the result can be very satisfying.
About 40% of Dr. Delgado’s gynecomastia practice is revision cases where the patient had surgery by another surgeon. Most revisions are a correction of “crater deformity” where too much fat and/or tissue was removed. Some revisions are because not enough fat/or tissue was removed.
In the before and after pictures below is a 43 year old man who was not satisfied with his original surgery done by another surgeon. Dr. Delgado removed 350cc’s of fat on the right side, and 375cc’s of fat on the left side to obtain a symmetric chest.
