Male Breast/Chest Wall Reduction

Gynecomastia (Male Breast/Chest Wall Reduction)

Male breast enlargement, or gynecomastia, is in fact quite common. It can happen on one side or both sides. Although it can occur at any time, it typically first occurs in our teens and in our late 40s or 50s. In the vast majority of cases, there is no known cause. However, in a small percentage of cases, certain medications or medical conditions can cause gynecomastia.

The enlargement of male breast tissue can create an embarrassing contour and make some male patients self-conscious about their appearance both dressed and unclothed.

The surgery to treat gynecomastia involves both the use of liposuction to remove excess fat tissue, and direct excision of breast tissue using a small access incision around the lower half of the areola (pigmented tissue around the nipple to hide the scar).

Pre Surgery Instructions

Before the procedure
No aspirin or blood thinning medications for two weeks prior to surgery. Fasting begins at midnight the night before surgery. Any medications that you take in the AM may be taken with a sip of water (except for blood thinning medications). If you get ill prior to surgery please notify us.

The Surgery

During the procedure
Performed under general anesthetic (nothing to eat or drink after midnight) male breast reduction (gynecomastia) surgery takes approx. 2 hours and is a day surgery (there is no overnight stay). On the morning of surgery, Dr. Eckhaus makes all the markings on the chest wall and breast in the pre operative area.

The final scars are placed around the lower edge of the areola. This extends from the 4 o’clock position where the areola meets the skin and runs around the lower edge of the areola to the 8 o’clock position. Only dissolvable sutures are used and a compression garment is applied at the end of the procedure over top of the dressing. There are no post-operative drains used.

After Your Surgery

Post procedure
While in hospital or clinic
You will be in the recovery room anywhere from 1-3 hours where the team will ensure you are comfortable, eating and drinking, walking and able to urinate.
On discharge home
Immediately upon discharge from the recovery room, you are encouraged to rest under supervision and start a light diet as tolerated.

You will have been given a prescription for antibiotics that is started when you return home from surgery and is taken for 1 week.
Day 1
You should be up and walking, drinking fluids, taking your antibiotics and pain medication as described below. Increase activity as tolerated, but there is no heavy lifting for 4 weeks. Leave the dressings alone until your first follow up appointment 1 week after surgery.
What do I take for pain?
If you have pain, you are encouraged to start with:

• Two Tylenol extra strength (total of 1000 mg of Tylenol) and one Advil extra strength (400 mg of Advil) to be taken at the same time as they work by different mechanisms and work very well together.
• You can take the above three pills (two Tylenol extra strength and one Advil extra strength) every 8 hours around the clock for the first day or two.
• However, you will also have a prescription for a stronger pain medication that can be taken as needed if the Tylenol and Advil combination mentioned above does not suffice. This stronger pain medication may be taken on top of the above regimen. Please ensure the maximum dose of Tylenol in 24 hours does not exceed 4000 mg.

** Please be aware that with any medication and particularly Advil (a type of non-steroidal anti-inflammatory) there are risks of allergy, severe allergy, gastro-intestinal bleeding and stomach ulcers. Taking your medication with food can sometimes help with some of the stomach symptoms.

An initial wrap and post-operative compression vest are left in place for 6-8 days. During this period of time, you may use a hand held shower or sponge bath but the dressings must stay dry.
First post-operative appointment
The initial dressing change is done 1 week after surgery. The gauze and foam pads are removed and the white steri strip tapes are left on. The compression vest is worn directly over the tapes for the 4 weeks day and night (other than for your shower).
Second post-operative appointment
The second appointment is close to 2 weeks after surgery and the white steri strip tapes will be removed. You will start the silicone gel sheeting for scar management 3-4 days after this appointment (given to you at this appointment).

Post-operative swelling and bruising begins to subside after 7 days but can take up to 2-3 weeks. Patients usually require 3-7 days of downtime and should avoid heavy lifting and strenuous exercise for 4 weeks.
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