Gynecomastia Surgery and Avoiding a Seroma

 

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.

 

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