What is gynecomastia?

Breast reduction for gynecomastia is performed when there is excess breast and fatty breast tissue. It is not uncommon for males to develop excess breast tissue during development that commonly resolves on its own thereby not requiring surgery. It can also occur secondary to medications and less commonly due to certain tumors. For the majority, gynecomastia is a benign occurrence that is often a social embarrassment, which can be improved with surgery. This procedure reduces the size of your breasts, improves asymmetries and shape of the chest as well as, lifts the nipple and areola if they are droopy. Patients with this condition are often very self-conscious about the size of their breasts and typically refrain from taking their shirt off in public.

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How is the procedure done/Where will I have scars?

There are different incision options depending on the size of the breast and presence of descent of the nipple-areola. Typically, a small incision is made along the curvature of the inferior aspect of the areola as well as a very small incision in the axilla and or in the chest fold. The very small incisions in the axilla and or chest fold allow liposuction removal and contouring of the excess fatty breast tissues and the areola incision allows direct access for removal of firm breast tissue that cannot be removed with liposuction alone. Sometimes, there needs be elevation of the nipple and areola on the chest wall that require additional incisions. Dr. Mezrow will discuss which technique you are a candidate for.

The procedure is performed as an outpatient. The procedure typically takes approximately 2-3 hours to perform depending on the size of the reduction. Most patients recover within 1 to 2 hours after surgery and are discharged home. It is important to arrange for someone to drive you home after surgery and to stay with you for at least the next day or two.

Consulting with Dr. Mezrow:

During the consultation, Dr. Mezrow will ask you about your particular concerns regarding your chest. This will help determine your expectations and determine whether they can be realistically achieved.

You should tell your plastic surgeon if you plan to lose a significant amount of weight, particularly if you have noticed that your breasts become smaller with weight loss. Your surgeon may recommend that you stabilize your weight before having surgery.

After obtaining a comprehensive medical and surgical history, Dr. Mezrow will examine your breasts and chest wall. The breast volume, asymmetries, breast skin tone, presence of masses, and nipple-areola position will be assessed.

What are the potential complications?

Fortunately, significant complications from gynecomastia breast reduction are infrequent, however, all surgery has risks. Dr. Mezrow will discuss with you, the risks, benefits and alternatives and answer all your questions.

Some potential complications include infection, bleeding, delayed healing, altered nipple sensation, asymmetries, contour deformities and poor scarring. A complication, which delays healing and prolongs recovery, is more common in diabetic patients and those who smoke.

Preoperative and postoperative instructions will be given to you by Dr. Mezrow in attempt to reduce the likelihood of complications and make you as comfortable as possible with the whole process. Smokers will be instructed to stop smoking 4-6 weeks prior to surgery and not resume smoking to reduce the risk of delayed healing, wounds, infections and compromised outcome. Aspirin, anti-inflammatory medications as well as agents that cause bleeding should be discontinued two weeks prior to surgery (or as otherwise instructed by Dr. Mezrow and your primary physician) to reduce the likelihood of bleeding.

What kind of medications will be given to me?

Medications are administered for your comfort during the surgical procedure. Typically, general anesthetic or intravenous sedation is administered, so that you will be asleep throughout the procedure. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. You will be placed with an elastic bandage around your chest and have gauze dressings over your incisions. You may have a small drain under the skin of each breast placed at the time of surgery.

What happens after surgery?

You may be permitted to go home after recovery, unless you and Dr. Mezrow have determined that you will require a short stay in the hospital or post surgical facility. You will be instructed to get out of bed for short walks to promote blood circulation and decrease the risk of blood clots. Strenuous activities should be avoided for the first several days, since these activities might cause compromised results including but not limited to increase swelling or even bleeding.

Sutures will not be removed as they are resorbable and the drains are usually removed within a few days. You will be instructed on taping of incisions to optimize healing of the scars.

You will have swelling and bruising, which will resolve with time. It is not uncommon to have some altered sensation of the breast skin and nipples. The incisions will be initially be reddish and then slowly fade over months resulting in permanent scars.

When can I return to work?

Depending on your physical condition, you may be able to return to non-strenuous work in approximately one to two weeks after surgery.

How long is the healing process?

During healing you may experience some mild, periodic discomfort and swelling, such feelings are normal. Severe pain should be reported to Dr. Mezrow.

Breast reduction for gynecomastia will reduce the size of your breasts, improve asymmetries and lift droopy – saggy breasts. It is not uncommon to feel more comfortable, less self-conscious and be more confident about your appearance.

Healing from your surgery is a process that takes up to a year for final result. You will be instructed to return to Dr. Mezrow’s office for follow-up care at prescribed intervals to monitor your progress and optimize your outcome.

If you have any questions or concerns prior to surgery or during your recovery, you should contact Dr. Mezrow.